Electronic medical records are fundamental in ensuring patient medical data is accessible and available to healthcare workers. It comprises computerized medical information systems which help in collecting, storing, and displaying patient information. The study’s purpose was to investigate institutional determinants and the implementation of Electronic Medical Records in Government HIV Clinics in Nairobi County, Kenya. This study intended to achieve the following objectives: examine the extent to which leadership skills, human capacity, information communication technology, and stakeholder involvement influence the implementation of Electronic Medical Records in Government HIV Clinics in Nairobi City County. The research made use of a cross-sectional survey research design. This study targeted population of the study was 250 drawn from medical officers, nurses, clinicians, hospital administrators, ICT officers, records clerks, and counselors in Nairobi County, Kenya. A sample size of 152 participants was derived from the target population using Cochran’s formula from which proportionate stratified sampling was employed to obtain a sample for each stratum. Data was collected using open and closed-ended surveys and interview guides. Cronbach’s alpha coefficient was used to ascertain reliability obtained through the split-half technique. Descriptive statistics in the form of frequencies, percentages, mean, standard deviation, and correlation were employed to analyze quantitative data. It was established that leadership skills with a positive correlation of 0.324; human capacity with a positive correlation of 0.842; information communication technology with a moderate positive correlation of 0.578; and stakeholder involvement with a moderate positive correlation of 0.501 had a significant influence on the implementation of Electronic Medical Records. The study recommended that there is a need for facility leaders to be on the frontline in advocating for system users to have better buy-in from the system users; users need to continuously be offered refresher training to enhance their knowledge in system use; there is a need to always engage and involve the system users in major system decisions to increase their buy-in and to improve accessibility and full usage of systems in the facilities there is need to have all departments provided with the equipment.

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