Understanding the Role of Technology in Health Information Systems

Introduction

This working paper produced by the University of Queensland Health Information Systems Knowledge Hub aims to address four objectives, firstly the development of a 'common language' of healthcare and Information and Communication Technology (ICT) in developing countries, secondly to explore the opportunities and benefits of ICT implementation in health care, thirdly to explore critical factors which result in success or failure of ICT implementation in both the developed and developing world, and fourthly to introduce 'evaluation frameworks' for ICT in health. The paper focuses on the Western Pacific Region and the challenges in that developing region when it comes to implementing ICT and health care systems.

What it does right

The paper utilises a deft grasp of the problems and benefits of implementing ICT within healthcare systems in both the developed and developing worlds. It explores the complexity of health care knowledge entailed in providing a multifaceted health care system and acknowledges the demands placed upon that knowledge and its need to be flexible and accessible at different levels of organisation, e.g. administrative level, clinical level and global level.

The level of contrast the paper explores between developed and developing countries is extensive and very clear. The recognition that many health-based ICT innovations have been implemented with little to no evidence of effectiveness is repeated throughout the paper, and it becomes more developed in exploring the different factors that play into success or failure in developed and developing worlds. The factors that contribute to the failure of ICT in health systems in the developed world are mainly administration and managerial in nature, that is, lack of senior management sponsorship, insufficient time and resources, under-investment in human resource capacity-building, whereas contributing factors to failure in the developing world hinge mainly on infrastructure issues such as telecommunications systems and steady electricity. Both developed and developing worlds rely on people and training for any ICT venture to succeed.

The evaluation tools listed in the paper are an intuitive approach to assessing and implementing the 'stage' health care systems are currently at, allowing different levels of ICT sophistication to be applied where it is appropriate. Out of the seven different stages, it would be unlikely that many of the communities across Western Pacific Region are beyond using paper-based systems. It may be that the humidity and salt content in the air causes computer hard drives to corrode and corrupt, leaving an expensive problem without altering the reliance on paper-based data collection.

What it does wrong

The paper acknowledges the diversity in geography, populations, cultures, economics and politics in a peripheral way, it mentions that they are factors that need to be addressed but it does not give any more time to them beyond a few mentions. Cultural factors such as Languages other than English do become a significant hurdle to overcome when designing and implementing ICT and health systems. While this point is made in the paper, I feel it could have mentioned how important supporting education in the Pacific Region is to ongoing future health care and the provision of local staff who can interface with ICT-focused health systems.

In conclusion, I felt that this paper was an incredibly well thought out and implemented approach to the problem of the digital divide that exists between the developed world, such as Australia, and the developing world, such as the Pacific Islands. I found it very helpful for thinking about the different needs of organisations who perform similar tasks, for example, it caused me to reflect on public libraries, and the differences between an inner-city library and a rural library and the potential failures and successes of technological implementation.

References:

Lewis, D., Hodge, N., Gamage, D &Whittaker, M. (2011) Understanding the role of technology in health information systems. Available here: http://www.uq.edu.au/hishub/wp17