Feasibility of Introducing Electronic Health Records at Federal Medical Centre

In recent years, electronic medical records (EMRs) have transformed healthcare systems worldwide, improving service delivery, enhancing data accuracy, and promoting continuity of care. Globally, it is estimated that over 90% of hospitals in high-income countries have adopted some form of EMR (van Velthoven et al., 2016). In contrast, low- and middle-income countries (LMICs), including Nigeria, continue to struggle with the adoption and implementation of electronic health technologies, despite their known benefits to public health infrastructure. Health information systems (HIS), particularly electronic medical records, are foundational to effective and efficient healthcare delivery. EMRs support the systematic collection, storage, and retrieval of patient health information, enabling timely decision-making and reducing clinical errors (Adedeji et al., 2022). Globally, countries have adopted EMRs at varying rates. High-income settings benefit from robust infrastructure, stable funding, and institutional commitment, leading to more integrated and interoperable systems (van Velthoven et al., 2016). Conversely, LMICs face fragmented adoption patterns, characterized by localized pilot implementations, funding dependencies, and limited national health informatics policies. Sub-Saharan Africa exhibits a growing yet inconsistent trajectory in EMR deployment. Research shows that while some countries in the region, like Rwanda and Kenya, have made commendable progress with national-scale EMR rollouts, others, including Nigeria, are still in early stages, grappling with fragmented efforts and systemic bottlenecks (Akwaowo et al., 2022). In Nigeria, EMR implementation remains largely experimental and institution-specific, with many hospitals still relying on paper-based records for clinical and administrative functions. Although federal initiatives such as the National Health ICT Strategic Framework exist, their impact has been limited by inconsistent funding, lack of standardization, and poor implementation follow-through (Ogaji & Anyanwu, 2021). The healthcare industry has increasingly recognized the transformative potential of electronic health records (EHRs) in improving healthcare delivery, efficiency, and patient outcomes. An EHR is a digital version of a patient’s paper chart, which contains comprehensive, real-time data accessible to authorized users (WHO, 2022). Globally, the adoption of EHR systems has been associated with improved coordination of care, reduced medical errors, enhanced data management, and increased operational efficiency (Zhou et al., 2023). This study aims to explore the feasibility of introducing EHRs at the Federal Medical Centre (FMC) Bida, Niger State, in light of global trends and local contextual realities. EHRs are pivotal in modernizing healthcare systems, ensuring that patient information is systematically stored, retrieved, and utilized (Manca, 2022). They facilitate interoperability among healthcare facilities, promote data-driven decision-making, and support comprehensive documentation of healthcare services (Olaniyi & Afolabi, 2023). Developed nations such as the United States and the United Kingdom have reported significant improvements in healthcare quality and patient safety following the widespread implementation of EHRs (Bhatt et al., 2022). In low- and middle-income countries (LMICs), EHRs have been instrumental in addressing inefficiencies in record-keeping and minimizing information loss (Adeleke et al., 2023). Nigeria has witnessed growing interest in digitizing health information systems due to challenges associated with traditional paper-based records, including data fragmentation, limited accessibility, and increased likelihood of errors (Ogundele et al., 2022). Despite this recognition, the pace of EHR adoption in Nigeria remains slow, hindered by infrastructural deficits, lack of technical expertise, cost implications, and resistance to change (Eze et al., 2023). Several government-led initiatives, including the National Health ICT Strategic Framework (2020-2024), have emphasized the importance of integrating ICT in healthcare, yet many facilities still lack the foundational systems required for full-scale implementation (Federal Ministry of Health, 2021). FMC Bida is a tertiary healthcare institution located in Niger State, Nigeria. It provides a wide range of medical services to a diverse population from Niger State and neighboring regions. As a referral center, it is burdened with managing large volumes of patient records, necessitating efficient data management systems. Currently, FMC Bida predominantly relies on manual record-keeping, which poses several challenges, such as delays in retrieving patient files, loss of critical information, and inefficiencies in patient care coordination (Abubakar et al., 2023). These issues not only compromise the quality of healthcare but also impede research and administrative efficiency. The implementation of EHRs at FMC Bida has the potential to address these challenges by streamlining processes, improving data accuracy, and ensuring secure storage of patient information. Furthermore, an effective EHR system can enhance research and policy formulation by providing reliable and comprehensive data on healthcare trends (Olatunji & Okonkwo, 2022). According to Adetunji et al. (2023), EHRs can significantly enhance continuity of care, reduce duplication of diagnostic tests, and improve clinical decision-making. Additionally, electronic records offer audit trails and enhanced data security features that surpass paper systems (Lambo et al., 2024). Several factors must be considered when assessing the feasibility of EHR implementation. These include infrastructure readiness (power supply, internet connectivity, and hardware), software compatibility with existing workflows, availability of trained ICT personnel, institutional leadership support, and budgetary allocations (Okeke et al., 2023). A study by Adebayo et al. (2023) noted that facilities with clear digital health strategies and support from management were more likely to successfully adopt EHRs. In this context, assessing the current state of readiness at FMC Bida is crucial to determining potential success. Resource-limited settings such as Nigeria’s tertiary hospitals stand to gain immensely from EHRs. For instance, studies have shown that EHRs facilitate disease surveillance and epidemic response, particularly in areas affected by recurrent public health emergencies (WHO, 2022; Eze & Okonkwo, 2024). Furthermore, digital records improve administrative accountability, streamline billing processes, and allow for better resource allocation (Olawale et al., 2022). Lessons from other countries can inform the implementation process in FMC Bida. In Rwanda, the introduction of the OpenMRS platform a free, customizable EHR solution demonstrated that even low-resource settings can successfully digitize patient records with appropriate technical and institutional support (Zhou et al., 2023). Similarly, in Kenya, the AfyaPro system improved documentation and healthcare quality in multiple government hospitals by tailoring EHR features to local contexts (Adetunji et al., 2023). These cases highlight the importance of adopting scalable and context-sensitive digital tools that align with existing capacities. In Nigeria, pilot projects such as the adoption of EHRs at the University of Nigeria Teaching Hospital (UNTH) in Enugu have offered practical insights into the challenges and opportunities of digital transition. Ogundele et al. (2022) noted that key challenges included limited stakeholder engagement, inadequate training programs, and infrastructural gaps. Nonetheless, staff members acknowledged that EHRs greatly improved patient tracking, reduced delays, and enhanced communication across departments. These experiences stress the need for proactive change management and capacity-building initiatives. Another critical dimension of feasibility is user acceptance. Healthcare workers must perceive EHR systems as beneficial, easy to use, and reliable (Bhatt et al., 2022). Research suggests that systems perceived to add administrative burden or disrupt established routines often face resistance from users (Onwujekwe et al., 2024). Hence, designing an EHR solution that integrates seamlessly into existing workflows and supports clinical duties is essential for acceptance and sustained use. Training and continuous professional development are equally vital to ensure that staff can use EHR tools effectively.

The aim of this study is to assess the feasibility of implementing Electronic Medical Records (EMRs) at the Federal Medical Centre (FMC).

1. 1What health records systems are currently in use at the Federal Medical Centre (FMC) Bida, Niger State?
2. 2What infrastructural, financial, and technical resources are required for the implementation of an Electronic Medical Records system at FMC Bida?
3. 3What is the level of readiness and competence of health information management staff in the use of Electronic Medical Records systems at FMC Bida?
4. 4What factors influence the implementation of Electronic Medical Records systems on clinical and administrative workflow within FMC Bida?