Assessing the usability and performance of digital healthcare systems in Nigerian teaching hospitals: Challenges and future directions

Abstract

Background: Several developing countries, including Nigeria, are still in the nascent stages of adopting digital healthcare support solutions to enhance clinical service delivery. Consequently, there currently exists a scarcity of research and gaps in the literature regarding the efficacy, effectiveness, overall performance, and possibly success factors associated with these systems, or conversely, identify the design and implementation deficiencies, as well as the use-based challenges present in them. This is the gap this research seeks to address. The findings from these evaluations are anticipated to inform improvements to the existing systems and guide future implementations. Method: The research was conducted at three referral and university teaching hospitals in southern Nigeria. It involved an extensive period of on-site observations and clinician engagements. A validated 5-point Likert scale questionnaire was designed to capture the peculiarities of the prevailing contexts across these hospitals. The survey targeted 150 clinicians, and responses were analyzed using SPSS, while visual representations were created in MS Excel. Result: Findings showed that 79.4% of clinicians identified feature gaps and expressed the need for additional functionalities. However, 71.9% acknowledged that their systems had interfaces facilitating electronic requests to service units like radiology and pharmacy. Despite this, some clinicians faced challenges due to missing features, which prevented them from fully achieving their clinical goals. Furthermore, 80.2% reported experiencing instances where the electronic health record (EHR) systems were slow, unresponsive, or caused prolonged interruptions that hindered workflow efficiency. Conclusion: The findings, particularly the 79.4% of clinicians desiring additional features and the 80.2% experiencing system slowdowns, highlight the urgent need for digital healthcare policies in developing nations to prioritize user-centered design protocols during systems implementation in order to better align EHR systems with clinical workflows and reduce clinician burnout. It would as a result be pertinent to engage the clinicians in any future design or redesign process and also provide targeted trainings which will ensure EHR systems better support healthcare providers in delivering quality patient care.