Challenges of Health Information Systems (HISs) During COVID-19 Pandemics: Lessons Learned from Teaching Hospitals in a Developing Country

Background: Health information systems have major impacts on improving the decision-making process during pandemics. Objectives: The qualitative study explored health information systems (HISs) challenges based on HIS’s manager viewpoint during the COVID-19 outbreak. Methods: In the study, data were collected in two phases: First, in response to an official letter, all participants reported their challenges with HISs. Second, semi-structured interviews were conducted with the same participants. Results: The semantic units were extracted, collected, and coded. Eighteen HIS managers from 18 hospitals reported the challenges of HISs. The 46 HIS challenges and 24 solutions were classified into three categories: technology, organization, and human. The technology category included three sub-categories: multiple non-interoperable HISs, inconsistencies between reports of HISs, and lack of suitable hardware equipment. The organizational category encompassed three sub-categories: data quality, environment and equipment contamination by COVID-19 virus, and lack of sufficient preparedness to respond to the pandemic condition in hospitals. The human category had four subsets: multiple resources of stress, instability in business conditions, and shortage of human resources, and increased workload. Conclusions: It seems that reconstruction of health information systems, revision of medical record documentation processes, holding training courses, and planning to deal with pandemics, human resource support programs are very necessary.