Challenges and Attitudes Towards Electronic Health Record Implementation in Secondary Healthcare Settings: A Review of Two Centres

Abstract

Introduction: Electronic Health Records (EHRs) are recognised globally for their role in improving healthcare quality, patient safety, data management, and operational efficiency. However, their adoption in low-resource settings such as Nigeria remains challenging. This study investigated healthcare professionals’ attitudes towards EHR implementation and identified key challenges in two secondary healthcare centres in Abuja.

Methods: A cross-sectional survey was conducted among 201 healthcare professionals, using structured electronic questionnaires based on the Unified Theory of Acceptance and Use of Technology (UTAUT). The survey incorporated Likert scale questions, both close-ended and open-ended questions, and stratified sampling ensured balanced representation. The validity of the data was established through a pilot study. A mixed-methods approach was adopted, incorporating quantitative analysis, utilizing both descriptive and inferential statistics, and thematic analysis of open-ended questions to achieve a more comprehensive understanding.

Results: Out of 201 questionnaires distributed, 123 were completed, resulting in a 61.2% response rate. Unreliable internet connectivity 90 (73.2%), lack of power generators 114 (92.7%), absence of new uninterruptible power supplies (UPS) 96 (78.0%), and lack of antivirus protection 119 (98.7%) were major challenges to EHR implementation. Additionally, 52 (42.3%) of respondents demonstrated previous knowledge of computers, which, combined with the available technical support reported by 50 (40.7%) of participants to positively influenced attitudes toward EHR usage.

Conclusion: The adoption of Electronic Health Records in secondary healthcare centres is significantly hindered by unreliable internet connectivity, insufficient power backup systems, and poor cybersecurity. These infrastructural issues are further complicated by limited technical expertise among staff. However, previous knowledge of computers and the presence of technical support have been shown to improve staff attitudes towards using EHRs.