Research Topic
A framework for designing and deploying e-health
systems in developing countries
Abdul Wahid Samadzai
PhD Student
Institute of Informatics, Tallinn University
2014
Contents
• Problem Area
• Introduction & Related Definitions
• Health information systems in the developing
countries
• Health Management Information System & ICT
• The role of e-Health System in Information Society
• Our Possible Contribution
• Group Activity
• References
Problem Area
Health care system is one of the major issues for
developing countries and thus the information
technology is becoming progressively more important
now a days.
Health is one of the most important and valuable things
in human life. Every nation is aware of its public health.
Each year millions of people die from basic health care
deficiencies.
Problem Area (Cont.)
Most of the people in the rural area don’t even know
much about the technological improvement over the
world. Even the people who live in the rural areas are
worried about the basic needs of their daily life;
sometimes they depend on their local health facilitator
who has no academic knowledge of medicine. Health
care facilities available in the Government hospitals are
having not enough seats for patients and there are
always a lack of doctors, nurses, proper medical
instruments and free medicines.
Problem Area(Cont.)
Local pharmacies are selling medicine with or without
prescription from the doctors. So the abuse of selling
medicine that affects the general people suffering
different diseases and young generations getting
addicted which spread out over the country.
Most of the doctors prescribe medicine on a hand
written prescription paper and giving suggestion to
make the laboratory test to the patients to verify their
diseases.
Problem Area(Cont.)
Mostly, patients lose their previous prescription and also
the laboratory test report which will create problem to
doctors to verify their previous diseases and to make
decisions. At present in the cities, healthcare and
diagnostic centers practice limited applications of
electronic patient record mainly in the diagnostic
services but having no share or access to their database
in the local hospitals
Introduction
• Health information technology (HIT) consists of set
of technologies with a great diversion for transmitting
and managing health data for the use of all
stakeholders.
• Stakeholders of health information include payer,
providers and all other groups having interest in
health and health system.
Health information technology
Health information technology (HIT) means the use of
computer in the form of physician digital assistance,
electronic health records, computerized physician order
entry system by doctors, patients, hospitals,
laboratories, x-ray facilities and all other stake holders.
Health information technology is very important part of
constantly changing environment of health care system.
With the use of HIT, health related information can be
communicated well and can be used in evidence based
decision making process .
Health management
Health management is the intersection of information
science, computer science, information technology and
health. It deals with the resources, devices, and
methods required in optimizing the acquisition, storage,
retrieval, and use of information in health and
biomedicine. This includes not only computers but also
clinical guidelines, formal medical terminologies, and
information and communication systems.
Eelectronic Hhealth Record
• A national health information
system
• A way for medical doctors to
exchange health records
• Access for the patient to his or her
health records through a
designated patient’s portal
• Health care providers are able to
enquire patients’ time-critical and
general data
• The system stores the patient’s
medical history and is a vital
information source for physicians
Digital Images
• Electronic Health Records has separate links to
analysis results
• No need to make repeat analysis because of loss of
images
• (Foreign) experts can
be easily included in
medical procedures
• More efficient use of
analysis made with
complex diagnostics
equipment
Digital Registration
• Overview of vacant reception times of all medical
specialists of the given area and a possibility to
book/cancel the reception time through a web portal
• Registration systems of medical establishments
continue to work in parallel
• Enables to remind the patient
about the reception time
• Provides an objective and
accurate survey of the length of
treatment queues in health care
establishments for health care
management and national
statistics
Health systems levels
In order to improve the coordination between health
systems levels, the flow of necessary information needs
to be understood. The flow of health data from the
lower level (primary health facilities) to higher level
(secondary facilities) needs reliable data from the lower
level. The upper levels where strategies and plans are
made rely on the information collected from the lower
level (operational level). Proper data collection methods
allow regular monitoring of health information systems.
Levels of health care system and the data flow
Health information systems in the developing
countries
Health information systems(HIS) are the systems for
collecting and processing health data from different
sources. HIS have become a crucial component for
strengthening the health systems in developing
countries. There has been tremendous growth of these
systems in recent years; this has been the result of
advancement of technologies, which is taking place all
over the world.
Health information systems in the developing
countries(Cont.)
Health information system emergence has therefore lead
to shifting from paper based to computer-based ways of
processing health information. This shift has increased
the opportunities of manipulating patient data
efficiently. However, it has also raised challenges of
technological complexity in using the advanced tools of
processing health data. The usage of health data is
extended not only for patient care and administrative
purpose but also for planning and decision making in
improving health service
Health information systems in the developing
countries(Cont.)
The lack of shared standards in data collection methods
cause the gaps in reporting health data as it might lead
to important data not to be reported. Furthermore lack
of coordination between health care system levels in
reporting health data lead to poor utilization of the
collected data which might therefore affect the quality
of service that is offered by health management
systems.
Information and communication Technology in
Health
Information and communication technologies (ICT) are
being widely used in health management system. Rapid
advancements in ICT in the last decade or so provide
solutions to the problems in healthcare management
systems. These include a wide spectrum of issues such
as patient safety, dietary management, telemedicine,
digital imaging and document management.
Information and communication Technology in
Health(Cont.)
The definition of healthcare system has changed due
to the advancement in ICT. Quick and fast access to the
medical data is available to all the stakeholders
through internet and the developing countries may
take advantage of it. Having said that, there is a
financial constraint as well and most of the developing
nations are not in a position to spend huge amount
on healthcare projects.
Information and communication Technology in
Health(Cont.)
ICTs enable online communication about medical issues
and diagnosis of complicated diseases by linking
medical practitioners who are separated geographically.
They have the potential to change the delivery of health
services and patient care, as well as the management of
health systems. e-health is an emerging field in the
intersection of medical informatics, public health and
business, with referral and information delivery
enhanced through the Internet and related technologies.
Information and communication Technology in
Health(Cont.)
In a broader sense, the term characterizes not only a
technical development, but also a state-of-mind, a way
of thinking, an approach, and a commitment for
networked, global thinking to improve healthcare
locally, regionally and worldwide by using information
and communication technologies.
Mobile technologies in health systems
The dramatic advancement of mobile technology has
geared new opportunities of improving social lives in
developing countries. The societies are now becoming
mobile oriented and therefore, there is an increased
pressure on the efforts of exploiting this technology in
improving social services. Usage of mobile technologies
in developing countries could now be able to handle
many existing problems of their health systems; data
collection process is one of the aspects that can be
fuelled by exploiting mobile technology as enabling
technology in improving the accuracy and efficiency of
the process as whole.
Central Health Database Management System of
e-Health Card
The Central Health Database Management System
explores the connectivity with different service center,
where the physician and other service units will have
the rights to use on customer data through the e-Health
card system. The platform performs several stages to
provide a better e-Health card service to the citizens.
e-Health Card Service Center Connectivity Unit
The e-Health card service center will help the citizens to
learn the advantages of different type of health care
services for the patients. The e-Health card service
center will give the facilities to the citizens about their
health literacy.
From this health service center people will know
how they are working behind the technology and
their connectivity with each other, and their
responsibilities of different healthcare units.
e-Health Card Service Center Connectivity
Unit(Cont)
However, e-Health card information service center
will provide the information to assist in accessing
various public health resources. This service will make
sure a better and secure health service for every citizen.
Verifying National ID Card
After arriving at the e-Health card service center, the
patients will be verified personally with his National
ID card and proceeded to continue his/her queries
regarding e-Health care services. After verification of
the patient, e-Health card of the patient will be issued
and made an appointment with the doctor for his/her
treatment.
The role of e-Health System in Information
Society
People, as part of the society, form the core of health
systems. They use health services, contribute finances,
are care givers and have a role in developing health
policies and in shaping health systems. In all these
respects, there is growing pressure for public
accountability and increased response to inputs from
civil society. The manner in which the state responds to
these changes, and the extent to which society actors
are recognized and included in health policies and
programs, are some of the critical factors determining
the course of public health today.
The role of e-Health System in Information
Society(Cont.)
society has a long history of involvement in public
health. Early public health actions to clean up American
cities in the 1800s, for example, were led by well
known public figures supported by women's’ groups.
However, the recognition of civil society’s contribution
to health has varied over time. One of the most
significant developments in the recent past has been the
1978 Alma Ata declaration, which is considered a
landmark for recognizing people’s participation in
health systems as central to Primary Health Care and for
recognizing the role that organized social action plays in
securing health gains.
The role of e-Health System in Information
Society(Cont.)
• Patient Portal – access by one’s ID card to his or her
medical data regardless of time and place
• Patient no longer needs to carry papers between different
physicians
– Physicians have an objective and accurate overview of
the patient’s health history
– In collecting data to the electronic health record it is no
longer necessary to recall earlier diseases or drugs
– Better overview of the health history improves the
medical quality
The role of e-Health System in Information
Society(Cont.)
• Improves and speeds up exchange of information
– between doctors of different specialisation
– between specialised and family doctors for mutual
counselling, considering second opinions
• The system provides and overview of time-critical data of the
patient
• A more comprehensive and faster overview of the medical
history
– earlier visits and diagnoses
– results of research and analyses
– issued prescriptions
Our Possible Contribution
• My research possible contribution to the e-health
system is to develop and evaluate an approach for
designing and deploying e-health systems in developing
countries.
• This is the goal of my research in the broad area of eHealth system.
Research questions
• The main question of the research is:
How to support developing countries in development of
health management systems?
• In order to answer to the main question, we need to
answer to following sub-questions:
● To learn how does a health Information Systems
Work already in developed countries?
● What practices from such scenarios can be applied
for developing countries and what cannot?
Research questions(Cont.)
● What the main obstacles are exists in developing
countries for introduction of solutions that are exists
in developed countries?
● What are the critical issues affecting the introduction
of a health management information system in
hospitals on the district level?
Research Methods
We will use the qualitative research approach. In this
case we will conduct the research work in the following
stages:
• Data Collection: In this research, relevant research
data will be collected. New data sources allow us to
learn from and improve with each patient’s
interaction with the health care system.
Research Methods(Cont.)
• Data Analysis: Collected data has been further
analyzed to resolve the existing problems in the
healthcare system. Data that is collected and available
does not on its own support better care, improve
system performance or inform health policies. As
noted, the volume of health data being collected and
made available is increasing, and its nature is
changing; this is transforming how data is analyzed
and used.
Group Activity
Group of 4-5 persons
List the challenges of e-Health system in developing
countries. (15 Minutes)
Present your findings. (4 Minutes)
References
[1] M. Aanestad, E. Monteiro, H. Kimaro, E. Macombe, G. Macueve, F. Mukama, H.
Muquingue, L.J Nhampossa, and J. Lungo, Strategies for development and integration
of health information systems: coping with historicity and heterogeneity. Working
paper, University of Oslo 2005
[2] Oladosu J. B. (2011). Framework For A Service-Oriented Mobile E-health
Infrastructure For Rural and Suburban Healthcare; A Ph.D. Thesis in the Department of
Computer Science and Engineering, Ladoke Akintola University of Technology,
Ogbomoso, Nigeria.
[3] Chetley, A. (2006), Improving Health, Connecting People: The role of ICT in the
Health Sectors of developing countries. A framework paper. InfoDev.
[4] Heywood, A. (2005). The Vietnam Health Management Information System, Health
Metrics Network (HMN).
References
[5] Brender J, Ammenwerth E, Nykanen P, Talmon J. Factors influencing success and
failure of health informatics systems—a pilot Delphi study. Methods Inf Med. 2006;45
(1):125–36.
[6] UNESCAP (2010). E-Health in Asia and the Pacific, Challenges and opportunities.
[7] Dr. Muga R., Dr. Kizito P., Mr. Mbayah and et al.,(2011). Chapter 2: Overview of
the Health system in Kenya.
Thank you!