Implementation of Electronic Health Record Systems in Health Facilities of Nepal: A Scoping Review of Evidence and Policy Implications

This project is a scoping review that aims to systematically map the existing evidence on the implementation of electronic health record systems (EMR/EHR) in health facilities in Nepal. Electronic health record systems are increasingly promoted as a key component of health system strengthening, with potential benefits for improving data quality, health service delivery, continuity of care, and evidence-informed decision-making. In Nepal, the implementation of EMR/EHR systems has largely occurred through donor-supported pilots, program initiatives, and facility-based systems, resulting in fragmented adoption and limited synthesis of available evidence. The Government of Nepal has recently endorsed the Integrated EMR Operation and Management Directives 2081, which sets national expectations for EMR functional modules, interoperability with HMIS, data security, and system registration. However, there is currently no consolidated evidence base that describes which EMR/EHR systems are implemented in Nepal, where they are deployed, what outcomes have been reported, and what barriers and facilitators influence their adoption and use. Available evidence is dispersed across peer-reviewed publications and grey literature, including government reports, program evaluations, and academic theses. This scoping review will systematically identify and map the extent, nature, and distribution of evidence on EMR/EHR implementation in Nepal. Specifically, it will examine the types of EMR/EHR systems implemented, reported outcomes related to data quality and health service delivery, and documented barriers and facilitators to implementation. The review will include both peer-reviewed and grey literature and will follow the Joanna Briggs Institute methodology for scoping reviews, with reporting guided by PRISMA-ScR. The expected outcomes of this review include an evidence map of EMR/EHR systems in Nepal, a summary of reported impacts on data quality and service delivery, and an overview of implementation challenges and enabling factors. Findings will help identify key evidence gaps and provide policy-relevant insights to support the implementation and scale-up of the Integrated EMR Operation and Management Directives 2081. The results will be used for fellowship reporting, shared with mentors and stakeholders, and may inform future research and policy planning related to digital health systems in Nepal.