Abstract
Background Electronic medical records (EMRs) are vital tools in enhancing healthcare delivery through better documentation, communication, and data retrieval. In low- and middle-income countries (LMICs), including Nigeria, EMR implementation faces challenges such as limited infrastructure, poor usability, and insufficient training. This study assesses the impact of EMRs on healthcare professionals' satisfaction and its effect on healthcare service delivery at Federal Medical Centre (FMC) Gusau, identifying key predictors and challenges to inform implementation strategies. Methods A cross-sectional study was conducted at FMC Gusau, Zamfara State, Nigeria, a tertiary healthcare facility, from October 2024 to January 2025. Among 415 clinical staff selected through stratified random sampling after data cleaning, responses with more than 50% unfilled fields were removed from the initial 423; a semi-structured questionnaire was adapted, modified, and pretested for internal consistency (Cronbach alpha 0.88 with 10% sample, n=42) to evaluate EMR satisfaction, service delivery impact, and utilization challenges. Data were analyzed using SPSS version 20 (IBM Inc., Armonk, New York); summary statistics included frequencies and percentages for categorical variables, means for normally distributed continuous variables, and medians with interquartile ranges for skewed data. Ordinal logistic regression was used to identify predictors of satisfaction (p<0.05). Results Of the 415 respondents, 36 (8.7%) reported high satisfaction, 192 (46.3%) reported moderate satisfaction, and 187 (45.1%) reported dissatisfaction. Satisfaction was highest for system navigability, 294 (70.9%), and data retrieval speed, 303 (73.0%). EMRs were perceived to improve documentation 279 (67.2%), record access 334 (80.4%), and interdepartmental communication 265 (63.9%), though 204(49.2%) noted increased documentation time. Training (AOR=2.68, 95% CI=1.52-4.71, p=0.001) was a significant predictor, while duration of practice showed no significant effect (AOR=0.95, 95% CI=0.55-1.64, p=0.852). Major challenges included limited training 108 (26.0%), IT support 97 (23.3%), and interface issues 80 (19.3%). Conclusion EMRs offer clear benefits in improving healthcare delivery, yet user satisfaction remains moderate due to technical and training-related barriers. Strengthening training, IT support, and user-centered design is crucial for effective EMR adoption and sustainability in resource-constrained settings.