Beyond technology: Understanding digital healthcare through patient experience and sociotechnical resilience in...

Digital transformation in healthcare systems within low- and middle-income countries offers significant potential to enhance operational efficiency and improve patient care. Ghana's implementation of the Lightwave Health Information Management System (LHIMS) and its transition to the Ghana Health Information Management System (GHIMS) represent important milestones in this process. However, limited empirical research has examined patients' lived experiences during such transitions, particularly how infrastructural instability and system changes shape care across different levels of healthcare delivery. This study addresses this gap by exploring patient experiences during the LHIMS-GHIMS transition in Northern Ghana.

The study adopted a qualitative phenomenological design grounded in Sociotechnical Systems Theory (STS). Semi-structured interviews were conducted with 30 purposively selected patients across metropolitan, municipal, and rural healthcare facilities. Data were analyzed thematically to identify patterns in patient experiences with digital health system use and disruption.

Two interrelated themes emerged. First, participants described digital systems as improving organization, reducing waiting times, and minimizing loss of medical records, particularly in metropolitan and municipal settings. Second, participants reported that system disruptions, such as power outages and network failures, frequently interrupted care processes, with these challenges being more pronounced in rural facilities. These findings highlight that while digitalization enhances efficiency, its benefits are conditional on infrastructural reliability and system stability.

Digital health transformation in resource-constrained environments is not merely a technological upgrade, but a sociotechnical process shaped by the alignment of infrastructure, organizational systems, and human actors. Sustaining its benefits requires strengthening infrastructure reliability, supporting healthcare workers, and continuously assessing patient experiences across diverse contexts to inform resilient, patient-centered digital health implementation.