Effects of Digital Transformation on Employee Performance and Engagement in Public Health Facilities in Lagos State, Nigeria

Abstract

This study examined the effect of digital transformation on employee performance and engagement in selected public health facilities in Lagos State, Nigeria. Lagos State was selected because it is Nigeria's leading commercial centre and one of the first states to implement digital health initiatives across several public health facilities, providing an appropriate context for examining the influence of digital transformation on healthcare employees. Although previous studies have investigated digital transformation in healthcare, most have focused on technology adoption, healthcare quality, or patient outcomes, with limited empirical evidence on the combined influence of Electronic Health Records (EHRs) and Digital Patient Engagement (DPE) systems on employee performance and engagement in public health facilities in Lagos State, Nigeria. This study was conducted to address this contextual and empirical gap. The study adopted a descriptive survey research design, enabling the systematic collection of quantitative data on employees' perceptions without manipulating the study variables. The study population comprised 921 employees drawn from three selected public general hospitals in Lagos State, Nigeria. Using proportionate sampling, a sample size of 279 respondents was selected, of which 235 valid questionnaires were retrieved for analysis. Data were collected using a structured questionnaire with a Cronbach's Alpha reliability coefficient (r = 0.723), indicating acceptable internal consistency. The data were analysed using descriptive statistics and multiple regression analysis with the Statistical Package for the Social Sciences (SPSS). The findings revealed that Electronic Health Records significantly improved employees' service quality (β = 0.612, p < 0.05), while Digital Patient Engagement significantly enhanced employees' adaptability and effectiveness (β = 0.487, p < 0.05). The results further showed that digital transformation systems accounted for 68% of the variation in employee performance (R² = 0.680, F = 124.56, p < 0.05), demonstrating their significant positive influence. Based on these findings, the study recommends strengthening ICT infrastructure in public health facilities, providing continuous staff training and capacity building, implementing integrated e- health systems across all departments, strengthening digital health policies, establishing sustainable technical support systems, and instituting regular monitoring and evaluation of digital transformation initiatives. The study provides valuable empirical evidence to guide policymakers, healthcare administrators, hospital management boards, technology partners, and other critical stakeholders in formulating evidence-based strategies that strengthen digital transformation, enhance employee performance and engagement, and improve healthcare service delivery in Nigeria.