Assessment of HIM Practices in Selected Tertiary Health Facilities

Health Information Management (HIM) is essential to contemporary health services: accurate collection, storage, processing, and use of health information enhance patient care, inform decision making, and optimize hospital operations. In developed countries, HIM has largely shifted from paper to digital systems, improving coordination and reducing errors (World Health Organization [WHO], 2020). Integrated electronic health records in the United States, United Kingdom, and Canada have yielded better service delivery, disease surveillance, and research capacity (WHO, 2020). By contrast, many low- and middle-income countries remain paper based, resulting in data fragmentation, inefficient patient tracking, and suboptimal planning (Numair et al., 2021). Although Rwanda and Kenya have made progress in digitization, most Sub-Saharan nations still struggle with outdated systems, hampered by inadequate infrastructure and limited technical expertise. Nigeria’s healthcare system comprises primary, secondary, and tertiary levels, with tertiary hospitals serving as specialized referral centers that handle complex cases requiring multidisciplinary coordination and advanced data management. Effective HIM in these settings is vital for managing voluminous patient data, facilitating clinical research, and informing policy development. Yet Ogunniyi et al. (2014) reported that most Nigerian hospitals rely extensively on paper documentation, leading to retrieval delays, loss of records, and lengthy patient wait times. Even where electronic health records (EHRs) are available, progress is hindered by budget constraints, insufficient staff training, and resistance to change among health practitioners. In Ogun State, teaching hospitals and federal medical centers face similar challenges. Opele and Adepoju (2023) found that at Olabisi Onabanjo University Teaching Hospital, inadequate ICT infrastructure, limited technical support, and reluctance of clinicians to adopt new systems impaired successful HIM implementation. Likewise, Oyedipe (2014) revealed that low awareness and limited utilization of electronic health systems among healthcare professionals in the North Eastern Zone of Ogun State adversely affected record keeping quality and operational efficiency. Combined, these studies underscore that without robust ICT infrastructures and comprehensive training programs, EHR initiatives remain underutilized and vulnerable to system failures. Beyond infrastructure and awareness issues, poor HIM practices directly impact patient satisfaction and clinical outcomes. Owolabi et al. (2021) demonstrated that delays in record retrieval, inaccuracies in medical documentation, and discontinuity in care processes undermine patient confidence and satisfaction. Their study at three tertiary facilities in Ogun State indicated that 65% of patients reported dissatisfaction linked to administrative inefficiencies in record handling. The authors recommend substantial investment in information systems and workflow redesign to enhance data accessibility, reduce waiting times, and build patient trust. Recognizing these barriers, the Nigerian government and international health bodies have enacted policies and strategic frameworks to strengthen HIM. The National Health Information System Policy advocates for standardized data collection, interoperability, and digital health initiatives aimed at modernizing health data management. Similarly, the National Digital Health Strategy outlines phased implementation of EHRs, capacity building, and regulatory reforms. However, the success of these initiatives depends on sustained funding, strong institutional commitment, and continuous professional development for HIM staff. Despite these policy efforts, there remains a significant empirical gap in assessing HIM effectiveness in Ogun State’s tertiary facilities. Most existing studies focus broadly on national trends or individual pilot projects, without comprehensive evaluation of system performance, user satisfaction, or patient outcomes. This study therefore seeks to fill that gap by systematically assessing current HIM practices in selected tertiary hospitals in Ogun State. Specifically, it will evaluate retrieval efficiency, regulatory compliance, system interoperability, and workflow efficiency, drawing on both quantitative metrics (e.g., average retrieval times, error rates) and qualitative insights (e.g., staff perceptions, patient satisfaction). By identifying key challenges and best practices, the study aims to inform hospital administrators, policymakers, and HIM professionals in Ogun State and beyond. The findings will offer evidence based recommendations to optimize HIM systems, enhance data quality, and support evidence based decision making. Ultimately, strengthening HIM practices in tertiary health facilities will contribute to improved patient care, more efficient resource utilization, and better public health outcomes across Nigeria.

The aim of this study is to assess the Health Information Management (HIM) practices in selected tertiary health facilities.

1. 1What is the average time taken to retrieve patient information in tertiary health facilities in Ogun State, Nigeria?
2. 2To what extent do tertiary health facilities in Ogun State adhere to national and international legal and regulatory requirements in their Health Information Management (HIM) practices?
3. 3How effectively do the HIM systems in tertiary health facilities in Ogun State integrate with other health information systems?
4. 4How do current HIM practices impact the workflow efficiency of HIM practitioners in tertiary healthcare facilities in Ogun State?

1. H1There is no significant difference in the time taken to retrieve patient information among the selected hospitals
2. H2There is no significant difference in the compliance of Health Information Management practices with legal and regulatory requirements among the selected hospitals
3. H3There is no significant difference in the interoperability of Health Information Management practices with other health information systems used in the selected hospitals
4. H4There is no significant difference in the workflow efficiency of Health Information Management practitioners among the selected hospitals