Semantic Challenges in Electronic Health Record Systems: A User-Centric Study

Semantic interoperability; Electronic Health Records (EHR); User-centered design; Health informatics; Clinical decision-making; Data standardization; Digital health systems

Saidov Akbar Ahadovich1*
Professor of the department of orthopedic
dentistry and orthodontics of the Bukhara State
Medical Institute, 23, Gijduvanskaya str,
Bukhara city, 200118, Uzbekistan
E-mail: akbar_saidov@bsmi.uz
ORCID:https://orcid.org/0009-0009-7535-9839

Ruziyev Jasur Asliddinovich2
PhD. Assistant at the Department of Pediatric
Surgery No. 1, Samarkand State Medical
University.
jasur1204@gmail.com
https://orcid.org/0009-0002-5017-8029

Rabbimova Gulnora Toshtemirovna3
Associate Professor of the Department of
Obstetrics and Gynecology, Samarkand State
Medical University, Uzbekistan
gulnora_1968_r@mail.ru
https://orcid.org/00000003-2519-027X

Kalanova Sabakhat Muradovna4
National University of Uzbekistan Faculty of
Social Sciences, Associate Professor,
Department of Sociology, Doctor of Philosophy
in Sociology, PhD
s.kalanova@nuu.uz; s.kalanova@gmail.com
https://orcid.org/0009-0001-4577-6625

Kalanov Kamil Kulakhmatovich5
Professor of the Department of "Social and
Humanities and History" of the Tashkent
University of International Financial
Management and Technologies (TIFT)
k.kalanov@tift.uz
https://orcid.org/0009-0009-2344-1814

Akramov Khusan Furkatovich6
PhD in Sociology, Associate Professor of the
Department of Social and Human Sciences, Law
Enforcement Academy, Republic of Uzbekistan
E-mail: x.f.akramov@proacademy.uz; x.akramov@mail.ru
https://orcid.org/0009-00008035-7832

Received-23-05-2026
Revised-25-06-2026
Accepted-29-06-2026

European Journal of Prosthodontics and Restorative Dentistry (2026) 34(4s), 120–130

Semantic Challenges in Electronic Health Record Systems: A User-Centric Study

Electronic Health Record (EHR) systems have become foundational to contemporary healthcare infrastructures, yet persistent semantic inconsistencies continue to undermine their interoperability and clinical utility. While prior research has emphasized technical standardization, comparatively limited attention has been paid to how these semantic disruptions are experienced and negotiated by end users. This study adopts a user-centric perspective to examine how clinicians, patients, and administrative staff interpret, navigate, and respond to semantic ambiguities embedded within EHR environments. Drawing on a mixed-methods design, the study integrates survey data analyzed ‫ באמצעות‬structural equation modeling (SEM) with in-depth qualitative interviews across diverse healthcare settings. The findings reveal that semantic misalignment—manifested through inconsistent coding schemes, ambiguous terminologies, and fragmented data representations— significantly impairs perceived usability and introduces latent risks into clinical decision-making processes. Notably, users frequently engage in informal cognitive workarounds, which, while adaptive, may further exacerbate systemic inconsistencies (Zhang et al., 2021; Neter & Brainin, 2022). The study contributes theoretically by extending user-centered health informatics frameworks to incorporate a semantic dimension, highlighting the interplay between data meaning, user cognition, and system design. Practically, it underscores the need for context-aware standardization strategies, enhanced interface design, and targeted training interventions to mitigate semantic friction. By foregrounding the lived experiences of EHR users, this research advances a more nuanced understanding of interoperability—one that moves beyond technical compatibility toward meaningful, actionable data exchange in clinical practice. •••••••••••••••••••••••••••••••• ejprd.org- Published by Riset Publishing Services LLC.

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