Health management information systems are designed to generate information status of ongoing
health related activities to facilitate evidence based decision-making and effective management
of health care systems. It is widely known that effective HMIS exits but their affectivity declines
over time due to a number of reasons thus affecting service delivery. According to Ngafeeson,
(2015), introduction of health information within a complex adaptive health system has potential
to improve care but also introduces unintended consequences and new challenges.
One of the major challenges affecting health record is poor records management by people who
are saddled with the responsibility in various health institutions. Wong & Bradley (2009) reveal
that an effective medical records management is often lacking in most of the developing world
characterized by lack of requisite infrastructure. Besides, Lorenzi & Riley (2000) argues that
information systems failures occur for various reasons, including lack of psychological
ownership, communication problem, and cultural problems within the information system
organizations as well as failure to determine and maintain success criteria. Furthermore, lack of a
clear vision of change, ineffective reporting structure, low staff competency, lack of full support
from top management, confusion on roles and responsibilities, inadequate resources, failure to
benchmark existing practices, and inability to measure success and training factors also
contribute to ineffective health management information systems.
Health management information system staff are forced to undertake irrelevant tasks such as
typing official and non-official letters for senior management. This is as a result of lack of
coordination among various information systems, lack of interdepartmental and
intradepartmental coordination in terms of information sharing (Qazi & Ali, 2009).
Ojo (2009) reveals that staff with inadequate or poor knowledge of information and
communication technologies manages health records in most of the health facilities in Africa
while some facilities are faced with inadequate well-trained personnel. According to Qazi & Ali
(2009), in Pakistan before the 1990s several vertical programs with categorical disease specific
information systems resulted in fragmented data transmission which made assessment of
programs effectiveness difficult for managers. Coiera et al (2018), argues that poor user interface
design leads to error input and comprehension. For example, most EHRs intensive care units or
vital signs monitors and infusion devices may have different methods of presenting patient
identifying information requiring users to acknowledge their acceptance of entered data in
different ways. This inconsistency and lack of accepted and implemented standards force the
provider to constantly switch mental models regarding how each interface functions which
increases the likelihood for error.