Electronic health record system (EHRS) is an important healthcare innovation associated with many controversies about the benefits and challenges to different stakeholders. The aim of this study was to investigate the utility of EHRS by outpatient physicians in Macao and to identify, in their opinions, the significance of EHRS on health institutes, patients, and physicians. Semi-structured interviews were conducted with 32 physicians who worked in the outpatient department. The interview data showed that 78 % physicians interviewed used EHRS frequently during their daily practice despite individual preferences of documentation methods. They agreed that systemic health record offered by EHRS allowing smooth communication was beneficial to the health institutes, patients and physicians. However, privacy and confidentiality concerned both the health institutes and patients. Inefficiency of the EHRS that only allowed retrieval of limited medical information of the patients hindered physicians' acceptability of EHRS. It was also suggested that the health institutes should take into consideration interests of different stakeholders when designing and implementing EHRS.