The Effect of Computer Applications on Health Information Management and Patient Outcomes in Healthcare Delivery: A Case Study of the National Orthopedic Hospital, Igbobi, Lagos
Chapter One
Aim and Objectives of the Study
The main aim of this study is to examine the impact of computer applications in Health Information Management on patient outcomes in healthcare delivery at the National Orthopaedic Hospital, Igbobi, Lagos. The specific objectives of the study include:
- To assess the extent of computer application use in health information management at the National Orthopaedic Hospital, Igbobi.
- To evaluate the effect of computer-based health information systems on patient outcomes, such as quality of care, diagnosis accuracy, and treatment timeliness.
- To identify challenges associated with the implementation and utilization of computer applications in health information management.
CHAPTER TWO
LITERATURE REVIEW
Conceptual Framework
Health Information Management (HIM)
Health Information Management (HIM) refers to the systematic process of acquiring, managing, analyzing, and safeguarding health data vital for the effective delivery of healthcare services. HIM involves both electronic and paper-based medical records and ensures that the information is accurate, secure, and easily accessible for healthcare professionals. The goal of HIM is to support healthcare decision-making, improve patient outcomes, and streamline operational efficiencies within healthcare organizations (Abimbola, 2023). The growing reliance on electronic health records (EHR) and health information exchange platforms highlights HIM’s role in modern healthcare (Kana et al., 2020).
The concept of HIM has been defined by several scholars and practitioners. Akyala et al. (2020) describe HIM as the process that involves the collection, storage, and sharing of health data to improve patient care, ensuring its accessibility and security. Odafe et al. (2023) emphasize the role of HIM in supporting healthcare workers by providing timely, accurate, and valid patient data, which is essential for clinical decision-making. Aniekwe et al. (2023) further define HIM as a mechanism for ensuring that health information is accurate, complete, and accessible across different healthcare providers, thus improving the quality of patient care. These definitions underscore HIM’s critical role in healthcare data management and its potential for enhancing patient care through better information sharing.
Criticism of existing HIM definitions primarily revolves around their failure to account for the challenges faced in low-resource settings. While these definitions focus on the technical aspects of managing health information, they often overlook factors such as infrastructure limitations, lack of skilled personnel, and resistance to change, particularly in resource-constrained environments like Nigeria (Adereti & Olaogun, 2019). Additionally, HIM is often seen as too focused on the digital aspect of healthcare data management without sufficiently addressing the human and organizational barriers that hinder effective implementation (Olagundoye et al., 2021).
Despite these critiques, HIM remains highly relevant in modern healthcare systems. As healthcare systems become increasingly digitized, HIM facilitates the integration of various healthcare processes, such as patient data management, medical record keeping, and health information exchange (Abayomi et al., 2021). HIM is integral to reducing medical errors, improving the efficiency of healthcare delivery, and ensuring that healthcare providers have timely access to the necessary patient information for better clinical decision-making (Hassan et al., 2024). Furthermore, HIM supports compliance with health regulations and helps organizations meet quality standards set by health authorities (Olagundoye et al., 2021).
CHAPTER THREE
METHODOLOGY
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Research Design
The research design refers to the blueprint for conducting the study and outlines the methodology for gathering and analyzing data. In this study, a quantitative research design has been adopted. Quantitative research is essential for investigating the relationship between variables and providing statistical insights into the adoption and implementation of electronic medical records (EMRs) in Nigerian hospitals. Specifically, a descriptive survey design was selected because it enables the collection of numerical data, which will be used to quantify healthcare workers’ perceptions, attitudes, and challenges regarding EMR adoption. The rationale behind selecting a quantitative approach is that it allows for precise measurement of the phenomena under investigation, which is necessary to assess the adoption rate, identify barriers, and provide actionable insights that can be generalized to a broader population (Saunders, Lewis, & Thornhill, 2019). Furthermore, a survey design facilitates the collection of large volumes of data from a diverse group of respondents, thus ensuring that the findings are representative of the population.
This quantitative approach aligns with the study’s aim of measuring the extent of EMR adoption and identifying factors that either promote or hinder its successful implementation in Nigerian hospitals. It also provides an avenue for testing hypotheses using statistical methods, contributing to the rigor and objectivity of the findings. The quantitative design is particularly appropriate for addressing the research questions and objectives, which include determining the factors influencing EMR adoption and assessing the challenges faced by healthcare workers in implementing and utilizing EMR systems. The use of descriptive survey design also enables the researcher to describe the current state of EMR adoption and identify patterns or trends, which will inform the study’s conclusions.
Study Settings
The study is set in Nigerian hospitals, specifically focusing on a case study from the National Orthopaedic Hospital, Igbobi, Lagos. Lagos, being one of Nigeria’s largest cities with a significant healthcare infrastructure, serves as an ideal setting for the study. It is a region where both public and private healthcare institutions are located, providing a broad perspective on EMR adoption in Nigeria. The choice of a tertiary hospital in Lagos is justified by the importance of such institutions in providing specialized healthcare services and their potential to lead the way in the adoption of advanced technologies like EMRs. The setting is crucial to understanding the challenges faced by both healthcare providers and the hospital management in integrating EMR systems within the broader Nigerian healthcare system.
Additionally, Lagos has a diverse population, which is essential for understanding the varying levels of EMR adoption across different healthcare settings. By focusing on a single hospital in Lagos, the study will have a more detailed insight into the local context, including infrastructural limitations, organizational culture, and the availability of technical expertise. This will allow the research to provide actionable recommendations that are relevant not only to Igbobi Hospital but also to other healthcare facilities across Nigeria.
Population of the Study
The target population for this study consisted of healthcare workers employed at the National Orthopaedic Hospital, Igbobi, Lagos. This includes doctors, nurses, administrative staff, and IT professionals involved in the EMR implementation process. The target population of this study was 2000 employees, which included both clinical and non-clinical staff. The target population is justified because these individuals are directly involved in the daily operations of the hospital and have firsthand experience with the implementation and use of EMR systems. Their perspectives on the adoption of EMRs provided critical insights into the challenges and benefits of these systems, as well as the organizational and technical barriers that need to be addressed.
The inclusion of a diverse range of healthcare workers allows for a comprehensive understanding of how EMRs impact different roles within the hospital, from clinicians who use the system for patient care to administrative staff responsible for data entry and system maintenance. Furthermore, it is crucial to capture the perspectives of healthcare workers who may have varying levels of experience with EMR systems, as this provided a well-rounded understanding of the factors that influence successful adoption. The size of the target population also ensures that the study’s findings will be generalizable to other healthcare settings in Nigeria.
CHAPTER FOUR
DATA PRESENTATION ANALYSIS AND DISCUSSION
Data Presentation
Demographic Distribution of Respondents
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATIONS
Summary of Findings
The research findings presented a comprehensive picture of digital health system implementation at the National Orthopaedic Hospital, Igbobi, revealing both significant progress and persistent challenges in the adoption of computer-based health information management. The study demonstrated that while digital technologies had become increasingly integrated into hospital operations, their full potential remained unrealized due to systemic barriers that required urgent attention.
A central finding of the study was the moderate but growing adoption of health information systems, with approximately 60% of staff acknowledging their integration into daily workflows. This adoption had yielded measurable benefits, particularly in clinical decision-making and patient outcomes. The systems proved particularly effective in improving diagnostic accuracy, with two-thirds of respondents noting enhanced precision in patient assessments. Furthermore, the majority of healthcare workers observed tangible improvements in treatment outcomes, attributing these gains to better information accessibility and reduced medical errors facilitated by digital records.
However, the research uncovered substantial obstacles that hindered optimal system utilization. The most critical barrier identified was inadequate staff training, with over three-quarters of respondents highlighting this deficiency. This training gap existed despite reasonable system accessibility, suggesting that mere availability of technology did not guarantee effective utilization. Many healthcare workers lacked the necessary digital literacy to fully leverage these systems, resulting in underutilization of available functionalities and persistent reliance on paper-based processes in some cases.
Technical challenges emerged as another major impediment to seamless digital health implementation. Frequent system downtimes, largely attributed to unstable power supply and unreliable internet connectivity, disrupted clinical workflows and eroded staff confidence in the technology. These infrastructure limitations were compounded by software complexity, with many respondents finding the systems unnecessarily difficult to navigate. Such usability issues discouraged consistent use and contributed to resistance among less tech-savvy staff members.
Data security concerns represented another significant finding, with nearly three-quarters of respondents expressing apprehension about patient privacy and information protection. These concerns reflected both genuine vulnerabilities in current systems and a growing awareness of data protection issues among healthcare professionals. The anxiety surrounding data security explained some staff members’ reluctance to fully embrace digital record-keeping, particularly for sensitive patient information.
Interestingly, the study found that demographic factors such as age, education level, and professional role had minimal influence on technology perceptions. This suggested that the challenges identified were systemic rather than being limited to specific staff categories. However, variations did emerge between clinical and administrative staff in terms of perceived benefits, with clinicians more likely to recognize the positive impact on patient care outcomes.
The findings collectively suggested that while digital health technologies had begun transforming healthcare delivery at the institution, their impact remained constrained by implementation challenges. The hospital had successfully laid the foundation for digital transformation, but realizing its full potential required addressing the identified barriers through targeted interventions. These should have prioritized comprehensive staff training programs, infrastructure improvements, system usability enhancements, and robust data security measures.
The study’s results had important implications for healthcare digitization efforts across Nigeria. They confirmed that while the benefits of health information technologies were achievable in resource-constrained settings, successful implementation required more than just technological deployment. Organizational readiness, continuous capacity building, and sustained infrastructure support were equally critical components of successful digital transformation. The findings particularly emphasized the need for context-appropriate solutions that considered local challenges such as intermittent power supply and varying levels of digital literacy among healthcare workers.
The hospital’s digital health strategy needed to adopt a phased approach that addressed the most critical barriers first. Immediate priorities should have included establishing ongoing training programs to bridge the digital skills gap and implementing measures to improve system reliability. Subsequent efforts needed to focus on simplifying user interfaces and strengthening data protection protocols to build staff confidence in the systems. Regular monitoring and evaluation were essential to assess the effectiveness of these interventions and guide continuous improvement.
The study’s findings contributed valuable insights to the ongoing discourse on healthcare digitization in developing countries. They provided empirical evidence that while the path to full digital transformation was challenging, the benefits for patient care and health system efficiency made it a worthwhile investment. By addressing the identified implementation barriers, healthcare institutions in Nigeria and similar settings could accelerate their digital health journeys and deliver higher quality care to their patients.
Conclusion
The findings from this study provide compelling evidence that computer-based health information systems significantly impact healthcare delivery at the National Orthopaedic Hospital, Igbobi. The tested hypotheses confirmed that these systems enhance patient outcomes through improved diagnostic accuracy (66% agreement), better treatment decisions (74.1%), and reduced medical errors (63.9%). However, the research also revealed critical implementation challenges that must be addressed to maximize these benefits.
Substantial barriers persist, particularly in staff training (77.1% reporting inadequacies), system reliability (75% experiencing downtimes), and data security (73.2% expressing concerns). These challenges hinder optimal utilization despite the proven clinical value of digital systems. The findings demonstrate that successful health information management requires more than technological adoption – it demands comprehensive workforce development, infrastructure strengthening, and robust data protection measures.
For Nigerian healthcare institutions to fully realize digital transformation benefits, policymakers and hospital administrators must prioritize targeted training programs, system usability improvements, and cybersecurity enhancements. A phased implementation approach, focusing first on critical care areas while building staff capacity, may prove most effective. The study confirms that when properly implemented, health information technologies can significantly improve healthcare quality in resource-constrained settings, but their success depends on addressing both technical and human factors in implementation.
Recommendations
Based on the findings, the following recommendations were proposed:
- The hospital administration should implement comprehensive and ongoing training programs to enhance staff proficiency in using health information systems, with particular emphasis on hands-on workshops and peer-to-peer learning approaches to ensure all healthcare workers, including non-technical personnel, can effectively utilize digital tools in their daily workflows.
- Significant investments must be made in upgrading the hospital’s IT infrastructure, including ensuring stable power supply through alternative energy solutions, improving internet connectivity, and establishing reliable backup systems to minimize technical disruptions that currently hinder the effective use of digital health applications.
- The hospital should collaborate with software developers to redesign system interfaces with a focus on user-friendliness and intuitive navigation, incorporating feedback from frontline healthcare workers through regular usability testing sessions to identify and address specific challenges in system operation.
- Robust data security measures need to be implemented, including advanced encryption protocols, strict access controls, and regular security audits, complemented by clear policies on patient data protection and mandatory training for all staff on cybersecurity best practices to address current privacy concerns.
- A phased implementation strategy should be adopted, beginning with high-impact departments such as outpatient clinics and radiology units, allowing for thorough evaluation and refinement of digital systems based on user feedback before expanding to other hospital departments, ensuring more effective and sustainable adoption across the entire facility.
Limitations of the Study
This research has several limitations that should be considered when interpreting the findings. First, the study was conducted in a single tertiary healthcare facility, which may limit the generalizability of the results to other hospitals with different operational contexts or resource levels. Second, the reliance on self-reported data through questionnaires introduces the possibility of response bias, as participants may have provided socially desirable answers or may not have fully understood some technical aspects of the questions. Third, the cross-sectional design of the study only provides a snapshot of the situation at one point in time, making it difficult to assess long-term trends or causal relationships between variables. Additionally, the study did not examine specific technical specifications of the health information systems in use, which could have provided deeper insights into system performance and usability challenges. Finally, while the sample size was adequate for the analysis, the exclusion of certain staff categories due to non-response may have introduced some selection bias in the findings. These limitations suggest that while the study provides valuable insights, the results should be interpreted with caution and may need to be validated through broader, longitudinal studies incorporating multiple data collection methods.
Suggestions for Further Studies
Future research should expand on this study by employing a multi-center approach across different tiers of healthcare facilities (primary, secondary, and tertiary) to enhance the generalizability of findings and better understand how institutional characteristics influence digital health system implementation. A longitudinal study design would be valuable to track the evolution of system adoption over time and assess the sustainability of digital health interventions. Researchers should consider incorporating mixed methods approaches, combining quantitative surveys with in-depth interviews and system usability testing, to gain deeper insights into user experiences and technical challenges. Comparative studies between public and private healthcare facilities could reveal important differences in implementation strategies and outcomes. Additionally, future investigations should examine the cost-effectiveness of different digital health solutions in resource-constrained settings and explore innovative approaches to addressing infrastructure limitations. There is also a need for research focusing specifically on patient perspectives regarding digital health interventions and their impact on healthcare experiences. Finally, studies evaluating the effectiveness of various training methodologies for healthcare staff in digital health system adoption would provide valuable evidence for capacity-building strategies. These suggested research directions would contribute to developing more robust, context-specific frameworks for successful digital health implementation in Nigeria and similar settings.
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