A framework for enhancing digital systems adoption in referral healthcare

Abstract

This study aimed to design a framework for enhancing digital systems adoption in healthcare, using Mubende regional referral hospital as a case study. The study was guided by three independent variables; technological infrastructure, human digital capacity, and organizational readiness, and the dependent variable: digital systems adoption. A mixed methods approach was adopted, using structured questionnaires and interview guides. Data was collected from a sample of 250 respondents, including clinical staff, administrative personnel, ICT support staff, and patients. Descriptive and inferential analyses were conducted using SPSS, while thematic analysis was used for qualitative data. Findings revealed that technological infrastructure significantly influenced digital systems adoption (β = 0.395, p < 0.001), with respondents citing poor internet access, frequent power outages, and limited equipment as major challenges. Human digital capacity also showed a strong positive relationship (β = 0.289, p = 0.004), with most staff lacking consistent training in the use of digital tools. Organizational readiness had a significant yet lower influence (β = 0.241, p = 0.016), particularly due to the absence of internal ICT strategies and weak management commitment. The study recommended that the Ministry of Health prioritize investment in ICT infrastructure, health facility leadership strengthen internal digital policies, and development partners support ongoing capacity building. A context-specific adoption framework and model were proposed to guide structured, sustainable digital transformation in Uganda’s healthcare systems. Keywords: Digital systems adoption, technological infrastructure, human digital capacity, organizational readiness, healthcare, Uganda.