Practical guidance on web design, SEO, and EMR for healthcare providers in Nigeria
Waiting is the most common complaint in Nigerian healthcare and the most commonly misdiagnosed. The cause is rarely that clinicians are slow, and adding staff often fails to fix it.
New staff in small practices are usually inducted by being sat next to someone busy. It works eventually, teaches them that colleague's habits including the bad ones, and takes far longer than it needs to.
Most Nigerian practices are run administratively by the founding clinician, in the evenings, badly, because there was never a moment when hiring someone felt affordable. There are clearer signals than affordability.
A patient asking for a copy of their records, or a relative asking on their behalf, puts a practice on the spot. Deciding the rules in advance is much easier than deciding them at the counter.
Every Nigerian practice has lost power during a clinic. Very few have written down what happens next, which means the response depends on who is on duty and how calm they are.
Most clinic schedules assume every consultation takes the same time and nothing goes wrong. The first complicated patient of the morning then pushes the delay through every appointment after it.
A clinic phone that rings constantly is usually answering the same small set of questions all day. Writing the answers down, once, frees the desk for the calls that genuinely need a person.
Missed appointments are usually treated as a patient discipline problem. Most of them are caused by things the practice controls, and the cheapest fixes are not technological.
Keeping the paper system going during an EMR rollout is sensible insurance for a few weeks and a slow failure after that. The difficulty is that nobody wants to be the person who removes the book.
Demonstrations show a system at its best. The questions that determine whether you will still be happy in three years are mostly about what happens after the sale, and they are rarely volunteered.
Rejected claims are rarely rejected for clinical reasons. They are rejected for missing authorisation, wrong enrolment details, late submission and incomplete documentation, all of which are process problems.
Inventory modules fail for a predictable reason: they require perfect data entry to give useful output, and busy staff cannot sustain perfection. The systems that survive are the ones designed around that.
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