Date of Conferral

2-6-2026

Degree

Ph.D.

School

Health Sciences

Advisor

Cynthia Newell

Abstract

The increasing complexity of healthcare delivery in Ghana highlighted the need for accurate and timely data-driven decision-making in clinical settings. The study examined how implementation affects the accuracy of immunization records, the speed of clinical decision-making, and overall immunization coverage rates in Ghanaian healthcare facilities. A quasi-experimental, cross-sectional design was used to compare clinical encounters in facilities that implemented the EIR with those that continued using paper-based systems. The Technology Acceptance Model guided the assessment of how healthcare providers’ perceptions of the EIR affected system utilization, while the Data-Driven Decision-Making framework and Anderson’s Behavioral Health Theoretical Model provided additional conceptual support. Findings indicated that healthcare providers who used the EIR demonstrated improved accuracy in immunization status verification (r = 0.345, p < .001, M = 1.72, SD = 0.45), increased immunization uptake and patient follow-up (r = 0.171, p = .031, M = 1.79, SD = 0.41), and increased in patient immunization coverage rate (r = 0.503, p < .001, M = 1.92, SD = 0.28). Key factors that influenced EIR adoption included perceived usefulness (M = 1.72, SD = 0.45), system usability M = 1.79, SD = 0.41), and organizational support (M = 1.92, SD = 0.28). The potential implications for positive social change included strengthening immunization coverage, reducing preventable diseases, and improving equitable access to immunization services through enhanced digital data systems. These results supported the need for scaling EIR implementation across Ghana and offered evidence to inform future research, digital health policy development, and strategies for improving data-driven healthcare delivery in resource-limited settings.

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