JMIR Publications

ABSTRACT

Background:

Background:

Digital transformation has increasingly influenced healthcare systems globally, with Electronic Medical Records (EMRs) becoming central to improving healthcare documentation, communication and decision-making. Despite growing recognition of EMRs as tools for strengthening health data quality, healthcare institutions in many low- and middle-income countries like Nigeria continue to experience setback as regards digital inclusion, infrastructural limitations and workforce readiness. In Nigeria, public tertiary hospitals still experience inconsistent EMR implementation and persistent concerns regarding the quality of patients’ health data.

Objective:

Objective:

This study explored healthcare providers’ perspectives on EMR adoption and health data quality in selected public tertiary hospitals in North-Central Nigeria within the broader context of digital health inclusion in the Global South.

Methods:

Methods:

The study adopted explanatory sequential mixed-method design. The design involved quantitative phase, identification of key quantitative results, qualitative phase, integration of findings and interpretation. The quantitative data were collected using a structured clinical chart review checklist developed from internationally recognized health data quality dimensions and existing literature on EMR systems and health information management. The qualitative data were collected through semi-structured key informant interviews among physicians, nurses and Health Information Management professionals purposively selected from three public tertiary hospitals with varying levels of EMR implementation. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analysis.

Results:

Results:

The study revealed an overall moderate level of health data quality, with high a Health Data Quality Index (HDQI) of 73%. Healthcare providers acknowledged the potential benefits of EMRs in improving accessibility, timeliness, comprehensiveness, relevancy and consistency of health data. Participants identified ease of information retrieval, reduction in missing records and improved continuity of care as major strengths of EMR systems. Several barriers to meaningful digital inclusion however emerged. These include unstable electricity supply, poor internet connectivity, inadequate training, workload pressure, dual documentation practices and limited institutional support. Providers further reported that system reliability, ease of use and user satisfaction strongly influenced their willingness to utilize EMRs consistently. Positive attitudes toward digital systems were associated with improved documentation practices and enhanced health data quality.

Conclusions:

Conclusion: Electronic medical records adoption in Nigerian tertiary hospitals remains shaped by complex technological, organizational and behavioural factors. Strengthening digital inclusion through reliable infrastructure, workforce capacity building and supportive institutional policies is essential for improving sustainable EMR utilization and health data quality in resource-constrained healthcare settings.