Domains of Electronic Medical Records Quality in Global Health: Stakeholder Perspectives Using the STEEEP Framework

Background Many Low-and middle-income countries (LMICs) are moving rapidly to digitize the health sector, and health leaders need ways to evaluate the quality of available Electronic medical records (EMRs), to guide their investments. Yet EMR quality is an ill-defined concept and methods to operationalize assessment of EMR quality are also lacking. The study investigates domains that stakeholders in LMICs consider crucial to quality of EMRs using the STEEEP framework—Safety, Timeliness, Effectiveness, Efficiency, Equity, and Patient-centeredness. Materials and methods We conducted 27 individual semi structured virtual interviews across 14 countries with diverse stakeholders, including EMR builders, implementers, domain experts, and decision-makers, to explore the factors affecting EMR quality globally. We used deductive and inductive approaches to identify salient themes within the six STEEEP domains. Results Salient factors included technical, environmental, and human issues, with most stakeholders prioritizing effectiveness and efficiency. Effectiveness encompasses clinical decision support and data quality, whereas efficiency is related to cost, infrastructure, and training. Interoperability was identified as critical to safety and timeliness, whereas patient-centeredness and equity received limited attention. Discussion Stakeholder perceptions reveal the need for a multifaceted approach to ensure EMR quality, addressing gaps in patient-centeredness and equity—key principles of digital development. There is a need to sensitize stakeholders in these domains and integrate assessments into EMR evaluations, particularly in LMICs, to improve healthcare equity. Conclusion Our study highlights stakeholder perspectives on defining a practical framework for assessing EMR quality in LMICs, but further work is needed to operationalize the domains of patient-centeredness and equity.