A Nigerian hospital once agreed to deploy a new electronic medical records system with the full support of its management. Doctors were briefed, consultants were brought into the process, and the instruction came from senior leadership. Within weeks, however, the rollout had failed. Doctors quietly returned to paper charts, consultants ignored the new workflow, and a project that had secured every executive approval broke down at the point where day-to-day clinical work was supposed to happen.

Medismarts, the health-tech company founded in 2015 by Obinna Osuji and Damilola Oni, built the system behind that rollout. After the failure, the company shelved the product and started again.

That episode has become central to how Medismarts, which says on its website that it has more than 20 clients, now describes its approach to healthcare software. The experience also reflects a wider challenge in Nigeria's health technology sector. According to the company's view of the market, healthcare technology in Nigeria does not fail only because of limited ambition or funding. It often fails because hospitals are not single-user environments, and software designed around one category of user may not survive contact with the others who must use it. This is a problem that is not unique to Nigeria. Studies of EMR deployments in both developed and emerging markets have documented that clinician resistance, workflow disruption, and inadequate user-centered design are among the most common reasons these projects stall regardless of the country or budget involved.

A consumer app typically answers to one person. A hospital platform, by contrast, must serve doctors who need speed, nurses who need accuracy under pressure, administrators who need compliance records, finance teams that need claims to reconcile, and health maintenance organizations, or HMOs, that need the entire chain to be auditable. Each group can have a different understanding of what the software is meant to do. A product that satisfies one group while neglecting the rest is more likely to be quietly abandoned than formally rejected. That is what happened with the Medismarts electronic medical records, or EMR, rollout. Executive approval had led the company to believe adoption was settled, but the doctors who would use the system on the hospital floor had not been asked.

According to Medismarts, that gap between deployment and adoption now shapes its product philosophy. Instead of treating a signed contract as the finish line, the company treats the period after go-live as the more difficult part of implementation, because that is when software either becomes part of existing clinical routines or is bypassed by the people expected to use it.

Medismarts' current platform connects healthcare providers, HMOs, and claims processing within a single operational chain. The company points to its claims-processing activity as evidence of how far the platform has moved from the failed EMR deployment. The focus on claims processing sits inside a broader Nigerian health insurance landscape that remains thinly penetrated. Nigeria's National Health Insurance Scheme, established in 2005, was strengthened by the National Health Insurance Authority Act of 2022, which made health insurance mandatory for all citizens and legal residents. Despite that framework, coverage rates have historically remained in the single digits, meaning that the volume of claims flowing through any single platform represents a meaningful slice of a market that is still far from saturated.

According to Medismarts, its platform processed an average of roughly 798,000 healthcare claims annually across a sample of four HMOs in 2025. In June 2026 alone, the platform processed an average of about 67,600 claims across the same group.

For one of those HMOs, Medismarts said 17,697 of 18,859 submitted claims were processed in 2025, representing a completion rate of close to 94%. The company said regulatory reporting for this data is handled by each individual HMO or client rather than by Medismarts itself, though it did not specify which regulator its partners report to.

Vendor-provided figures can be easy to present. More difficult is independent confirmation that a platform holds up inside the institutions using it. In Medismarts' case, its HMO partners provide part of that validation. An IT infrastructure manager and a service centre lead at one partner HMO, as well as the executive director at a second partner HMO, have each spoken about the platform's reliability in everyday use. Their comments offer a form of validation from people who do not have a direct stake in how the company presents itself publicly.

The lesson Medismarts draws from its failed EMR project extends beyond healthcare. Enterprise software in regulated, multi-stakeholder industries in Nigeria can encounter the same problem: a founder may mistake a signed deal or executive endorsement for proof that a product will actually be used. The people who determine whether software survives are often not the people who approved it. They are the people who must open it every day, and building for them can be slower and less visible than building for a product demonstration.

Medismarts is still developing within that discipline. The failed EMR rollout did not end the company's ambitions in that part of the market, and the operating figures it now shares suggest that its platform has grown well beyond the early setback. The broader point, however, is not only about scale. It is that in healthcare technology, and in enterprise software more generally, the hardest problem is not always engineering.