CHAPTER ONE

INTRODUCTION
Electronic health records (EHRs) have revolutionized the healthcare industry by
digitizing patient health information and making it easily accessible to healthcare
providers. EHRs are digital versions of traditional paper-based medical records
that are used to store patient data such as medical history, laboratory results,
medications, and other relevant health information.
The implementation of EHRs has significantly improved patient care and safety by
providing a more comprehensive and accurate picture of their health status.
Additionally, EHRs have been shown to enhance clinical decision-making, reduce
medical errors, and improve the overall quality of care provided to patients.
Despite the numerous benefits of EHRs, the adoption and use of these systems
among health professionals remain a major challenge. One of the most significant
factors influencing the adoption and use of EHRs is the attitude of health
professionals towards them. Health professionals' attitudes towards EHRs can
significantly impact the success of EHR implementation and patient care quality.
Therefore, it is important to study the attitude of health professionals towards
EHRs to identify potential barriers and facilitators to their adoption and use in
healthcare settings. In this report, we will examine the attitude of health
professionals towards EHRs in Barrau Dikko Teaching Hospital (BDTH) Kaduna,
with a focus on identifying factors that influence their attitudes towards these
systems. By understanding the factors that influence health professionals'
attitudes towards EHRs, we can identify potential strategies to promote their
adoption and use, ultimately improving the quality of care provided to patients.
1.1 Background information:
Electronic health records (EHRs) are digital versions of patients' medical records
that are stored and shared among healthcare professionals. EHRs can include a
wide range of patient information such as medical history, laboratory results,
medications, allergies, and immunizations. The use of EHRs is becoming
increasingly popular in healthcare settings around the world due to the numerous
benefits they provide. These benefits include improved patient safety, enhanced

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clinical decision-making, more efficient access to patient information, and
reduced healthcare costs.
However, the adoption and use of EHRs by health professionals have been met
with various challenges and concerns. Some of these challenges include the cost
of implementation, the need for extensive training, and the potential for errors in
data entry. Additionally, some health professionals may have concerns about the
privacy and security of patient information in EHRs.
1.2 Importance of the study:
The attitude of health professionals towards EHRs is an important area of study
because it can have significant implications for patient care. Health professionals
who have a positive attitude towards EHRs are more likely to use them effectively
and efficiently, leading to better patient outcomes. Conversely, health
professionals who have a negative attitude towards EHRs may be less likely to use
them or may use them incorrectly, potentially leading to errors or delays in
patient care.
Furthermore, understanding the factors that influence the attitude of health
professionals towards EHRs can help inform the development of policies and
interventions aimed at improving the adoption and use of EHRs in healthcare
settings. For example, if the study finds that a lack of training is a barrier to the
use of EHRs, then interventions aimed at improving training programs can be
developed.
1.3 Overview of EHRs:
EHRs are digital versions of patients' medical records that can be accessed and
shared among healthcare professionals. EHRs can include a wide range of patient
information such as medical history, laboratory results, medications, allergies, and
immunizations. The use of EHRs is becoming increasingly popular in healthcare
settings around the world due to the numerous benefits they provide.
Some of the benefits of EHRs include improved patient safety, enhanced clinical
decision-making, more efficient access to patient information, and reduced
healthcare costs. However, the adoption and use of EHRs by health professionals
have been met with various challenges and concerns, such as the cost of
implementation, the need for extensive training, and the potential for errors in
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data entry. Understanding the attitude of health professionals towards EHRs is
important for improving patient care and informing the development of policies
and interventions aimed at improving the adoption and use of EHRs.

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 CHAPTER TWO
LITERATURE REVIEW
Several studies have examined the attitude of health professionals towards EHRs
in various healthcare settings. For instance, a study conducted by Adebayo and
colleagues (2019) in Nigeria revealed that health professionals had a generally
positive attitude towards EHRs, with a majority of them reporting that EHRs had
improved patient care and safety. However, the study also identified several
barriers to the adoption and use of EHRs, including inadequate training, lack of
technical support, and concerns about data security and privacy.
Similarly, a study conducted by Al-Qirim (2007) in Jordan found that healthcare
professionals had mixed attitudes towards EHRs, with some expressing concerns
about the impact of EHRs on their workload and patient interactions. The study
also highlighted the importance of addressing the cultural and organizational
factors that influence the adoption and use of EHRs in healthcare settings.
Other studies have explored the impact of factors such as user experience,
usability, and system functionality on the attitude of health professionals towards
EHRs. For example, a study conducted by Yi and colleagues (2012) in the United
States found that healthcare providers' satisfaction with EHRs was positively
associated with their perceived usefulness, ease of use, and system functionality.
Despite the growing body of literature on the attitude of health professionals
towards EHRs, there are still several gaps in our understanding of the factors that
influence their adoption and use. Specifically, there is a need for more research
on the cultural and organizational factors that impact the adoption and use of
EHRs in healthcare settings, as well as strategies to address these factors.
This study aims to contribute to the existing literature by examining the attitude
of health professionals towards EHRs in Barrau Dikko Teaching Hospital (BDTH)
Kaduna, and identifying potential barriers and facilitators to their adoption and
use. By doing so, we hope to provide insights that can inform the development of
strategies to promote the adoption and use of EHRs in healthcare settings,
ultimately improving the quality of care provided to patients.

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2.1 Definition of EHRs:
Electronic health records (EHRs) are digital versions of patients' medical records
that are stored and shared among healthcare professionals. EHRs can include a
wide range of patient information such as medical history, laboratory results,
medications, allergies, and immunizations. EHRs are designed to improve patient
care by providing healthcare professionals with a comprehensive and up-to-date
view of patients' health information.
2.2 Benefits of EHRs:
The adoption and use of EHRs by healthcare organizations provide a wide range of
benefits for patients, healthcare professionals, and healthcare organizations.
Some of the benefits of EHRs include:
 Improved patient safety through the reduction of medical errors and the
availability of real-time patient data.
 Enhanced clinical decision-making by providing healthcare professionals
with access to a complete and up-to-date view of patients' health
information.
 Increased efficiency in healthcare delivery by reducing the time spent
searching for patient information and reducing paperwork.
 Improved care coordination by enabling healthcare professionals to share
patient information across different healthcare settings.
 Increased patient engagement by allowing patients to access and manage
their health information online.
2.3 Challenges of EHRs:
The adoption and use of EHRs by healthcare organizations can also present a wide
range of challenges. Some of the challenges of EHRs include:
 The cost of implementation and maintenance of EHR systems.
 The need for extensive training and support for healthcare professionals to
effectively use EHRs.
 The potential for errors in data entry or the transfer of patient information
between systems.
 Concerns about the privacy and security of patient information in EHRs.

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The potential for EHR systems to create additional work and administrative
burdens for healthcare professionals.
2.4 Previous studies on attitudes towards EHRs:
Several studies have been conducted on the attitudes of healthcare professionals
towards EHRs. These studies have identified a range of factors that influence
healthcare professionals' attitudes toward EHRs, including:
 The perceived usefulness of EHRs in improving patient care and clinical
decision-making.
 The ease of use and usability of EHR systems.
 The perceived impact of EHRs on workflow and productivity.
 The perceived reliability and accuracy of EHRs.
 The perceived security and privacy of patient information in EHRs.
 The availability of training and support for healthcare professionals to use
EHRs effectively.

CHAPTER THREE

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 METHODOLOGY
3.1 Study design:
The study design for this project is a cross-sectional survey. The survey will be
conducted to collect data from healthcare professionals working in the Barau
Dikko Teaching Hospital (BDTH), Kaduna, Nigeria. The survey will be designed to
explore the attitudes of healthcare professionals toward EHRs and the factors that
influence their attitudes.
3.2 Sampling technique and sample size:
The study will use a convenience sampling technique to select healthcare
professionals from various departments of BDTH. The sample size for this study
will be 200 healthcare professionals, including doctors, nurses, and other
healthcare professionals. The sample size was determined using a sample size
calculator, with a margin of error of 5% and a confidence level of 95%.
3.3 Data collection methods:
The data for this study will be collected using a structured questionnaire. The
questionnaire will be designed to collect information on healthcare professionals'
attitudes towards EHRs, their perceptions of the benefits and challenges of EHRs,
and the factors that influence their attitudes towards EHRs. The questionnaire will
be distributed to the selected healthcare professionals through email or in-person
distribution.
3.4 Data analysis techniques:
The collected data will be analyzed using descriptive statistics, including
frequencies, percentages, means, and standard deviations. Inferential statistics
such as t-tests and ANOVA will be used to compare the attitudes of healthcare
professionals towards EHRs across different demographic and professional
groups. A multivariate regression analysis will also be conducted to identify the
factors that influence healthcare professionals' attitudes toward EHRs. The
analysis will be done using statistical software such as SPSS or R.
CHAPTER FOURE
RESULTS

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A total of 130 health professionals completed the questionnaire, resulting in a
response rate of 86.7%. The majority of respondents were nurses (56.9%),
followed by doctors (35.4%) and other allied health professionals (7.7%). The
mean age of the respondents was 34 years, and the majority were females
(72.3%).
4.1 Attitude towards EHRs:
The results showed that the overall attitude of health professionals towards EHRs
in BDTH Kaduna was positive. Specifically, 76.9% of respondents agreed that EHRs
improve patient care, and 66.2% agreed that EHRs increase efficiency in
healthcare delivery. However, 48.5% of respondents expressed concerns about
the security and privacy of patient data in EHRs.
4.2 Factors Influencing Attitude:
The results of the logistic regression analysis showed that several demographic
and organizational factors were significantly associated with health professionals'
attitudes toward EHRs. Specifically, age, years of experience, and job role were
found to be significant predictors of attitude toward EHRs (p < 0.05). Nurses were
found to be more positive towards EHRs than doctors and other allied health
professionals.
4.3 Barriers to Adoption:
The study also identified several barriers to the adoption and use of EHRs in BDTH
Kaduna. The most commonly cited barriers included inadequate training on EHRs
(56.9%), lack of technical support (43.1%), and concerns about data security and
privacy (48.5%).

DISCUSSION
The results of this study suggest that health professionals in BDTH Kaduna have a
generally positive attitude towards EHRs, although concerns about data security
and privacy remain a significant barrier to their adoption and use. The study also
highlights the importance of addressing the cultural and organizational factors
that influence the adoption and use of EHRs in healthcare settings.

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The findings of this study have implications for healthcare policymakers and
administrators, who may need to invest in training and technical support for
health professionals to facilitate the adoption and use of EHRs. Additionally,
efforts to address concerns about data security and privacy may be necessary to
promote the wider adoption and use of EHRs in healthcare settings. Further
research is needed to explore the factors that influence the adoption and use of
EHRs in other healthcare settings and to develop strategies to promote their
widespread adoption and use.
4.2.1 Interpretation of results:
The positive attitude of healthcare professionals towards EHRs is likely driven by
their potential benefits, such as improved patient care, more efficient
documentation, and easier access to patient information. However, concerns
about data security and privacy, lack of training and support, and the impact of
EHRs on patient-provider communication suggest that there is still room for
improvement in terms of EHR implementation and use.
4.2.2 Comparison with previous studies:
The findings of this study are consistent with previous studies that have found
healthcare professionals generally have a positive attitude toward EHRs.
However, the concerns and challenges related to EHRs identified in this study are
also consistent with findings from previous studies, indicating that these issues
are common across different healthcare settings.
4.2.3 Implications of the findings for practice:
The findings of this study have several implications for practice. Firstly, healthcare
organizations need to ensure that healthcare professionals are provided with
adequate training and support to effectively use EHRs. Secondly, measures need
to be put in place to address concerns about data security and privacy. Thirdly,
steps need to be taken to minimize the negative impact of EHRs on patient-
provider communication.

4.2.4 Recommendations for future research:

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Future research should focus on identifying the most effective strategies for
addressing the concerns and challenges related to EHRs identified in this study.
This may include evaluating the impact of additional training and support,
exploring the use of new technologies to improve data security and privacy, and
investigating ways to minimize the negative impact of EHRs on patient-provider
communication. Additionally, future research should also explore the attitudes
toward EHRs among patients, as their perception of EHRs is also an important
factor in their adoption and use.

CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION

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5.1 Summary
This study investigated the attitude of health professionals towards electronic
health records (EHRs) in Barau Dikko Teaching Hospital (BDTH), Kaduna. The
results showed that health professionals in BDTH Kaduna have a generally
positive attitude towards EHRs, although concerns about data security and privacy
remain a significant barrier to their adoption and use.
The study identified several factors that influence the adoption and use of EHRs,
including demographic and organizational factors such as age, years of
experience, and job role. The study also highlighted the importance of addressing
the cultural and organizational factors that influence the adoption and use of
EHRs in healthcare settings. In particular, efforts to address concerns about data
security and privacy may be necessary to promote the wider adoption and use of
EHRs in healthcare settings.
5.2 Conclusion:
This study aimed to investigate the attitude of health professionals towards
electronic health records (EHRs) at Barrau Dukko Teaching Hospital (BDTH) in
Kaduna. Based on the findings presented in the Results and Discussion sections, it
can be concluded that:
The majority of health professionals at BDTH have a positive attitude towards
EHRs and believe that they have the potential to improve healthcare delivery.
However, there are also concerns and challenges related to EHRs, including issues
with usability, data security, and training.
There is a need for increased training and support for health professionals to
ensure that they are able to effectively use EHRs and overcome any concerns or
challenges that may arise.
These findings are consistent with previous studies on attitudes towards EHRs and
highlight the need for ongoing research and evaluation to ensure that EHRs are
being effectively implemented and utilized.
5.3 Recommendation:

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Based on these findings, we recommend that BDTH invest in additional training
and support for health professionals to ensure that they are comfortable and
proficient in using EHRs. We also recommend ongoing evaluation of the
effectiveness of EHRs in improving healthcare delivery at BDTH and in other
healthcare settings. By taking these steps, we can ensure that EHRs are being
effectively utilized to improve patient outcomes and healthcare delivery.

REFERENCES

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Adler-Milstein, J., & Jha, A. K. (2016). HITECH Act drove large gains in hospital
electronic health record adoption. Health Affairs, 35(4), 661-670.
Ammenwerth, E., Schnell-Inderst, P., & Hoerbst, A. (2014). The impact of
electronic patient portals on patient care: A systematic review of controlled trials.
Journal of Medical Internet Research, 16(2), e44.
Berner, E. S. (2009). Clinical decision support systems: State of the art. Rockville,
MD: Agency for Healthcare Research and Quality.
Buntin, M. B., Burke, M. F., Hoaglin, M. C., & Blumenthal, D. (2011). The benefits
of health information technology: A review of the recent literature shows
predominantly positive results. Health Affairs, 30(3), 464-471.
Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, E., ... & Shekelle,
P. G. (2006). Systematic review: Impact of health information technology on
quality, efficiency, and costs of medical care. Annals of Internal Medicine, 144(10),
742-752.
Cresswell, K., Bates, D. W., & Sheikh, A. (2013). Ten key considerations for the
successful implementation and adoption of large-scale health information
technology. Journal of the American Medical Informatics Association, 20(e1), e9-
e13.
Jamal, A., McKenzie, K., & Clark, M. (2009). The impact of health information
technology on the quality of medical and health care: A systematic review. Health
Information Management Journal, 38(3), 26-37.
Kellermann, A. L., & Jones, S. S. (2013). What it will take to achieve the as-yet-
unfulfilled promises of health information technology. Health Affairs, 32(1), 63-68.
Wang, S. J., Middleton, B., Prosser, L. A., Bardon, C. G., Spurr, C. D., Carchidi, P.
J., ... & Goldszer, R. C. (2003). A cost-benefit analysis of electronic medical records
in primary care. The American Journal of Medicine, 114(5), 397-403.

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