In 2018, a Nigerian startup achieved something even the largest U.S. electronic medical records (EMR) companies are still working toward: a centralized medical records system accessible to patients.
This innovation had the potential to redefine healthcare access in Nigeria and beyond. Yet today, Casenote is inactive, a victim of systemic challenges that hinder technological advancements in healthcare.
Casenote, a secure mobile health platform, was created to address fundamental problems plaguing the healthcare sector: inefficient data collection, limited access to timely medical information, poor health-seeking behavior, and the high cost of treatment.
The goal was simple: ensure continuity of care, reduce medical errors, and improve efficiency in hospitals.
Today, however, the platform sits in “deep hibernation”, a cautionary tale of innovation without sufficient institutional support.
Casenote’s genesis story is rooted in a near-fatal incident. During an emergency department shift, Oghosa Evbuomwan, the founder, witnessed a woman brought in unconscious, with dangerously low blood pressure. She had unknowingly doubled her hypertension medication after receiving a prescription at a free medical outreach, then taking her regular medication at home.
“Had she arrived just five minutes later, she might not have survived,” recalls the founder. A lack of accessible medical history nearly cost her life. Had she been able to share her records with the outreach team, the incident could have been avoided.
This close call highlighted a critical gap in healthcare: the absence of portable, patient-controlled medical records that could prevent such dangerous scenarios.
This experience catalyzed the development of Casenote, a platform designed to “enable continuity of care” by giving patients control over their medical history with secure access management and comprehensive audit trails.
Despite its promise, Casenote struggled to gain traction at scale. While several hospitals in Lagos used the platform, expanding beyond this required government buy-in.
In many countries, including the U.S. and Europe, governments actively support EMR adoption through policy and financial backing.
Nigeria lacked this commitment. Even a well-funded competitor backed by Microsoft failed despite offering free hardware to hospitals.
Government engagement was critical because of data sovereignty issues; handling medical records means scaling through regulatory frameworks.
The absence of structured policies supporting digital health innovation left startups like Casenote in limbo.
Hospitals expressed interest but couldn’t afford the costs, and unlike in other regions where hospitals receive government funding to adopt such platforms, Casenote had no such backing.
Another major hurdle was resistance to change. Many hospitals and medical professionals were skeptical of digital record-keeping.
Some asked Casenote to pay them to use the platform, assuming monetization would come from selling patient data; an assumption that ran counter to the startup’s ethical standards.
Others simply preferred traditional paper-based methods. Even when trials demonstrated improved efficiency, adoption remained slow.
Despite limited adoption, Casenote demonstrated meaningful impact when implemented. A Surulere hospital’s patient survey revealed overwhelmingly positive feedback, with patients willing to pay additional fees for access to the service.
Yet, despite this acceptance, the hospital began charging patients an additional access fee, without sharing any revenue with Casenote. Another hospital in Ikeja used Casenote to allow its Chief Medical Director to monitor operations remotely while traveling.
The platform also showed promise in government settings, receiving positive feedback from a Lagos State Government healthcare center serving civil servants.
During Lagos’ public service health day, Casenote digitized medical records that would traditionally have been recorded on easily lost paper slips, creating accessible digital accounts for patients.
Casenote also implemented decision tree AI as early as 2017, launching it officially in 2018, years before generative AI would capture global attention with ChatGPT’s release in late 2022.
This functionality helped streamline patient management and improve diagnostic accuracy. However, broader AI adoption in Nigerian healthcare remains limited due to economic constraints and underdeveloped infrastructure.
The contrast between Nigeria’s healthcare digitization and its banking sector is striking. “Nigerian banks achieved a digital revolution despite being just as regulated, if not more, than the health sector,” notes the founder, who has lived in multiple countries including the US, Ghana, Mexico, UAE, Switzerland, Germany, and France.
Nigeria’s digital banking infrastructure outperforms those of these countries. If we had applied the same commitment and innovation to digital health, we could have been a global model for success.”
Casenote’s future remains uncertain, with the founder expecting continued hibernation. The platform represents a missed opportunity for Nigeria to establish leadership in digital healthcare.
There is no shortage of innovative ideas, but without institutional support, many of them struggle to survive.
“If our leaders get it right and we prioritize research, development, and innovation, there’s no nation we can’t surpass in tech-driven advancements, especially in healthcare,” the founder reflects. “The potential is there; what’s missing is the will to harness it.”
This sentiment echoes across many sectors in Nigeria, where momentary progress, like the stock exchange growth in the early 2000s, comparable to China’s, has given way to widening gaps.
Countries like France and Singapore successfully implemented centralized health records because their governments prioritized it. Nigeria could do the same and lead Africa in digital healthcare. Instead, progress has stalled.
AI is already redefining global healthcare through improved diagnostics and patient management, but Nigeria risks falling further behind without addressing fundamental infrastructure and commitment issues.
Without resolving these foundational challenges, even the most innovative healthcare technologies will struggle to take root and flourish in Nigerian soil.
For Nigeria to take its place in tech-driven healthcare, a fundamental shift in mindset is needed. Investment in research, development, and structured policies is crucial to creating an environment where innovations like Casenote can scale.
The question remains whether future healthcare innovations will face the same fate or if Nigeria will finally create the conditions for digital health solutions to succeed.
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