Health information systems (HIS) are critical systems deployed to help organizations and all stakeholders within the healthcare arena eradicate disjointed information and modernize health processes by integrating different health functions and departments across the healthcare arena for better healthcare delivery ^{[1][2][3][4][5][6]}[1,2,3,4,5,6]. Over time, the HIS has transformed significantly amidst several players such as political, economic, socio-technical, and technological actors that influence the ability to afford quality healthcare services [7]. The unification of health-related processes and information systems in the healthcare arena has been realized by HIS. HIS has often been contextualized as a system that improves healthcare services’ quality by supporting management and operation processes to afford vital information and a unified process, technology, and people ^[7][8][7,8]. Several authors assert this disposition of HIS, alluding to its remarkable capabilities in affording seamless healthcare [9]. Haux [10] modestly chronicled HIS as a system that handles data to convey knowledge and insights in the healthcare environment. Almunawar and Anshari [7] incorporated this construed method to describe HIS to be any system within the healthcare arena that processes data and affords information and knowledge. Malaquias and Filho [11] accentuated the importance of HIS in the same light, highlighting its emergence to tackle the need to store, process, and extract information from the system data for the optimization of processes, enhancing services provided and supporting decision making.

HIS’s definition was popularized by Lippeveld [12], and reported to be an “integrated effort to collect, process, report and use health information and knowledge to influence policy-making, programme action and research”. Over the course of time, this definition has been adopted and contextualized countlessly by many authors and the World Health Organization (WHO) ^{[3][8][13][14][15]}[3,8,13,14,15]. Although Haule, Muhanga [8] claimed the definition of HIS varies globally, in actuality, the definition has never changed from its inception, but on the contrary, it has been conceptualized over various contexts. Malaquias and Filho [11] reiterated this definition in the extant literature. These scholars affirmed HIS as “a set of interrelated components that collect, process, store and distribute information to support the decision-making process and assist in the control of health organizations” [11].

2. The Evolution of Health Information Systems

The concept of enhancing healthcare applications has always been the foundation of HIS, which posits that the intercession of information systems with business processes affords better healthcare services ^[7][16][7,21]. According to Almunawar and Anshari [7], many determinants, such as technological, political, social and economic, have enormously influenced the nature of the healthcare industry. The technological determinant, particularly the computerized component, is thought to be deeply ingrained in the enactment and functioning of HIS. According to Panerai ^[17][16], this single attribute can be held solely responsible for HIS letdowns rather than its accomplishment. The ownership of HIS has been contested in the literature, with some authors claiming that HIS belongs to the IT industries ^[18][22]. While IT has enabled many developments in various industries, it has also resulted in many dissatisfactions. Recently, there has been an insurgence from many industries, particularly the healthcare industries, who acknowledge the role of IT in optimizing and enhancing health initiatives but want appropriation of their integrated IS. However, according to the definition of HIS, it is presented as “a set of interconnected components that collect, process, store, and distribute information to support decision-making and aid in the control of health organizations”; thus, the disposition of HIS was established. Without bias, the development of HIS was conceived due to unavoidable changes and transformations within the global space. A good representation and consolidation of this dispute are within the realization that there is a co-existence of different related and non-related components in a system. In this case, the HIS is an entrenched system with several features, including technologies. Panerai ^[17][16] supported this notion and theorized HIS to be broad, stating that the relevance of its definition is contextual. In the study, HIS was reiterated as any kind of “structured repository of data, information, or knowledge” that can be used to support health care delivery or promote health development ^[17][16]. Thus, maintaining a rigid definition is of minimal practical use because many HIS instances are not directly associated with health development, such as the financial and human resource modules. Moreover, several different HIS examples are categorized according to the functions they are dedicated to serving within the healthcare arena. They highlight the instances of the existence of outliers that are not regarded as the normal HIS even though they contain health determinants data, such as socioeconomic and environmental, which can be used to formulate health policies. The development of HIS over the years has led many to believe they are solely computer technology. This notion has contributed dramatically to the misconception of the origin of HIS and the lack of peculiarity between the HIS conceptual structure and implemented HIS technology. The literature dates back the origin of HIS, which can be associated with the first record of mortality in the 18th century, revealing their existence to be 200 years or older than the invention of computers ^[17][16]. This demonstrates the emergence of digitalized HIS from the availability of commercialized episodes of “electronic medical records” EMR records in the 1970s ^[19][23]. Namageyo-Funa, Aketch ^[20][24] commended the advancement of technologies in the healthcare arena, recounting the implementation of digitalized HIS that significantly revolutionized the recording and accessing of health information. A study by Lindberg, Venkateswaran ^[21][25] highlighted an instance of HIS transition from paper based to digitally based, revealing a streamlined workflow that revolutionized health care applications in the healthcare arena. This HIS transition over the course of time has led to increased adoption of it within the health care arena. Tummers, Tekinerdogan ^[22][26] highlighted the landmark of HIS from its transition to digitalization and reported a current trend in healthcare that has now been extended with the inclusion of block chain technology within the healthcare arena.

3. HIS Structural Deployment

HIS’s unified front is geared toward assimilating and disseminating health gen to enhance healthcare delivery. HIS consists of different sub-systems that serve several actors within the healthcare arena ^[23][29]. These sub-systems are dedicated to specific tasks that perform various functions such as civil registrations, disease surveillance, outbreak notices, interventions, and health information sharing within the healthcare arena. It also supports and links many functions and activities within the healthcare environment, such as recording various data and information for stakeholders, scheduling, billing, and managing. Stakeholders are furnished with health information from diverse HIS scenarios. These include but are not limited to information systems for hospitals and patients, health institution systems, and Internet information systems. Sligo, Gauld ^[24][30] regarded HIS as a panacea within the healthcare ground that improves health care applications. Despite all the limitless capabilities of HIS, it has been reported to be asymmetrical, lacking interactions within subsystems ^[1][25][1,18]. Many decision making methods and policies rely on good health information ^[26][31]. According to Suresh and Singh ^[27][32], the HIS enables stakeholders such as the government and all other players in the healthcare arena to have access to health information, which influences the delivery of healthcare. The sundry literature further reveals accurate health information to be the foundation of decision making and highlights the decisive role of the human constituent ^{[23][26][28][29]}[29,31,33,34]. Furthermore, HIS can be classified into two cogs in today’s era: the computer-related constituent that employs ICT-related tools and the non-computer component, which both operate at different levels. These levels include strategic, tactical, and operational. The deployment of HIS at the strategic level offers intelligence functions such as intelligent decision support, financial estimation, performance assessment, and simulation systems ^[3][30][3,35]. At the tactical level, managerial functions are performed within the system, while at the operational level, functions including recording, invoicing, scheduling, administrative, procurement, automation, and even payroll are carried out. 

4. Health Information Systems Benefits

HIS, as an interrelated system, houses several core processes and branches in the healthcare arena, affording many benefits. Among these are the ease of access to patients and medical records, reduction of costs and time, and evidence-based health policies and interventions ^{[8][16][31][32][33]}[8,21,36,37,38]. Several authors revealed the benefits of HIS to be widely known and influential within the healthcare domain ^[33][38]. Furthermore, many health organizations are drawn to HIS because of these numerous advantages ^[18][34][22,39]. Moreover, investment in HIS has enabled effective decision making, real-time comprehensive health information for quality health care applications, effective policies in the healthcare arena, scaled-up monitoring and evaluation, health innovations, resource allocations, surveillance services, and enhanced governance and accountability ^{[31][35][36][37]}[36,40,41,42]. Ideally, HIS is pertinent for data, information, and broad knowledge sharing in the healthcare environment. HIS critical features are now cherished due to their incorporation with diverse technology ^[17][38][16,43]. The extant literature reveals the role of HIS to extend beyond its reimbursement.

5. Information System and Knowledge Management in the Healthcare Arena

5.1. Information System

The assimilation and dissimilation of health information and data within the healthcare system is an important task that influences healthcare outcome. Within the healthcare setting, IS plays a significant role in the assimilation and dissimilation of health information needed by healthcare stakeholders. Many continents endorse the deployment of IS mainly to consolidate mutable information from different sources within the systems. The primary objective for these systems’ deployment has been centered on bringing together unique and different components such as institutions, people, processes, and technology in the system under one umbrella ^[5][39][5,51]. An overview of the extant literature reveals that this has rarely been easy, as integration within this system has always been difficult in many contexts. In the context of HIS, many reported the integration phenomena to be problematic, attributing this to the global transformation within the healthcare arena ^[40][41][52,53]. This revolution, coupled with the advancement of the healthcare arena, has resulted in the need for robust allied health IS systems that incorporates different IS and information technology ^[5][18][5,22]. These allied health information systems are necessary to consolidate independent information systems within their healthcare arena use to enhance healthcare applications ^[42][43][54,55]. Organizations in the healthcare arena expect these systems to be sustainable and resilient; however, in order to satisfy these requirements, an integrated information system is needed to unify all independent, agile, and flexible health IS to mitigate challenges for HIS ^[44][56]. An aligned HIS that is allied is essential, as it supports health information networks (HIN) that subsequently enhance and improve healthcare applications ^[45][46][44,57]. Thus, many organizations within the healthcare settings are fine-tuning their HIS to be resilient and sustainable. However, the realization of a robust information system within the healthcare arena is challenging and depends on the flow of information as a crucial constituent for suave and efficient functioning ^[47][48][58,59].

5.2. Knowledge Management

The process of constructing value and generating a maintainable edge for an industry with capitalization on building, communicating, and knowledge applications procedures to realize set aspirations is denoted as knowledge management ^[49][60]. The literature reveals knowledge management as an important contributor to organizational performance through its knowledge-sharing capabilities ^[50][61]. In the healthcare industry, there is a high demand for knowledge to enhance healthcare applications ^[51][52][49,62]. Several studies reported that the deployment of knowledge management in the healthcare arena is set to enhance healthcare treatment effectiveness ^[47][50][51][49,58,61]. Many stakeholders such as governments, World Health Organization (WHO), and healthcare workers rely on the management of healthcare knowledge to complement healthcare applications. According to Kim, Newby-Bennett ^[50][61], the focus of knowledge management is to efficaciously expedite knowledge sharing. However, integrating knowledge from different sources is challenging and requires an enabler ^[50][61]. The HIS is an indispensable enabler of health knowledge generated from amalgamated health information within the healthcare arena ^[53][54][55][63,64,65]. Dixon, McGowan ^[56][66] asserted that efficacious modifications in the healthcare arena are made possible by knowledge codification and collaboration from information technologies. Similarly, some authors have pinpointed information and communication technologies within the healthcare arena to be a major determinant in the attainment of a sustainable health system development ^[47][58]. The knowledge management relationship with HIS is considered complementary and balanced, as it enables the availability of knowledge that can be shared. The importance of knowledge management is relevant for the realization of an enhanced healthcare application via HIS. Soltysik-Piorunkiewicz and Morawiec ^[47][58] claimed that the information society effectively uses HIS as an information system for management, patient knowledge, health knowledge, healthcare unit knowledge, and drug knowledge. The authors herein demonstrated how HIS facilitates knowledge management in the healthcare sector to improve healthcare applications. The role of HIS as an integrated IS and key enabler of healthcare knowledge management highlights its potential within the healthcare arena. From the conception of HIS and the records of its evolution, significant achievements have been attained that are demonstrated at different levels of its structural deployment. HIS deployment in several settings of healthcare have positively influenced clinical processes and patients’ outcomes ^[57][17]. Globally, the need for HIS within the healthcare system is critical in the enhancement of healthcare. Many healthcare actions are dependent on the use of HIS ^[58][59][60][67,68,69]. This demand is substantiated by the offerings of HIS in tackling the transformation and digitalization confronting the healthcare system. However, despite the need for HIS and its potential within healthcare, several barriers limit its optimization. Some authors posited the role and involvement of healthcare professionals such as physicians to be important measure that is paramount to decreasing the technical and personal barriers sabotaging HIS deployment ^[61][20]. Nonetheless, the design of HIS is accentuated on augmenting health and is considered to be lagging behind in attaining quality healthcare ^[62][70].