The introduction of the Electronic Health Record (EHR) system in Cyprus in 2019 marked a significant step towards modernising healthcare delivery within the General Health System (GHS). Despite this progress, efficiency levels among EHR users remain moderate, signalling the need for further improvements. A recent nationwide assessment of physicians’ experiences highlights how factors such as training, technological familiarity and institutional support shape the effectiveness of EHR use in clinical practice. These insights are critical for aligning Cyprus’ eHealth strategies with broader European objectives.
EHR Implementation and Current Adoption Trends
The path to EHR integration in Cyprus began after joining the European Union in 2004, but was hampered by legal, infrastructural and adoption challenges. Legislative reforms in 2019 formalised the system’s structure and operations, yet interoperability and telemedicine capabilities remain incomplete. While the EHR has been operational for several years, studies assessing its real-world impact on healthcare professionals are limited.
An assessment conducted between October and December 2022 gathered input from 429 physicians across Cyprus’ provinces. The majority of respondents were female, aged between 31 and 40, and based in Nicosia or Limassol. Over half worked as outpatient specialists, with private clinics being the most common practice setting. Notably, most participants reported high familiarity with both computers and the EHR system itself, and a majority had received some form of training. However, less than one-third felt adequately supported by the Cyprus Health Insurance Organisation (HIO).
The average efficiency score reported was 57.4 out of 100, indicating that while the EHR is being widely used, there is substantial room for improvement in its practical application.
Key Factors Influencing User Efficiency
The analysis identified several demographic and professional factors that significantly influenced efficiency scores. Younger physicians and those with fewer years of professional experience tended to report higher efficiency, suggesting that adaptability and digital fluency may be stronger among newer entrants to the profession. This aligns with international trends where younger healthcare workers adapt more readily to new technologies.
Technological proficiency emerged as a decisive factor. High familiarity with computers and information communication technology correlated strongly with better EHR performance. Similarly, users who were more familiar with the EHR platform itself reported markedly higher efficiency levels. Typing speed also played a notable role, with faster typists completing tasks more effectively within the system.
Must Read: Smarter EHR Rollouts: Lessons for Public Health Success
Training was another critical determinant. Physicians who received comprehensive instruction on EHR use achieved higher efficiency scores compared to those with limited or no training. Adequate institutional support also proved influential, with those who felt backed by the HIO performing significantly better. These findings underscore the importance of continuous professional development and structured support in digital transformation initiatives.
Challenges and Areas for Improvement
Despite the positive associations between training, support and efficiency, the findings reveal that substantial barriers remain. Only 32.6% of participants felt adequately supported by the HIO, indicating a gap in institutional engagement. Furthermore, while the system is used extensively—59.2% of respondents accessed it for over 80% of their registered patients—efficiency scores suggest that usage does not always translate into optimal performance.
The study also highlights limitations that must be addressed in future research and policy planning. The focus exclusively on physicians excluded other healthcare professionals, such as nurses and pharmacists, who also interact with the EHR. Their perspectives could provide valuable insights into system-wide efficiency and user experience. The use of convenience sampling and data collection during the COVID-19 pandemic may also have influenced participation and results, limiting generalisability to similar healthcare environments.
In addition, the absence of local comparative studies restricts the ability to benchmark progress within the Cypriot context. While findings can be compared with international data, understanding the influence of specific cultural, social and organisational factors in Cyprus remains a gap that future studies should address.
The introduction of the EHR in Cyprus’ GHS has laid an important foundation for healthcare modernisation, but the moderate efficiency levels reported by users indicate that the system’s potential is not yet fully realised. Enhancing efficiency will require targeted actions, including equal access for all healthcare professionals, integration of additional providers and a multidisciplinary approach to patient care.
Investment in continuous training, stronger institutional support and improvements to system architecture are essential for optimising usage. Broader advancements in interoperability, cross-border healthcare capabilities and telemedicine services will also be key to achieving Cyprus’ eHealth objectives. By systematically addressing the factors influencing user efficiency, policymakers can help transform the EHR into a fully effective tool for improving healthcare delivery across the GHS.
Source: Health Informatics Journal
Image Credit: iStock
