Background: Primary healthcare systems continue to face patient safety challenges, particularly misdiagnosis and medication errors, which contribute to preventable harm and reduced quality of care. Electronic Medical Records (EMRs) have the potential to improve clinical documentation, support decision-making, and reduce risks; however, these benefits depend on effective utilization in routine clinical practice. This study examined factors influencing EMR utilization in primary healthcare settings. Methods: A sequential explanatory mixed-methods design was conducted across 42 community health centers in one Indonesian city. Quantitative data from general practitioners were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) to examine the relationships among clinical workflow fit, digital health competency, governance, system capabilities, interprofessional collaboration, perceived patient engagement, and EMR utilization. Qualitative interviews were subsequently conducted to provide a contextual explanation of the quantitative findings. Results: Clinical workflow fit and digital health competency emerged as the strongest factors associated with EMR utilization. Their effects operated through interprofessional collaboration and perceived patient engagement, indicating the importance of integrating EMRs into everyday clinical workflows. Governance structures and system capabilities primarily functioned as enabling conditions rather than direct determinants of utilization. Qualitative findings further highlighted the importance of practical workflow integration, communication processes, and user competency in supporting meaningful system use. Conclusions: EMR utilization may contribute to improved care coordination, patient engagement, and service efficiency in primary healthcare settings. Strengthening workflow alignment and digital competency may help support safer and more reliable care delivery, particularly in resource-constrained environments where risks of misdiagnosis and medication errors remain significant.
Devira et al. (Mon,) studied this question.