Slow utilisation of digital medical records at health facilities frustrates Nigerians

Temitope Abiola was full of glee when her HomeKit pregnancy test confirmed she was expecting her first baby. But to put a formal recognition of her new condition, she needed to go for a pregnancy test at a private hospital in her community. Getting there, she was asked to conduct a routine test for her […]

Temitope Abiola was full of glee when her HomeKit pregnancy test confirmed she was expecting her first baby. But to put a formal recognition of her new condition, she needed to go for a pregnancy test at a private hospital in her community.

Getting there, she was asked to conduct a routine test for her blood group, hepatitis B and C, HIV status and others to gain her medical records. But she informed the nurse on duty that she had done the test already a few months back when she was seeking medical advice on how to get pregnant.

“I was rebuffed and told it was the protocol to conduct such tests anytime they receive new patients even if the same test was done yesterday. I have no choice but to pay as the other hospital is far from where I stay.”

But that won’t be the last time she would pay for the same test during her journey to give birth.

“Two months to my due date I needed to leave my husband to another state where our parents reside to give birth there to get their support for my post-natal recovery. The government hospital I was told to go for antenatal care also made me undergo the same tests to register in the hospital, and when I was told I would require a caesarean delivery for my child, I still did the routine test.”

“I was able to afford all this because my family helped me. But imagine if it were poor families, how would they cope with all the duplication of tests? I believe that is why most Nigerians don’t go to the hospitals and prefer local alternatives. Suppose there is a policy that all hospital records are digitized and transferable among themselves, it would save costs for patients who pay for healthcare out of pocket.”

The story is, however, different for some patients at some facilities in Nigeria. One of such is the Garki Hospital which is located in the heart of the country’s capital city, Abuja.

Despite living more than 50 kilometers from Garki Hospital, Khadija Alhassan and her husband prefer to visit there for any outpatient services.

For Khadijah, the prompt services the hospital renders despite hundreds of patients that frequent it for healthcare services has been topnotch, especially the deployment of digital systems to obtain patient data and transfer within the hospital.

“Even though the hospital is managed by a private organisation but owned by the government, it is expected that lots of people will go there for medical care. But unlike what was obtainable before, you don’t need to go there by 6am to join the queue and other delays you face in typical government hospitals.

“My information is already in their system and with my registration code I don’t need to stay long before I am attended to whenever I visit the hospital,” she said.

Nigeria’s slow adoption of digital health records

The digitization of medical records, which is also referred to as Electronic Medical records, in public hospitals gained momentum in mid-2010.

According to the Chief Record Officer of the National Hospital, Abuja, Wada Aliyu, the federal government decided to digitalize medical records at hospitals to improve efficiency and provide better health care to patients.

“So, they deployed a software, Health in a Box. We understand that the idea initially was to monitor revenue but they have to go together. For that reason, the ministries of finance and health came in to digitize the healthcare services. That is what made most federal-owned healthcare facilities digital.”

He said the initiative covered the federal medical centres and teaching hospitals which is well appreciated in terms of growth and covered both the outpatient and inpatient services.

But the success story in the National Hospital and its ilk has continued to elude other public hospitals owned by state and local governments despite the efficacy of digitisation in providing efficiency and effectiveness in terms of data generation, data storage, data transfer and statistical analysis in hospitals.

The issue has captured the attention of the federal government with the inauguration of a committee to oversee the implementation of the Nigeria Digital Health Initiative (NDHI) to transform the health sector.

The former Minister of State for Health and Social Welfare, Dr Tunji Alausa, acknowledged that those currently operating digitized records systems are not “standardised to integrate, collect and manage data across institutions or built to succinctly share patients data in real-time.”

Interoperability still a challenge

Khadija Alhassan and her husband though have concerns should an emergency health situation arise.

She won’t be able to use the Garki Hospital due to its distance and would rely on a hospital closer to her locality in Suleja, a community on the outskirts of the country’s capital.

“I won’t be able to use my data with Garki Hospital but will need to do a new test for my new hospital to also have my data.”

She wished there was a system that allowed for easy access to her data from Garki Hospital in another hospital.

Speaking with Daily Trust, on the issue of lack of interoperability to transfer patient data from one hospital to another, Wada Aliyu said health information management or the health records system in the country is based on a ‘single jurisdiction’, meaning that every hospital is taking care of itself.

“It has its own system. Some more hospitals have similar software they are using, but they are doing it within their own jurisdiction, meaning that all their patients are seen using the computer system. All the documentation and the data are saved in the system. But when they are going to another hospital that may be using a different system, or because there is no linkage, this hospital will give them what is called medical reports or referral data. Where all that has been done will be documented so that the other facility will look at it and continue from there.”

He explained the situation is also due to policy issues as healthcare data is not like ordinary data and if mismanaged can result in litigation resulting in huge loss of money.

He also said that lack of standardization on what the country’s digital medical record should be is another issue that needs the collaboration of stakeholders, the Federal Ministry of Health and other regulatory agencies to come in and provide.

While noting that the country is already on the right footing with digitisation in the federal hospitals, he said they would serve as a beacon for the sub-nationals in driving digital services in their facilities for improved healthcare services devoid of human error.

This report is produced under the DPI Africa Journalism Fellowship Programme of the Media Foundation for West Africa and Co-Develop.