Background: This paper presents a case study of the nationwide implementation of an Electronic Health Record system based on industry standards.

Objectives: To critically review the finalized nationwide EHR implementation in Albania, pointing out the achievements and the shortcomings, gained knowledge and sharing lessons learned.

Methods: This paper reports on our analysis of the project's documentation, first-hand experience working with healthcare professionals during and after project implementation. The initial system uptake analysis has been made using EHR usage statistics.

Results: Despite very poor initial ICT infrastructure, minimal or non-existing medical nomenclature and a rather challenging project schedule, the nationwide implementation of the EHR system was successfully completed in less than two years.

Conclusion: Although the system is already in use by 79 healthcare providers and is covering secondary and tertiary care, the majority of clinical data still remains in paper format; the access for clinicians to the system is limited due to insufficient ICT infrastructure.