Assessing the Perceived Effectiveness of Hospital Information Systems in Ghana: Agreement Between Two Information System Success Models Using Bland–Altman Analysis

Abstract

Introduction: This study evaluated the effectiveness of hospital information systems (HIS) in 25 hospitals under the National Catholic Health Service in Ghana, using two information system success models (ISSM): an extended six-dimensional ISSM and the upgraded seven-dimensional DeLone and McLean model. The aim was to assess HIS effectiveness from the users’ perspectives and determine the level of agreement between the two models. Methods: A cross-sectional survey design was employed. Data were collected using two structured self-administered questionnaires based on the respective ISSM frameworks. Descriptive statistics were used to summarize user characteristics and system performance. The HIS effectiveness rate was calculated as a normalized percentage score. Within each construct, all items were weighted equally, and no differential weighting scheme was applied to the items. Effectiveness rates were classified as high (≥75%), moderate (50%–<75%), low (25%–<50%), or very low (<25%). We used Bland–Altman analysis in a descriptive way to assess the agreement between hospital-level normalized effectiveness scores from the E-ISSM framework and the U-DM framework. Results: A total of 1,416 (81%) out of 1,738 HIS users participated in the study. The majority of respondents were men (729, 51.48%). More than 77% were in the 30–44 years age bracket. More than 90% had a tertiary education. Most of the users (1232, 87%) had more than six years’ experience with HIS. The overall HIS effectiveness rate was above 80%, indicating high perceived HIS performance among users. Bland–Altman analysis showed that 96% of hospital mean effectiveness scores fell within acceptable limits (75.5%–87.0%), and regression analysis found no significant proportional bias between the models. Conclusion: The findings indicate that HIS in the surveyed Ghanaian hospitals is perceived to be highly effective. Both ISSM tools are reliable and can be used in future assessments of HIS effectiveness.