Comparative Assessment of Health Information Management Efficiency Before and After Electronic Health Records Adoption in Tertiary Healthcare Facilities in Kogi State, Nigeria

Abstract

The adoption of Electronic Health Records (EHRs) has been promoted globally as a strategy for improving healthcare delivery, yet challenges persist in Nigeria’s public health facilities, particularly during the transition from paper-based to electronic systems. This study therefore investigated how the adoption of EHRs influences Health Information Management (HIM) practices in Tertiary Healthcare Facilities in Kogi State, Nigeria. The study was a facility-based cross-sectional study conducted among 327 healthcare workers across major professional categories. Data were collected using a structured, self-administered questionnaire. A stratified random sampling technique was used to select participants to ensure adequate precision across staff groups. Differences in Health Information Management practices before and after EHR adoption were examined using paired sample <i>t</i>-test and Wilcoxon Signed-Rank test. The results show that 30.31% of respondents were aged between 25-29 years old, 67.70% were female, 22.12% held an MSc degree, and 23.01% had more than 20 years of work experience. The mean overall HIM performance score improved from 3.55 ± 0.76 before EHR implementation to 4.54 ± 0.50 after implementation, with a mean difference of –0.99 (CI: –1.09 to –0.90). The mean overall accessibility score before implementation was 2.17±0.86, increasing to 2.83±0.98 after implementation. Patient records were more easily accessible to authorized personnel after EHR adoption, with mean scores increasing from 1.813 ± 1.169 before adoption to 2.801 ± 1.449 after adoption. The difference was statistically significant (Z = -8.2, p < 0.001) and the effect size was large (r = 0.45). Timely retrieval of historical patient data for clinical decision-making improved, with mean scores rising from 2.147 ± 1.259 to 3.119 ± 1.330. The study demonstrates that although healthcare professionals recognise substantial improvements in data management, accessibility, and service delivery following EHR adoption, structural and capacity-related constraints continue to hinder optimal utilisation. Strengthening digital infrastructure, expanding ICT training, and ensuring sustained technical support are essential for maximising EHR benefits and advancing digital health implementation in Nigeria.