Research Article
Electronic Health Record Adoption Among Health Information Management and ICT Staff in Tertiary Hospitals in North-East Nigeria: Level and Associated Factors
Issue:
Volume 11, Issue 4, December 2026
Pages:
86-98
Received:
2 October 2026
Accepted:
12 October 2026
Published:
21 October 2026
DOI:
10.11648/j.bsi.20261104.11
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Abstract: Background: Electronic health records (EHRs) underpin clinical documentation, disease classification and health reporting, but little is known about their adoption in tertiary hospitals in North-East Nigeria or about the views of the staff who manage them. This study assessed the level of EHR adoption among health information management (HIM) officers and information and communication technology (ICT) personnel and identified factors associated with high adoption. Methods: A cross-sectional survey was conducted in three tertiary teaching hospitals in Yola, Bauchi and Maiduguri. Staff were selected by proportionate stratified sampling (target 486, Cochran’s formula). A structured questionnaire measured adoption with 15 five-point items in five domains (availability, functional maturity, compatibility with the International Classification of Diseases, 11th Revision (ICD-11), interoperability, user proficiency); a score above 70% of the maximum was classed as high adoption. Data were analysed with chi-square tests and binary logistic regression in SPSS version 27. Results: Of 486 questionnaires, 475 were analysed (response rate 97.7%): 373 from HIM officers and 102 from ICT personnel. The mean adoption score was 3.77 (standard deviation [SD] 0.84) out of 5, and 74.9% (95% confidence interval [CI] 70.9-78.6) were high adopters (HIM 74.0%, ICT 78.4%, p = 0.359). ICD-11 compatibility was the lowest-scoring domain in both groups. High adoption was reported by 90.6% of respondents in Yola, 67.1% in Bauchi and 73.4% in Maiduguri (p < 0.001). After adjustment, high adoption was less likely in Bauchi (adjusted odds ratio [AOR] 0.18; 95% CI 0.08-0.38) and Maiduguri (AOR 0.23; 0.11-0.48) than in Yola, and more likely among middle-status respondents (AOR 3.19; 1.49-6.81) and those with 11 or more years of experience (AOR 2.94 and 3.01); odds fell with age (AOR 0.96 per year; 0.93-0.99). Professional group was not associated with adoption. Conclusion: Reported EHR adoption is high among HIM and ICT staff but differs markedly between hospitals, and readiness for ICD-11 is the weakest dimension. Hospital-specific support and ICD-11-oriented system configuration should be prioritised; the findings reflect staff perceptions and need confirmation by system audits.
Abstract: Background: Electronic health records (EHRs) underpin clinical documentation, disease classification and health reporting, but little is known about their adoption in tertiary hospitals in North-East Nigeria or about the views of the staff who manage them. This study assessed the level of EHR adoption among health information management (HIM) offic...
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,
Peter Uduak Augustine,
Queen Desmond Atuzie
