Evidence map›Paper›PMID 40663789›Full record

ArticleJMIR medical informatics2025

Implementing Electronic Health Records in Philippine Primary Care Settings: Mixed-Methods Pilot Study.

Anton Elepaño, Carol Stephanie Tan-Lim, Mark Anthony Javelosa, Regine Ynez De Mesa, Mia Rey, Josephine Sanchez, Leonila Dans, Antonio Miguel Dans

Abstract read
In one paragraph

Article in JMIR medical informatics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Anton ElepañoNuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Radcliffe Observatory Quarter, 43 Woodstock Road, Oxford, OX2 6GG, United Kingdom, 44 7879663695.ORCID 0000-0002-8709-135X
Carol Stephanie Tan-LimProgram on Health Systems Development, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines.ORCID 0000-0001-8815-4191
Mark Anthony JavelosaDepartment of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines.ORCID 0009-0008-4099-9599
Regine Ynez De MesaProgram on Health Systems Development, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines.ORCID 0000-0001-8011-8567
Mia ReyProgram on Health Systems Development, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines.ORCID 0009-0000-5107-4825
Josephine SanchezProgram on Health Systems Development, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines.ORCID 0009-0003-4450-7647
Leonila DansProgram on Health Systems Development, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines.ORCID 0000-0002-5271-270X
Antonio Miguel DansProgram on Health Systems Development, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines.ORCID 0000-0002-9694-8757

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Between 2020 and 2022, the Philippine Primary Care Studies program, a government-funded initiative supporting universal health care implementation, piloted two electronic health records (EHR) systems across urban, rural, and remote primary care sites. Objective: The study aimed to evaluate the implementation of two EHR systems in diverse primary care settings in the Philippines over a three-year period. Methods: This implementation study used an explanatory mixed methods design. Two EHR systems were deployed: an Open Medical Records System (OpenMRS)-based platform in 2016, and a Microsoft-based system in 2021. Both systems integrated clinical documentation, pharmacy, laboratory, and reporting modules. Implementation strategies included training workshops and materials, iterative user feedback loops, and infrastructure cofinancing with local governments. Surveys were administered yearly to all end users. The primary outcome was behavioral intention to use the system. Quantitative data were supplemented by inductive content analysis of qualitative responses to explain observed trends. Results: A total of 351 survey responses were collected from 2020 to 2022. In 2020, the intention to use the OpenMRS-based EHR was high across all sites. By 2022, following the launch of the Microsoft-based EHR, acceptability declined significantly among doctors and administrative staff, particularly at the urban site. In contrast, the remote site which retained the OpenMRS-based system maintained high acceptability levels. Qualitative findings revealed that while the new EHR system provided a more privacy-focused design, users preferred a cross-platform EHR to allow more flexible access to patient data. At the rural site where the EHR was used to facilitate task-shifting among nurses involved in clinical management, users were less impacted by this shift. Conclusions: The disparities in EHR acceptability across urban, rural, and remote sites were influenced by contextual, technical, and demographic factors. The decline in acceptability following the EHR system transition highlights the importance of implementation strategies that reflect the specific needs and capacities of each setting. These findings offer practical insights for adapting EHR systems to diverse primary care contexts.

Indexed as

Electronic Health RecordsPrimary Health CareFemaleHumansMalePhilippinesPilot ProjectsSurveys and Questionnairesdigital healthelectronic health recordselectronic health records systemimplementation reportmedical informatics

Identifiers

PMID40663789
PMCPMC12283060

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.