From my experience in humanitarian health, using electronic medical records (EMR) in migrant and humanitarian settings offers clear benefits (good points) over paper records, but it also brings important risks (bad points) that must be carefully managed.
Advantages/Good points are
1.Improved Continuity of Care for Mobile and Displaced Populations
One major benefit of EMR in humanitarian and migrant health is improved continuity of care for highly mobile populations. Refugees, migrants, and internally displaced persons often move between clinics, regions, or even countries, making it difficult to maintain complete medical histories using paper records, which are frequently lost or damaged. EMRs allow healthcare providers to retrieve previous consultations, laboratory results, vaccination histories, and treatment plans across sites, which is particularly important for managing chronic conditions such as tuberculosis, HIV, non-communicable diseases, mental health conditions, and antenatal care.
2.Timely Access to Information for Safer Clinical Decisions
EMRs can improve efficiency and clinical decision-making in high-volume or emergency settings. Compared to paper files, electronic systems reduce time spent searching for records, re-registering patients, and repeating investigations. Faster access to patient information can enhance patient safety by reducing medication errors and improving clinical continuity, which is especially critical during outbreaks, mass influxes, or emergency responses where time and accuracy are essential.
3.Supporting Evidence-Based Program Management, Surveillance and Humanitarian Coordination
From a program management and public health perspective, EMRs provide stronger data for surveillance, monitoring, and accountability. Electronic systems enable real-time aggregation of data for disease surveillance, early outbreak detection, and reporting to donors and coordination mechanisms. This is particularly valuable in humanitarian operations where reporting requirements are complex and timelines are tight. EMRs can also reduce transcription errors that often occur when transferring data from paper registers into electronic reporting platforms.
Risks/Bad points are:
1.Infrastructure and System Reliability Issues
EMR implementation in humanitarian and migrant health settings is constrained by infrastructure limitations. Electronic systems depend on reliable electricity, hardware, and often internet connectivity, all of which may be unstable or absent in emergency or remote settings. Power outages, system failures, or lack of technical support can disrupt clinical services and delay care, especially if no functional paper backup system is in place.
2.Risks to Data Privacy and Patient Confidentiality
Data protection and confidentiality pose one of the most serious risks of EMR use in migrant health. Medical records in these settings may include highly sensitive information related to legal status, migration routes, sexual and reproductive health, HIV status, mental health, or experiences of violence. In contexts with weak data protection laws and governance, electronic data may be vulnerable to unauthorized access, misuse, or external pressure from authorities, potentially placing patients at risk. Poorly secured EMRs can therefore do more harm than paper records if privacy safeguards are inadequate.
3.Increased Workload and Staff Burden During Transition
The transition from paper-based systems to EMR often increases workload in the short term. During rollout phases, healthcare workers may be required to maintain both paper and electronic records, leading to longer consultation times and staff fatigue. In already overstretched humanitarian teams, this additional burden can reduce productivity and contribute to resistance against the new system, particularly if staff do not clearly perceive immediate benefits.
4.Digital Literacy Gaps Among Frontline Health Workers
Limited digital literacy among frontline health workers is another challenge. Many staff in humanitarian settings have basic computer skills and are more comfortable with handwritten documentation. Complex or poorly designed EMR interfaces can slow clinical workflows, increase errors, and cause frustration. Without adequate training and ongoing support, EMRs may undermine rather than improve quality of care.
5.Patient–Provider Relationships in the Context of EMR Use
There is also concern that EMR use may negatively affect the patient–provider relationship. Screen-focused consultations can reduce eye contact and interpersonal communication, which is particularly problematic in services that rely heavily on trust and rapport, such as mental health care, gender-based violence services, and trauma-informed care.
6.Donor Dependency and the Sustainability of EMRs
Sustainability remains a critical concern. Many EMR systems in humanitarian contexts are introduced through short-term donor funding and fail once financial or technical support ends. Without long-term planning for maintenance, updates, and local capacity building, EMR projects risk becoming unsustainable pilot initiatives rather than durable health system improvements.