Determinants of Electronic Health Record Implementation in Government-owned Hospitals across Calabar Metropolis, Cross River State, Nigeria.

Abstract:

The implementation of Electronic Health Records (EHRs) has been promoted globally as a strategy for improving healthcare delivery, yet progress remains uneven in many public health facilities in Nigeria. In Calabar Metropolis, concerns persist regarding the level of EHR integration and the conditions required for effective utilisation. This study therefore examined the determinants of Electronic Health Record implementation in Government own Hospitals across Calabar Metropolis, Cross River State, Nigeria. The study was a facility-based cross-sectional study conducted among healthcare professionals across major professional groups. Data were collected using a structured, self-administered questionnaire, and a multistage sampling approach was used to ensure adequate representation across staff categories. Descriptive statistics and multivariate regression analysis were employed to analyse the data. The findings showed that the mean age of respondents was 39.27 ± 0.79 years; 63.06% were female, 32.34% constituted the largest professional group, and 79.94% were full-time staff. A total of 50.3% reported moderate EHR implementation, while 49.7% reported low implementation. Furthermore, respondents aged 30–39 years had significantly lower implementation impact scores compared to those aged less than 25 years (β = -5.227, 95% CI: -9.207 to -1.247, p = 0.010), while those with more than ten years of service reported significantly higher barrier scores (β = 13.281, 95% CI: 4.999 to 21.562, p = 0.002). The study highlights that while EHR systems are operational in Calabar Metropolis, sustainable digital transformation requires strengthening workforce capacity, institutional support structures, and infrastructural reliability. Thus, policymakers and hospital management should prioritize human resource readiness and supportive organizational frameworks alongside technological investment to achieve effective, sustainable EHR integration