On the Increasing Need for Widespread EHR Adoption in Nigeria’s Public Health Institutions

On the Increasing Need for Widespread EHR Adoption in Nigeria’s Public Health Institutions

Electronic health records (EHRs) have been massively adopted as a significant tool in health delivery by health care providers and organizations.  It has brought significant improvements to the quality and efficiency of healthcare delivery. This is most evident in developed countries where EHRs have enjoyed widespread adoption at different levels of healthcare delivery. EHRs since their advent have significantly changed the way in which health information and data are collected, saved and shared.

EHRs are primarily meant to help improve on the delivery, management and other administrative process of the care the patient requires. This helps to create comprehensive record for patients that are useful to them individually and in making population health decisions by the appropriate bodies and authorized care providers. Paper records are difficult to store, maintain and losses (which are common) usually result in loss of useful patient information and data that are relevant to the patient individually and to the population in general.  The benefits of EHR to population health include contributions to the collection of cross-sectional and trend information about the health of populations, information on social and behavioral risks and other influences on population health.

The United States of America for example have the National Electronic Injury Surveillance System (NEISS) which is a system that aggregates robust injury reports across the country using data collected and extracted from EHRs of different hospitals that are part of the system. The datasets contain demographic information, narratives of the injuries, diagnosis and other important information relevant to the injuries.  With this system the American consumer safety commission can easily know which products are resulting in increased injury within the population, they can know how often cases of poisoning occurs without conducting any community studies. It has become a significant tool for surveillance of injuries in the community.

There are also Health Information Exchange (HIE) organization and systems that are created as a means of exchanging information between facilities that use Electronic Health Records, this facilitates the easy sharing of patient data between different facilities for continuation of care. This has also made some aspects of public health easier, for example Healthelink which is an HIE consortium that serves about 1.4 million people with 891 provider organizations in Western New York was used by the Erie County Department of Public Health in the surveillance of Hepatitis, STDs, food outbreak and Rabies investigation, it has played a role in time and cost savings through reduction in required public health field visits by helping to avoid unnecessary rabies post-exposure prophylaxis.

The usage of Artificial Intelligence (AI) in surveillance, prediction and provision of necessary recommendations on population health will also be reliant on the data generated from the EHR systems that will be adopted widely. This will improve the efficiency of community efforts and community health teams in predicting disease outbreaks, identify correlates among different datasets and any other possible use cases of AI in solving population health problems.

EHRs will help improve public health in all regards in Nigeria only if there is widespread adoption with the creation of exchanges especially for public health institutions which serve the largest numbers of the population. Achieving this cannot be done through private initiatives alone, European countries achieved this by central planning through policies, laws and incentives. The USA with its private oriented approach was able to achieve an adoption of about 83% due to the introduction of the Meaningful Use Policy by the US government which was a mix of incentives and penalties. Achieving this in Nigeria will require the Nigerian government to take the enabling seat and introduce policies and laws that will hasten widespread adoption and usage. The citizen’s health will be better for it.


Benson, T. & Greave, G. (2016). Principles of Health Interoperability (3rd ed.). London: Springer.

Friedman, D. J, Parrish, R. J, MD & Ross, D. A. (2013).  Electronic health records and US public health: current realities and future promise. American Journal of Public Health. 103(9), 1560–1567.        doi:10.2105/AJPH.2013.301220.

Heath. S. (2016). Reviewing the State of EHR Adoption Under Meaningful Use, MACRA. Retrieved here

Magnuson, J. A & Fu, P. C. (2014). Public health informatics and information systems. New York:

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