Abstract
<sec> <title>BACKGROUND</title> <p>Electronic health records (EHRs) have become a cornerstone of modern healthcare, yet a growing body of evidence links poorly designed systems to increased bureaucratic burden, clinician stress, and burnout. Whether current EHRs meet the real needs of their primary users—healthcare professionals—remains insufficiently understood, as studies capturing their perspectives are limited. Catalonia, with over 25 years of EHR experience but persistent system fragmentation, is now developing a next-generation EHR under its Digital Health Strategy, creating an opportunity to ground that redesign in professionals' first-hand experience.</p> </sec> <sec> <title>OBJECTIVE</title> <p>This study explores healthcare professionals' perceptions of current EHR systems in Catalonia to inform the design of a next-generation EHR that enhances quality, safety, and continuity of care.</p> </sec> <sec> <title>METHODS</title> <p>A cross-sectional survey was conducted among healthcare professionals in Catalonia over four weeks (February-March 2025). The 63-item questionnaire, adapted from Finnish and UK instruments, assessed different domains of EHR evaluation using five-point Likert scales together with a free-text comment. Surveys were distributed electronically via multiple channels. Responses were analysed descriptively, with stratified analyses by profession, care level, gender, age, and IT proficiency. Free-text comments were analysed using BERTopic modelling.</p> </sec> <sec> <title>RESULTS</title> <p>A total of 3,226 healthcare professionals responded to the survey, with physicians and nurses accounting for the largest respondent groups (70%). The overall perception of EHR, assessed on a 10-point scale, was notably poor (mean 5.75) with a Net Promoter Score of -55.5. Key challenges were identified across multiple domains: EHR integration, data quality, user experience, professional coordination, communication tools, safety, bureaucratic burden, and process support. Stratified analysis revealed diverse needs varying by professional role and care context. Topic modelling of free-text comments highlighted recurring themes emphasising the need for a unified EHR system with improved user experience, streamlined administrative processes, and enhanced system integration.</p> </sec> <sec> <title>CONCLUSIONS</title> <p>This study provides a clear mandate for EHR redesign, with professionals providing specific guidance on priorities. Findings highlight EHR improvement as a technological and wellbeing priority, offering an evidence-based foundation for next-generation systems where data quality, clinical pathway support, and improved user experience enhance care.</p> </sec> <sec> <title>CLINICALTRIAL</title> <p>N/A</p> </sec>