A Three-Tier, Role-Based Architecture for Electronic Patient Records Management in Nigerian Secondary Hospitals: Design and Specification

Many secondary hospitals in Nigeria still use paper-based patient records, which are linked to redundant files, slow retrieval times, and disjointed departmental care coordination. The design and technical specifications of a Hospital Management System (HMS) with integrated electronic patient records are presented in this paper. The system is based on a three-tier client-server architecture that consists of a PostgreSQL relational data layer, a Node.js/Express.js application layer, and a React.js presentation layer. Registration, appointment scheduling, clinical consultation, pharmacy, laboratory, billing, reporting, and access control are the eight integrated functional modules that make up the system. These modules operate on a relational schema consisting of seventeen tables that have been normalized to the third normal form. The NIST RBAC standard serves as the foundation for the six-role role-based access control (RBAC) paradigm used in access control. The suggested design fully addresses locally relevant requirements, such as local health-insurance billing integration, that current platforms only partially address, according to an organized, criteria-based comparison against three widely used open-source platforms, OpenMRS, Bahmni, and HospitalRun. The work is provided as a verified architectural blueprint and specification for installation and subsequent empirical assessment in a Nigerian secondary-hospital scenario; it has not yet been benchmarked on an operational deployment as a design-stage contribution.