Operational Challenges of Electronic Health Records use and their Implications for Patient Waiting Time and Healthcare Outcomes in University of Ilorin Teaching Hospital, Ilorin, Nigeria
DOI:
https://doi.org/10.4314/drjphet.v11i3.16Keywords:
Electronic health records, operational challenges, system downtime, internet connectivity, data quality, patient waiting time, NigeriaAbstract
Background: Electronic health records (EHR) can reduce delays and improve care only when they work reliably and are used well. In Nigerian tertiary hospitals, infrastructure, skills and organisational factors may prevent EHR from delivering their expected benefits, yet these operational challenges are rarely quantified from the perspective of frontline professionals.
Objective: This study identified the operational challenges associated with EHR use at the University of Ilorin Teaching Hospital (UITH), Ilorin, and examined their implications for patient waiting time and healthcare outcomes.
Methods: A descriptive cross-sectional survey was conducted among healthcare professionals (nurses, doctors, Health Information Management staff, laboratory staff and pharmacists). A sample of 315 was determined from a population of 1,481 using the Taro Yamane formula. A validated questionnaire (Cronbach's α = 0.76) was used, and 286 valid responses (90.8%) were analysed using frequencies, percentages, means, standard deviations and rank ordering against a criterion mean of 2.50.
Results: All operational challenge items exceeded the criterion mean (grand mean = 2.96). The most severe were inadequate internet connectivity (M = 3.16; 79.7% agreement), system downtime and technical issues affecting patient waiting time (M = 3.14; 80.1%), and frequent operational challenges in departments (M = 3.12; 81.1%). Insufficient training (M = 3.00; 74.5%) and data entry errors affecting clinical decisions (M = 2.73; 60.5%) followed. Resistance to EHR use was the least severe challenge (M = 2.58; 51.7%). Frequent downtime or slow loading (M = 3.07) and incomplete hospital-wide coverage (M = 2.65) were also reported.
Conclusion: EHR challenges at UITH are mainly infrastructural and technical, followed by human-capacity and data quality problems, rather than attitudinal. These challenges directly prolong patient waiting time and threaten the safety benefits of EHR. Investment in connectivity, power, technical support, training, data quality assurance and downtime procedures is recommended.
