By Basillia Obinna
From misplaced case notes to repeated laboratory tests and delayed consultations, paper medical records continue to frustrate patients across Nigeria. Experts say digital technology can improve healthcare delivery, patient safety and disease surveillance.
For more than 40 minutes, Jonathan Okorie sat in the waiting area of a private hospital in Lagos while a nurse searched for his medical file.
It was not his first visit to the hospital. He had been receiving treatment there for about a week and had visited the facility the previous day.
Yet, despite being an existing patient, his case file could not be located immediately.
“The nurse spent over 40 minutes looking for my file,” Okorie told InsightWireNG.
“It wasn’t because the file was missing. There were simply too many patient files that had piled up after my last visit. Imagine waiting that long just because someone had to search through hundreds of paper folders.”
As he waited, another patient experienced a similar problem.
“As if that was not enough, another patient who met me at the same hospital faced the same fate. Her case was worse because her file could not be found at all. It is a regular occurrence,” he said.
Stories like Okorie’s are common in many hospitals across Nigeria.
Patients often wait while health workers search through shelves filled with paper files. When records cannot be found, laboratory tests are repeated, consultations are delayed and treatment is interrupted.
For Sola Ade, delays in retrieving hospital files are only part of the problem.
Receiving treatment at a public hospital in Lagos, Ade said the manual filing system often creates opportunities for manipulation.
“When you arrive at the hospital, you are given a number and your case note is supposed to be arranged according to when you came,” he said.
“But sometimes people influence the records officers with tips, and the file of someone who arrived later is moved ahead of yours. You may come early and still end up being the last person to see the doctor.”
According to him, locating patient files is frequently slow.
“Sometimes they tell you they cannot find my file. Sometimes, after paying for your file, you are asked to pay again for file clips, especially in public hospitals. The whole process gives room for manipulation.”
A records officer at one of the hospitals, who pleaded anonymity, said most patient records remain paper-based and many have no electronic backup.
“If anything happens to the file, the patient’s medical history may be difficult to retrieve.”
Health experts say these experiences show why Nigeria needs to modernise its health information system.
Electronic Medical Records (EMRs), Electronic Health Records (EHRs), telemedicine, artificial intelligence and big data analytics are increasingly being used around the world to improve patient care, reduce medical errors and strengthen disease surveillance.
According to the World Health Organisation (WHO) says digital health can improve access to quality healthcare, strengthen health systems and support Universal Health Coverage. Under its Global Strategy on Digital Health, WHO encouraged countries to adopt digital technologies that improve the quality and efficiency of healthcare while ensuring equitable access.
In the views of the WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, digital technologies, including artificial intelligence, are improving disease diagnosis, disease surveillance and health system management, while stressing that countries must ensure these innovations do not widen health inequalities.
Nigeria has also begun implementing reforms. The Federal Government’s Nigeria Digital-in-Health Initiative seeks to establish an integrated digital health system that allows patient information to be securely shared across healthcare facilities.
According to the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, digitising healthcare will improve patients’ experience, strengthen protection of health data and improve health outcomes.
The former Minister of State for Health and Social Welfare, Dr. Tunji Alausa, once acknowledged that Nigeria’s healthcare system remains fragmented because only a small number of hospitals currently use electronic medical records, while most still depend on paper documentation.
He said even where electronic systems exist; they often cannot exchange information across health facilities, making continuity of care difficult.
Alausa described the transition to a unified digital health infrastructure as “not merely a choice but a necessity.”
However, a research by the Federal University of Technology, Owerri, supports the government’s position.
In a study titled:”Revolutionizing the Healthcare Industry in Nigeria published in Researchgate, “The Role of Internet of Things and Big Data Analytics,” researchers concluded that adopting digital technologies such as cloud computing, big data analytics, remote sensing and Internet of Things devices could significantly improve healthcare delivery in Nigeria.
According to the researchers, “the proposed model of IoT and big data analytics will have significant impact on healthcare industry in Nigeria if adopted.”
The study carried out by Oluigbo Ikenna V., Nwokonkwo Obi C., Ezeh Gloria N. and Ndukwe Ngoziobasi G. also found that these technologies could support telemedicine, remote patient monitoring, epidemic prediction, fraud detection and more efficient healthcare management.
Digital health could also improve disease surveillance.
Instead of waiting for paper reports to move through different levels of the health system, health authorities can receive information in real time, making it easier to detect outbreaks, monitor disease trends and deploy emergency response measures.
The researchers identified epidemic prediction and control among the public health benefits of adopting Internet of Things technologies and big data analytics.
Despite these benefits, challenges remain.
Many health facilities still struggle with poor internet connectivity, unreliable electricity, inadequate funding and shortages of trained personnel to manage digital health systems.
The researchers recommended increased investment in digital infrastructure, training for healthcare workers and stronger policy support to accelerate the adoption of digital technologies across Nigeria’s health sector.
Digital records can cut hospital delays, strengthen healthcare delivery
Speaking on the growing push for digital healthcare in a chat with InsightWireNG, President of the Association of Health Records and Information Management Practitioners of Nigeria (AHRIMPN), Comrade Abiodun Afolabi, said the transition from paper-based records to digital medical records has become imperative if Nigeria is to improve healthcare delivery and achieve a successful digital health transformation.
According to him, electronic medical records would significantly reduce the long delays patients experience while hospital staff search for paper files, eliminate cases of misplaced or missing records, and improve continuity of care by providing healthcare workers with instant access to patients’ medical history, diagnoses, laboratory results, medications and treatment records.
“Digital medical records improve the efficiency, quality, accessibility and security of healthcare information. They make it easier to retrieve patient records, provide secure backup of health information and support better clinical decision-making, research and health planning,” Afolabi said.
He, however, cautioned that technology alone would not guarantee quality healthcare, stressing that poorly designed or poorly managed electronic systems could still produce inaccurate, incomplete or insecure information.
“Digitalisation should not be seen as simply replacing paper files with computers. The success of electronic medical records depends on sound information governance, proper documentation processes, data quality, confidentiality and the expertise of trained health records professionals,” he said.
Afolabi noted that while Nigeria has made progress through digital health policies and initiatives, the country’s readiness remains uneven due to persistent challenges, including unreliable electricity, poor internet connectivity, inadequate funding, shortage of equipment and limited technical capacity, particularly at primary and secondary healthcare facilities.
He therefore urged governments at all levels to adopt a phased implementation strategy by strengthening infrastructure, establishing national standards for electronic medical records, cybersecurity and interoperability, while investing in reliable power supply, internet connectivity, secure data storage and workforce development.
He also called on private healthcare providers to adopt secure and interoperable electronic medical record systems, invest in staff training and employ qualified Health Records and Information Management professionals to oversee data management and information governance.
Afolabi further stressed that Health Records and Information Management practitioners must remain at the centre of Nigeria’s digital health agenda, arguing that while technology can automate record storage and retrieval, only trained professionals can ensure that health information remains accurate, complete, secure, confidential and fit for clinical use.
“The issue is no longer whether Nigeria should embrace digital medical records. The real challenge is implementing systems that produce health information that is accurate, timely, accessible, secure and interoperable. Achieving this requires collaboration among government, healthcare institutions, technology providers, regulatory bodies and health information professionals.”
For patients like Okorie and Ade, however, digital health is about something practical.
It means spending less time waiting for hospital files, avoiding unnecessary repeat tests and receiving treatment without delays caused by a paper-based record system.
