Prospects and Problems of Migrating from Physical Case Notes to Electronic Record Systems in the Spine Clinic in Nigeria: A Cross-sectional Study of 40 Healthcare Workers

Abstract

Background: The transition from paper-based medical records to electronic medical records (EMRs) is a central component of modern healthcare digitisation. In Nigeria, however, this transition faces specific challenges related to infrastructure, training, and user acceptance. This study assessed the prospects and problems associated with migrating from physical case notes to EMRs among healthcare workers in the spine clinic of a major Nigerian tertiary hospital. Methods: A cross-sectional study was conducted among 40 healthcare workers at the spine clinic of National Orthopaedic Hospital Dala, Kano. A pre-tested, self-administered questionnaire assessed participants’ knowledge, attitudes, perceptions, confidence, and perceived barriers regarding EMR adoption. Data were analysed using descriptive statistics and chi-square tests. Results: Most respondents (87.5%) had a positive attitude towards EMR adoption, and 82.5% expressed confidence in using EMR systems. However, only 52.5% reported consistent EMR use, reflecting a gap between positive perceptions and actual practice. The most frequently cited barriers were inconsistent power supply (85.0%), inadequate computers (82.5%), poor internet connectivity (77.5%), and insufficient training (65.0%). Age was significantly associated with confidence in EMR use: 94.1% of respondents aged <40 years were confident, compared with 58.3% of those aged ≥40 years (p = 0.006). Doctors demonstrated greater confidence (95.8%) than nurses and other staff (68.8%) (p = 0.04). Conclusions: Healthcare workers in the spine clinic held favourable attitudes towards EMR adoption, but infrastructural deficits and inadequate training were major barriers to consistent use. Younger age and medical qualification were associated with greater confidence. Addressing these barriers is essential to support successful digital transformation in Nigerian healthcare settings.