Healthcare providers’ perspectives on EHR systems for integrated care in Tanzanian primary healthcare

Abstract

Purpose This study investigates how Electronic Health Record (EHR) systems can be optimized to enhance integrated care delivery in Tanzania’s public primary healthcare (PHC) facilities. It examines healthcare providers’ perceptions, identifies barriers to effective system use and explores recommendations for improving EHR-supported collaboration and decision-making. Design/methodology/approach A cross-sectional, mixed-methods survey was conducted with 297 healthcare providers across urban, peri-urban and rural PHC facilities in Dodoma, Tanzania. Quantitative data from Likert-scale items were analyzed using descriptive statistics, exploratory factor analysis (EFA) and correlation analysis. Qualitative data from open-ended questions were analyzed thematically using NVivo software. The study was guided by four theoretical frameworks: the technology acceptance model (TAM), socio-technical systems (STS) theory, integrated care theory and the IS success model. Findings The findings indicate a response rate of 92.5%, with 297 out of 321 healthcare providers participating. Healthcare providers reported generally positive perceptions of EHR usefulness, particularly regarding decision-making (Mean = 3.82) and collaboration (Mean = 3.74). However, significant challenges were identified, including inadequate training, poor internet connectivity, limited system interoperability and an unstable power supply. Thematic analysis revealed practical barriers such as a lack of equipment and inconsistent data sharing. Recommendations included enhancing usability, providing continuous training, improving infrastructure and strengthening interoperability. Originality/value This study contributes novel insights into EHR implementation within a low-resource, decentralized health system. The integration of four theoretical models provided a multi-level perspective spanning user acceptance, technical design, organizational context and collaborative care functions, allowing for more detailed recommendations. Findings offer actionable pathways for optimizing digital health tools to support integrated care goals in Tanzania and similar LMIC contexts.