Navigating the Digital Shift: A Qualitative Assessment of Readiness and Barriers for Electronic Medical Record Implementation in Ogun State, Nigeria's Secondary Healthcare Facilities

Background: The global transition to Electronic Medical Records (EMRs) is a pivotal strategy for enhancing healthcare quality and efficiency. In Nigeria, despite national policy directives, the adoption of EMRs in public secondary facilities (General Hospitals) remains inconsistent and fraught with challenges. This study aimed to explore the ground-level perceptions of healthcare professionals regarding the prospects and impediments to implementing EMRs within this critical tier of Nigeria's healthcare system.
Methods: We employed a qualitative, interpretive case study approach. Through in-depth, semi-structured phone discussions, we engaged a purposive sample of medical doctors and medical records officers from three General Hospitals across different local government areas in Ogun State. The discussions, designed to reach thematic saturation, explored participants' understanding of EMRs, their perceived benefits, and the multifaceted barriers to adoption. Data were analyzed using a thematic analysis framework.
Results: Analysis revealed a strong consensus on the potential utility of EMRs, with participants highlighting advantages such as improved data security, enhanced operational efficiency, and reduced loss of patient records. A high degree of computer literacy and a palpable willingness to adopt new technology among clinical staff were identified as key enabling factors. Conversely, significant barriers emerged across three domains: (1) Severe infrastructural deficits, including chronic electricity instability, prohibitively poor internet connectivity, and a dire shortage of essential ICT equipment; (2) Human capital challenges, notably a significant digital skills gap among non-clinical staff and concerns over job security leading to potential resistance; and (3) Systemic and political bottlenecks, characterized by inadequate funding, deeply entrenched corruption in procurement processes, and a lack of sustained, visionary leadership.
Conclusion: The path to successful EMR integration in Ogun State's secondary facilities is primarily obstructed not by a lack of awareness or willingness among health workers, but by profound infrastructural and governance failures. Translating policy into practice necessitates a fundamental shift towards accountable governance, strategic investment in core infrastructure, and holistic change management programs that address both technical and human anxieties. The findings underscore the imperative for a multi-stakeholder approach, potentially involving public-private partnerships, to overcome these deeply rooted challenges and unlock the transformative potential of digital health in resource-constrained settings