CHAPTER ONE
INTRODUCTION
1.1            Background of the Study Health care service delivery in Nigeria falls short of international standards resulting from poor state of health care infrastructure, shortage of medical professionals, threat of re-emerging infectious diseases, and poor sanitation. Over the last five decades post-independence, growth, and development in health care has been very poor. HIV/AIDS has regrettably been a very serious health challenge overtime. About 3.6 million of the populations are HIV positive. More than 300.000 individuals die from AIDS every year (Aiken et al. 2012). Another major problem is that of infant mortality. The World Health Organization Report, (2010) indicated an infant mortality of 110 per 1000 live births in Nigeria. As a comparison, the infant mortality in Sweden is 2.7 per 1000 live births. Poverty has compounded these problems to give low life-expectancy of 52 years for women and 49 years for men. Recognizable demographic differences exist in Nigeria with consequent disparity in availability of health care facilities across the country (Weiner et al. 2015). Adequate evalution of clinical data of patients like the electronic medical record systems help to improve access to health care in remote suburban areas and ensure improved maintenance of long-term care. Mark et al. (2014), in separate studies conducted to assess patient and community satisfaction, found discontent with community members who decried the poorly staffed and inadequately equipped Primary Health Centers (PHCs) in their rural settlements compared to hospitals in urban centers. Such demographic disparity in health care accessibility benefits from hospital information technologies and telemedicine to foster collaboration between clinicians in urban areas and those in rural settlements. Clinical data evaluation for patients includes strategic decision support systems and clinical documentation systems. Some of the clinical support systems include Laboratory Information Systems (LIS), Radiology Information Systems (RIS), and Computerized Order Entry (COE). Others are pharmacy information systems and personal data analysis systems with important added feature for messaging between providers and staff, and the ability to share data with other medical facilities. Telemedicine is a unique application of hospital information technologies. In its simplest form, telemedicine uses audiovisual information and communications apparatus to deliver health care services in a bid to modify socio-economic circumstances of the beneficiaries and improve accessibility to medical care. A paucity of government policy regarding the implementation of clinical data evaluation for patients exists in Nigeria. The lack of strategic government programs has culminated in the poor adoption of hospital information technologies in health care facilities across the country. Kahn et al. (2015) posited that the lack of access to modern medical health care facilities has compelled many Nigerian patients to seek treatment with traditional healers and patent medicine dealers. The more affluent echelon of the society resorts to medical tourism overseas to obtain health care services, resulting in a loss of foreign exchange to Nigeria. According to Donabedian, (2016), poor leadership in Nigeria has led to years of economic downturn affecting every aspect of social life. Rather than develop medical services in Nigeria, government officials and wealthy individuals frequently seek medical treatment abroad even for the most basic health care needs.