Benin City hospitals

Background: Electronic Health Record (EHR) systems are increasingly recognized as essential components of modern healthcare delivery, with the potential to improve patient outcomes, enhance data management, reduce medical errors, and strengthen health system efficiency. Despite these benefits, the adoption and effective utilization of EHR systems in many low- and middle-income countries, including Nigeria, remain low and with influence ranging from multiple individual, institutional, and infrastructural factors. Objective: This study aimed to determine healthcare workers’ knowledge of EHR systems in patient care, assess their attitudes toward EHR utilization, determine uptake and the level of EHR utilization, and identify factors influencing their use across selected hospitals in Benin City, Edo State. Methods: A analytical cross-sectional study design was conducted among 478 healthcare workers selected from public and private hospitals using a multistage sampling technique. Data were collected using a structured, pre-tested, self-administered questionnaire comprising sections on socio- demographic characteristics, knowledge, attitude, utilization, and factors influencing EHR use. Knowledge and utilization scores were categorized based on a 70% cut-off, while attitude was assessed using a 5-point Likert scale which was grouped into appropriate and inappropriate responses and scored using a cut-off of 70%. Data were analyzed using SPSS version 27. Descriptive statistics were summarized as frequencies and percentages, while inferential analysis was conducted using chi-square tests and fisher’s exact and multivariate logistic regression to identify predictors of HER in line with study objectives. Statistical significance was set at p < 0.050, and 95% confidence interval. Results: The majority of respondents were aged 20–39 years (86.8%), with a mean age of 31.22 ± 8.32 years, and females constituted 63.4% of the study population. Nurses formed the largest professional group, and most respondents had less than five years of professional experience. Awareness of EHR systems was high (93.3%), and an equal proportion demonstrated good knowledge (93.3%). Respondents showed strong knowledge in areas such as data privacy, reduction of medical errors, and improvement of healthcare delivery. A majority of respondents (78.2%) had a positive attitude toward EHR utilization, with most agreeing that EHR systems improve patient management (98.1%) and enhance the speed of care delivery (93.3%). However, a considerable proportion expressed neutrality regarding preference for EHR over paper-based records, indicating a transitional phase in adoption. EHR systems were available in most facilities (84.7%), and utilization was high across multiple domains, including clinical documentation (94.1%), patient registration (93.3%), prescribing (92.1%), and laboratory result access (90.6%). Utilization patterns varied significantly by profession and facility type at the bivariate level. Multivariate logistic regression analysis identified knowledge level, sex, and facility type as independent predictors of EHR utilization. Respondents with poor knowledge were significantly less likely to utilize EHR systems compared to those with good knowledge (OR = 0.22; 95% CI: 0.06–0.86; p = 0.029). Male respondents had lower odds of utilization compared to females (OR = 0.32; 95% CI: 0.11–0.89; p = 0.029), while those working in private facilities were less likely to utilize EHR systems compared to those in public facilities (OR = 0.15; 95% CI: 0.03–0.74; p = 0.019). Factors such as training (OR = 5.83; 95% CI: 2.46–13.81; p = <0.001), stability of electricity supply (OR = 7.25; 95% CI: 1.88–27.94; p = 0.004), and availability of hospital policy (OR = 1.99; 95% CI: 1.15–3.47; p = 0.014) were significant predictors of utilization at the multivariate level. Conclusion: This study demonstrates that healthcare workers in Benin City possess relatively high levels of knowledge, positive attitudes, and increasing level of utilization of EHR systems, indicating a strong foundation for digital health integration. However, persistent gaps in training, infrastructure, and organizational support limit optimal utilization. Addressing these challenges through targeted capacity building, improved infrastructural investment, and strengthened institutional policies will be critical for maximizing the benefits of EHR systems and improving healthcare delivery outcomes.