Evaluation of Electronic Health Record System Adoption at Teaching Hospitals in Imo State, South East Nigeria

Electronic health record systems are central to modernising healthcare data management, improving care coordination, and enabling clinical decision support, but their adoption at Nigerian teaching hospitals remains partial and uneven. This study evaluates the adoption status and operational challenges of electronic health record systems at two teaching hospitals in Imo State: Imo State University Teaching Hospital and Federal Medical Centre Owerri, South East Nigeria. A mixed-methods descriptive study was conducted with 190 healthcare workers (nurses, doctors, records officers) through structured questionnaires and 18 key informant interviews with department heads and ICT administrators. Variables assessed include EHR module deployment completeness, data entry frequency, interoperability with laboratory and pharmacy systems, and staff satisfaction ratings. Descriptive statistics and thematic coding of qualitative data were applied. Literature from South East Nigerian hospital EHR implementations identifies change resistance among senior clinicians, high implementation costs, and inadequate vendor after-sales support as the most critical adoption barriers. The Unified Theory of Acceptance and Use of Technology and the DeLone-McLean IS Success Model provide the dual analytical framework. Findings indicate that EHR adoption is highest in laboratory and pharmacy modules, while clinical note-taking and specialist consultation records remain predominantly paper-based. Recommendations include phased module rollout strategies, clinician-centric EHR training programmes, and government subsidy for EHR system procurement at public teaching hospitals. Keywords: electronic health records, EHR adoption, teaching hospitals, Imo State, South East Nigeria.