Adoption of medical decision support systems in lower-middle-income countries: Evidence from Nigeria

Medical decision support systems (MDSSs) are widely utilized in developed countries to enhance clinical decision-making and improve healthcare delivery. However, many developing nations have yet to adopt and integrate these systems into their clinical practice. This study explores the willingness and readiness of physicians, healthcare managers, and other medical professionals to adopt and use MDSSs in their clinical operations to support patient diagnosis and treatment. A conceptual adoption model, based on an extended technology adoption model, was developed to guide the research. A cross-sectional quantitative survey was conducted across four Nigerian states, targeting both public and private healthcare facilities. A total of 1,177 valid responses were collected and analyzed using structural equation modeling. The findings revealed that factors such as awareness, perceived usefulness, ease of use, cost, compatibility with existing systems, and alignment with internal critical success factors significantly influence the adoption of MDSSs. Surprisingly, perceived risk and the availability of necessary infrastructure were not identified as significant determinants, despite the commonly acknowledged infrastructural limitations in many developing regions. These results offer valuable insights into the individual, organizational, and contextual factors affecting MDSS adoption. The study concludes with recommendations for policymakers and healthcare leaders on promoting MDSS adoption among clinicians, as well as suggestions for future research.
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