This study explored possible success factors for health information management certification exams. Based on the American Health national certification exam for ekg Technicians Information Management Association (AHIMA) website, in 2018 and 2019, only 70 percent of first-time test takers passed the Registered Health Information Administrator (RHIA) exam; 26 percent passed the Certified Health Data Analyst (CHDA) exam in 2018; and only 10 percent passed the Certified Health Data Analyst exam in 2019. A quantitative systematic review and meta-analysis offered insight into factors related to passing certification exams. Sources included existing, relevant peer-reviewed and published literature since 1990 within 87 educational and health/medicine databases and 62 other articles and journal databases available at the University of South Dakota library. Outcomes from the systematic review include illumination of factors for passing health information management, healthcare, and education certification exams. Ultimately, this new information will help improve pass rates on certification exams. During the past 10 years, implementation of electronic health records (EHRs) has dramatically changed how patients experience care, how healthcare professionals document and exchange patient information, and how health information is managed and maintained. Further, challenges such as data quality, interoperability, and usability continue to provide opportunities for improvement in healthcare work and decision-making.1, 2, 3, 4, 5 According to Cyganek et al.,6 “electronic health records should be considered as one of the most complex data objects in the information processing industry.”. In 2018, only 63 percent of new graduates eligible for the Registered Health Information Administrator (RHIA) entry-level exam sat for the exam and passed, and only 26 percent of first-time test-takers passed the Certified Health Data Analyst