Background: Hospitals in sub-Saharan Africa countries have been investing heavily in electronic medical records (EMR) systems aiming at improving patient safety, healthcare quality, and transforming the healthcare industry. Similarly, the Kilimanjaro Christian Medical Centre (KCMC) has been implementing various EMR systems in the past few years. However, the implementations of these systems have not been successful like in many hospitals in sub-Saharan Africa.

Objectives: To help the hospital avoid failure of EMR systems implementation in the future, this study assessed EMR systems implementation through adopting some elements of the technology–organization–environment (TOE) framework.

Methods: The qualitative research method involving 10 focus group discussions with a total of 46 respondents, documents reviews, and observation as data collection instruments. Results: The study found that poor ICT infrastructure, lack of participatory approach during EMR systems implementation, lack of policies and standards, and lack of ICT Directorate were among factors that contributed to the failure of EMR systems implementation at KCMC.

Conclusion: The findings of this study will help those hospitals planning to implement EMR systems to avoid these challenges during implementation especially in sub-Saharan Africa.