A hospital's memory deserves to be looked after together

There are stories that sound familiar from one hospital to the next. A patient who comes back to the emergency room ten years after their last visit, and whom the team struggles to trace in the archives. A doctor who prescribes a medication already prescribed elsewhere, simply because that information wasn't on hand. A family waiting an hour for an administrative document that, on paper, should take two minutes to produce.

In our hospitals and major university teaching hospitals, these situations are common — and they're not any one person's fault. A study published in 2025 in Health Research in Africa collected 284 questionnaires from healthcare workers, archivists, patients, and families. It paints an honest picture: 98.7% of patient records are still kept on paper, two out of three respondents say there is no dedicated archive room, and 90% don't know the exact retention schedule in place.

This isn't a lack of willingness. It reflects a simple reality: health facilities exist to treat patients, not to manage documentation systems. Their core mission is the patient. Archive management is an added burden, competing for resources and time that are already stretched thin elsewhere. This is exactly where Risin Health positions itself, bringing the hands, tools, and method that are often missing.

What a fragmented memory costs patient care

The most telling figure in the survey isn't about paper — it's about care. 52% of respondents believe that the current state of archive management has a direct negative impact on medical treatment.

In practice, this can mean:

1. clinical time spent reconstructing a medical history the patient has already shared several times;
2. decisions made without the full picture available;
3. confidentiality that's harder to guarantee when a file moves around without a clear trail.

A medical record isn't just an administrative document — it's a clinical memory. When that memory fragments, continuity of care suffers. This is also exactly what Risin Health helps its hospital partners rebuild, record by record, alongside the teams already in place.

A legal framework that exists, a method to strengthen

The country has a clear legal framework: Law No. 2013-450 protects personal data, and the Data Protection Authority publishes its texts on its official website. Yet 80% of the people surveyed say they aren't familiar with the details of these texts — an information gap more than a matter of willful non-compliance.

The study also points to an internal practice set by the head archivist at the facility surveyed: a 100-year retention period for patient records. That figure reflects a genuine intent to do things properly.

In other words, teams are moving forward with the resources they have, doing their best. That's a solid starting point — and it's exactly the kind of situation Risin Health steps into, working alongside teams on the ground to turn these good local practices into a structured, lasting system.

The real challenge is patient identity

Digitizing a stack of files solves little if each stack doesn't know it's talking about the same person.

The first building block is a unique patient identity, valid from registration through consultation, from the lab to the pharmacy, from billing to hospitalization. Without it, the same patient can end up with several different records depending on which department saw them first. It's also the first thing Risin Health puts in place with its partners: a shared, well-governed patient index built to last.

Then comes the method. Digitizing isn't the same as photographing. Each document benefits from being linked to:

1. an identifiable patient;
2. a dated episode of care;
3. a document type (consultation, imaging, lab work, operative report);
4. a confidentiality level;
5. an author, a modification date, an audit trail.

With this structure in place, what emerges is a genuine archive — usable, searchable, and able to grow with the institution.

The long haul: a challenge worth planning for together

An Ivorian medical archive today must meet a retention requirement exceeding 90 years — a horizon longer than the lifespan of most software, file formats, and even the IT departments that choose them.

Paper can last a long time on its own. Digital records need active support to do the same.

That's why a lasting digital archive is best thought of as infrastructure, not just software. It calls for:

1. backups that are actually tested, not just scheduled;
2. replication at a second site;
3. regular integrity checks;
4. document formats that will still be readable in fifty years;
5. a migration plan, because technology moves faster than 90 years.

This is something Risin Health plans for from the ground up, building long-term retention and format-migration mechanisms designed to carry records across decades alongside its partner institutions.

Access rights: getting the right information to the right person

A doctor treating a patient doesn't need the same information as billing staff, an archivist, or a network administrator. Clearly separating these roles helps avoid two opposite pitfalls: access being blocked when it's legitimate, and access being too broad when it isn't.

A well-designed archive logs every consultation: who viewed what, when, and why. It lets a facility answer a patient who wants to know who has accessed their file. It also allows staff to properly deny access that has no valid reason. This is one of the pillars of governance that Risin Health puts in place with its hospital partners.

The numbers that show real progress

A digitization effort measured only by scan quality misses the point. What actually matters are concrete indicators:

1. how many patients have a verifiable unique identity;
2. how many priority records are digitized and checked;
3. how many files are retrieved without manual searching;
4. the median time to retrieve a record;
5. the number of remaining duplicates;
6. the number of archive accesses logged;
7. the number of successful restore tests in the past month;
8. the number of confidentiality incidents reported.

An indicator that hasn't moved in six months is worth a closer look — a useful signal, not a verdict.

A challenge shared by many countries

This isn't an issue unique to one facility or one country. It's a global transition, moving at different speeds across regions.

The State of Digital Health 2023, based on responses from 67 countries to the Global Digital Health Monitor, makes this clear: 40% of participating countries were at digital maturity phase 3, 33% at phase 2, and only 22% at phase 4. And 90% of the countries studied only partially covered their national digital health needs.

Buying software isn't enough on its own — but it isn't a dead end either. What often makes the difference is governance, standards, skills, and a retention method built to outlast the software itself. This is what Risin Health brings: on-the-ground expertise, tools suited to low-connectivity environments, and support that doesn't stop at delivery.

What a well-designed archive really changes

Paper hasn't had its last word. It remains useful as evidence, as a source, as a safety net. But it can no longer be the sole memory system for an institution expected to retrieve a record across several generations.

Approached as infrastructure rather than an IT project, digitization brings three things paper alone cannot:

1. a unified identity, following the patient from one department to another, one decade to the next;
2. access traceability, protecting both patient and provider;
3. backup and migration capability, turning the archive into an asset rather than a liability.

It doesn't remove the institution's legal responsibility. It makes that responsibility more visible, more measurable, easier to stand behind — and it's this well-equipped chain of accountability that Risin Health builds with its partners, step by step.

The test that really matters

Picture a patient who returns to the facility fifteen years after their last visit. The team looks for their record. In a paper-based system, they hope to find it. In a well-governed digital system, they find it — and they know who has accessed it in the meantime.

That small test, repeated hundreds of times over twenty years, is what shows whether an archive holds up. And that's precisely the ground Risin Health chooses to stand on: alongside institutions, for the long run.

Sources

1. La Gestion des Archives Médicales en Côte d'Ivoire, Health Research in Africa, 2025. https://www.hsd-fmsb.org/index.php/hra/article/download/7035/5370
2. Autorité de protection de Côte d'Ivoire — Lois. https://www.autoritedeprotection.ci/lois
3. The State of Digital Health 2023, Global Digital Health Monitor. https://static1.squarespace.com/static/5ace2d0c5cfd792078a05e5f/t/656f97969301e337ada15270/1701812128734/State+of+Digital+Health_2023.pdf