Digital technology integration in healthcare: A comparative review of hospitals in the United States and selected African countries

The incorporation of digital technology has become a crucial emphasis in the pursuit of efficiency, quality, and sustainability in contemporary healthcare operations. This study offers a theory-driven comparative analysis of digital technology integration in hospitals throughout the United States and chosen African nations: Nigeria, Kenya, and South Africa, utilising the Diffusion of Innovation (DOI) theory as the principal analytical framework. This review synthesises evidence from secondary data, including peer-reviewed literature, policy documents, and institutional reports, regarding the influence of policy environments, infrastructural readiness, workforce capability, and governance structures on the adoption and integration of digital health technologies in various contexts. The results indicate that U.S. hospitals possess a sophisticated and developed digital ecosystem characterised by extensive utilisation of electronic health records, artificial intelligence-driven diagnostics, telehealth, and interoperable systems, primarily attributable to robust regulatory mandates and continuous investment. Conversely, hospitals in the chosen African nations exhibit inconsistent and fragmented integration, hampered by infrastructural deficiencies, restricted digital competencies, and regulatory inconsistencies, yet supported by adaptable mobile-first and open-source innovations. Utilising the principles of prominent diffusion theories relevant to drive contexts, the constructs of DOI (relative advantage, compatibility, complexity, trialability, and observability) delineate varied adoption trajectories and opportunities for contextualised policy learning. The study finds that the digital divide in healthcare must be reduced through measures that integrate technical methods with institutional capacity, governance frameworks, and workforce development to ensure equitable and sustainable implementation in healthcare.