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Introduction
Electronic Health Records System (EHRS) is a digital repository of medical data that can be exchanged securely and is accessible by multiple authorized users (Kanade and Kumar, 2021). EHRS assists service providers in delivering a higher quality of care to their patients (Koppel and Lehmann, 2015; Tianyang, 2019). While implementing EHRS, healthcare facilities seek to reach objectives such as improvement of physicians’ efficiency and decision-making, increased accuracy and reliability of medical data and improved patient safety (Spatar et al., 2019). Therefore, EHRS can include many potential capabilities, such as Clinical Decision Support (CDS) tools, Computerized Physician Order Entry (CPOE) and Health Information Exchange (HIE) (Menachemi and Collum, 2011). CDS tools assist the provider in making decisions concerning patient care. Some of the prominent functionalities of a CDS include providing the latest information about the drug, drug-interaction checking, adverse drug event detection such as drug-allergy alerting during medication order entry (Mccoy et al., 2015), preventive care reminders, automated clinical guidelines, evidence-based order sets, care recommendations and diagnostic support (Mandell, 2021). These functionalities provide means for healthcare to be delivered efficiently (Tetreault, 2016). Decision support is often mentioned as achievable by introducing an EHRS. The capabilities of the EHRS determine its effectiveness in supporting decision-making (Mercer et al., 2019). However, there are claims that an EHRS does not necessarily mean that decision support is effective (Rinke et al., 2016; Yanamadala et al., 2016; Zhou et al., 2009).
Despite EHRS’s benefits, healthcare facilities in low and middle-income countries (LMICs) face significant difficulties implementing the systems (Kumar and Mostafa, 2020). Although not all EHRS go unutilized, most are not effectively implemented to provide the abundantly envisaged need for improving healthcare practices (Fennelly et al., 2020), particularly decision support. Elsewhere in developed countries, things are different. In 2017, it was estimated that about 98.3% of hospitals in the United States of America had EHRS implemented, of which 55.6% had advanced CDS capabilities. Kose et al. (2020) report that 63.1% of hospitals in Turkey have adopted basic EHRS, and 36% have implemented EHRS with decision-support capabilities, which compares favorably to the results of Korean Hospitals. In Korea, a study by Park and Han (2017) found that 89.2% of hospitals were equipped with...