DOI: 10.12688/f1000research.182038.1 ISSN: 2046-1402

Policy Brief: Digital Competence as a Critical Enabler of Electronic Health Record Utilization in Low-Resource Settings

Brian Mugisha, Joe Mutebi, Venkateswarlu Maninti
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Background Electronic Health Record (EHR) systems are increasingly being implemented across low- and middle-income countries to improve healthcare delivery, strengthen data management, and support clinical decision-making. Despite substantial investments in digital health technologies, many healthcare facilities continue to experience underutilization of EHR systems, limiting the realization of their expected benefits. Understanding the factors contributing to this gap between system availability and effective utilization is critical for achieving meaningful digital health transformation. Policy and Implications Evidence indicates that digital competence among healthcare workers is a key determinant of effective EHR utilization. Limited digital skills, inadequate training, weak technical support, poor workflow integration, and infrastructure constraints continue to hinder the optimal use of EHR systems in many low-resource settings. These challenges suggest that technology deployment alone is insufficient to improve healthcare outcomes. Digital health policies must therefore move beyond technology-centered approaches and adopt competence-driven strategies that prioritize workforce capability, organizational support, and continuous capacity development. Recommendations Healthcare institutions should implement continuous and role-specific digital competence training programs, strengthen facility-based technical support systems, improve EHR usability and workflow integration, and invest in reliable digital infrastructure. Policymakers should also develop evaluation frameworks that measure effective system utilization rather than focusing solely on system availability or adoption. Conclusions Digital competence is a critical enabler of effective EHR utilization in low-resource healthcare settings. Maximizing the value of digital health investments requires equal attention to human capacity, organizational readiness, and technological infrastructure. A competence-driven approach can improve system utilization, enhance data quality, support better clinical decision-making, and ultimately contribute to improved healthcare outcomes.

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