Usage, Benefits, and Barriers of EMRs in Tanzanian Public PHC Facilities: Insights from Sociotechnical Systems Theory

Abstract

This study explores the usage, perceived benefits, and implementation barriers of electronic medical record (EMR) systems in Tanzanian public primary healthcare (PHC) facilities, drawing on sociotechnical systems theory to examine the interplay between technical functionalities and the social and organisational contexts of system use. A qualitative multi-case study design was employed, involving semi-structured interviews with 41 healthcare workers across six PHC facilities in Iringa and Manyoni districts. Participants were purposively selected based on their direct engagement with the national EMR system, the government of Tanzania health operation management information system. The data was thematically analysed using inductive coding in Microsoft Excel. The EMR system is widely used for clinical and administrative functions, including patient registration, billing, inventory control, diagnostics, nursing care, and radiology services. Participants reported improvements in record accuracy, workflow efficiency, revenue tracking, and service accountability. However, persistent sociotechnical barriers were identified: technical difficulties, organisational constraints, and individual-level challenges that collectively hinder optimal system use and sustainability. Sustainable EMR integration in resource-constrained environments requires a sociotechnical approach that prioritises user-centred design, ongoing capacity-building, and investments in supportive infrastructure and governance.