E-Health Systems and Service Delivery Efficiency in Ghana: Assessing the Role of Electronic Health Records (EHR) In Improving Service Delivery Outcomes - A Systematic Literature Review

Abstract

This systematic literature review assesses the role of Electronic Health Records (EHRs) in improving healthcare service delivery efficiency in Ghana. Following PRISMA guidelines, a comprehensive search of Google Scholar, PubMed, Scopus, IEEE Xplore, and Web of Science was conducted, yielding 24 empirical studies published between 2008 and 2026. Thematic analysis identified eleven interrelated themes, including perceived benefits, implementation barriers, user acceptance, training, infrastructure constraints, data security, policy support, interoperability, change management, financial sustainability, and patient engagement. Findings indicate that EHR systems positively impact healthcare efficiency by reducing patient waiting times, improving workflow processes, enhancing data accuracy, and supporting timely clinical decisions. However, these benefits are unevenly realised due to persistent challenges such as unreliable electricity, poor internet connectivity, inadequate technical support, limited staff digital literacy, and weak interoperability. Organisational factors, including leadership commitment, continuous training, and sustainable funding, critically determine adoption and long-term system performance. The study concludes that while EHRs are essential tools for modernising healthcare delivery, their effectiveness in Ghana depends on coordinated investments in infrastructure, capacity building, governance, and context-sensitive implementation strategies. Recommendations include a national digital health policy, enforced interoperability standards, sustained facility-level funding, and embedded digital health training for all healthcare workers. This review provides evidence-based insights to guide policy decisions and improve EHR implementation outcomes in low-resource settings.