Developing and Measuring the Business Case for Health Information Technology

This chapter examines the adoption of information technology and information systems to support the clinical process. It explores popular models of information systems adoption and success, and relates these to the health it context. The end result of successful adoption of technology should be the improvement in performance of health care delivery, yet measurement of performance is complex. The various approaches to performance measurement are discussed. As one of the challenges in predicting the outcomes of adoption is the lack of consistent taxonomy, a solution to which is proposed. The chapter then looks at evaluation of it projects and considers what special factors may affect health it adoption and benefits in developing health care systems.

Telemedicine in Low Resource Settings

Telemedicine is a means to support health-care provision utilizing information and communication technology (ICT) tools and telecommunication services. This chapter focuses on telemedicine practices in low resource settings, referencing key telemedicine initiatives in Botswana. Telemedicine is highly practiced in the developed world, and recently there is an increasing interest in the developing world. Current literature suggests telemedicine as an important tool for improving healthcare delivery for low resource settings. Hence the authors' interest in exploring the current status of telemedicine practices with reference to telemedicine projects from low resource settings such as Botswana. The chapter reveals that telemedicine in such settings is mainly implemented through mobile phones, also known as mobile health (mHealth). In this chapter, the authors discuss factors influencing successful implementation of telemedicine solutions in Botswana. Furthermore, the chapter discusses telemedicine implementation challenges in each of the projects and presents possible mitigation strategies. The chapter concludes by affirming the feasibility of successfully practicing telemedicine in low resource settings; notwithstanding challenges such as lack of legal and eHealth frameworks in most developing countries.

Knowledge Sharing for Healthcare and Medicine in Developing Countries

Knowledge sharing has always been used as a platform for cross-pollination of ideas and innovations in a bid to improve and enhance performance thereby increasing competitiveness and responsiveness both in organizations and individual levels. Healthcare systems are not an exception. However, for knowledge sharing to take place there is need for certain factors to be noted and addressed such as the individual, organizational and technological. Further, knowledge sharing goes hand in hand with knowledge management and must become part of the strategic fabric of organizations. This chapter focuses on knowledge sharing by health professionals in healthcare and medicine in developing countries. The chapter covers knowledge management and its link with knowledge sharing; the various methods of knowledge sharing in healthcare; factors that make knowledge sharing an important strategic move for healthcare organizations; and factors and issues that affect or determine knowledge sharing behavior. Finally, a literature search for examples of knowledge sharing in developing or low and middle-income countries was conducted and the results are presented. The chapter shows that developing countries have recognized the value of knowledge sharing in healthcare systems and there are tangible signs that this is going to shape cross-pollination of ideas and innovations in the health systems in the foreseeable future.

Use of Information and Communication Technology by Health Care Providers for Continuing Professional Development in Botswana

The impact of Information and Communication Technology (ICT) in the social and economic lives of people including the area of education cannot be overemphasized. Continuing education is an important vehicle for maintaining and improving professional standards and keeping in synch with the latest trends in the profession, especially for health care providers. Hinged on literature review, document review and case study, this chapter aims to elaborate on the importance of continuing professional development (CPD) to health and medical care, and how ICTs can be used as a platform for CPD. Focusing on Botswana as a case study, the chapter explores challenges and issues faced by health care providers in using ICTs to access CPD and includes solutions and recommendations. Challenges identified included underdeveloped ICT infrastructure and limited use of available ICT resources by health care providers.

Telemedicine and Electronic Health

This chapter reveals the overview of telemedicine; telemedicine in developing countries; Electronic Health Record (EHR); and mobile health technologies. Telemedicine and Electronic Health (e-health) are modern technologies toward improving quality of care and increasing patient safety in developing countries. Telemedicine and e-health are the utilization of medical information exchanged from one site to another site via electronic communications. Telemedicine and e-health help health care organizations share data contained in the largely proprietary EHR systems in developing countries. Telemedicine and e-health help reduce the cost of health care and increases the efficiency through better management of chronic diseases, shared health professional staffing, reduced travel times, and shorter hospital stays. The chapter argues that utilizing telemedicine and e-health has the potential to enhance health care performance and reach strategic goals in developing countries.

Next Wave of Tele-Medicine

Information and Communication Technologies (ICTs) are being embedded into healthcare system front-end and back-end platforms both in the developing and developing world contexts in ways unimaginable 20 years ago. This trend has brought about ubiquity culminating into spatial-temporal healthcare delivery models where health practitioners and patients do not need to be simultaneously in the same physical domain in order for healthcare to be delivered. This chapter presents a development projectile of healthcare systems and explores interventions and current trends in pervasive healthcare delivery systems and makes a prognosis of what is to come in future. The first parts of the chapter generally present formulaic concepts about telemedicine. The chapter is hinged on literature and document reviews focussing on innovations in telemedicine and gives a commentary on what needs to be done to achieve true ubiquity in healthcare delivery systems both in the developing and developed world contexts. The chapter posits that pervasiveness will be highly enshrined into healthcare systems to a point where physicians will not have to leave their working space to provide a service. The design of the Defibrillator Drone, for example, provides an opportunity for healthcare application developers to develop information system applications which do not only carry medical supplies from one place to the other, but are able to reason and prescribe medications. With acute advances in the science of robotics and ICTs in general, this is a reality in the foreseeable future.

Viral Education via Mobile Phone

This chapter documents a strategy for the development and deployment of educational content on Ebola prevention and treatment targeted at low-literate learners speaking diverse languages. During the outbreak of Ebola in Sierra Leone, Njala University partnered with Scientific Animations Without Borders (SAWBO) at the University of Illinois Urbana-Champaign to create educational animations on Ebola. Drawing on an international network of collaborators, these animations were then placed into multiple languages for Sierra Leone. Njala University in turn acted as the central hub for engaging local partner groups to deploy this content throughout Sierra Leone. This chapter describes the development process, which occurred during the outbreaks and the ICT tools now available to the global health community. The educational animations created during the 2014 Ebola outbreak are now available in multiple languages for Sierra Leone, as well as other West African countries, along with a highly scalable deployment pathway that can be rapidly operationalized during future outbreaks or modeled for other outbreak or health crisis situations.

Open Source Technology for Medical Practice in Developing Countries

The purpose of this chapter is to provide an overview of the role of open source technologies within medical practice in developing countries. First, the background and meaning of “open source” principles is explored. Second, several fields of open source implementation are described. These include open source software, hardware, and digital content. Within each field, specific case studies are given to illustrate how the technologies have been adapted to the developing world for usage in information and communication sharing, electronic data management, mobile data collection, disease mapping, scholarly publication, and education. The issues and controversies, as well as future research directions and solutions are addressed.

Health Information Systems, eHealth Strategy, and the Management of Health Records

South Africa's health sector faces two main transformation challenges: inequity and a legacy of fragmentation. This chapter traces the history of health policy development in the country in seven phases from the 17th century to the present time. It describes the efforts in transformation made through the promulgation of the National Health Act in 2003 and the eHealth Strategy in 2012. The chapter explores the utility of maturity assessment in assessing whether transformation goals through an analysis of five maturity models: Digital Preservation Capability maturity model, eHealth maturity model, Enterprise Content Management maturity model, Health Normative Standards Framework maturity model, and Records Management Capacity Assessment System. South Africa is already using two of the five models demonstrating that is not just reliant on technology but has developed strategies and principles to guide the transformation process. The chapter argues for more expansive adoption of maturity assessment to cover the full records lifecycle.

Case Study

In 2009, the Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) counted over 10 different health facility lists managed by donors, government ministries, agencies and implementing partners. These function-specific lists were not integrated or linked. The ministry's Health Sector Strategic Plan included the development of an authoritative source for all health facility information, called the Master Facility List (MFL). During development, the ministry adopted the term Health Facility Registry (HFR), an online tool providing public access to a database about all officially recognized health facilities (public and private). The MFL, which includes the health facility list at any specific point in time can be exported from the HFR. This chapter presents the Tanzanian case study describing the work and lessons learned in building the HFR—focusing on software development, introducing geographic positioning systems and harmonizing MFL data. MoHCDGEC launched the HFR public portal in September 2015.