A Review of Interoperability Standards in E-health and Imperatives for their Adoption in Africa

The ability of healthcare information systems to share and exchange information (interoperate) is essential to facilitate the quality and effectiveness of healthcare services. Although standardization is considered key to addressing the fragmentation currently challenging the healthcare environment, e-health standardization can be difficult for many reasons, one of which is making sense of the e-health interoperability standards landscape. Specifically aimed at the African health informatics community, this paper aims to provide an overview of e-health interoperability and the significance of standardization in its achievement. We conducted a literature study of e-health standards, their development, and the degree of participation by African countries in the process. We also provide a review of a selection of prominent e-health interoperability standards that have been widely adopted especially by developed countries, look at some of the factors that affect their adoption in Africa, and provide an overview of ongoing global initiatives to address the identified barriers. Although the paper is specifically aimed at the African community, its findings would be equally applicable to many other developing countries

A Blockchain-based Model for Securing Data Pipeline in a Heterogeneous Information System

In our digital world, access to personal and public data has become an item of concern, with challenging security and privacy aspects. Modern information systems are heterogeneous in nature and have an inherent security vulnerability, which is susceptible to data interception and data modification due to unsecured communication data pipelines between connected endpoints. This re-search article presents a blockchain-based model for securing data pipelines in a heterogeneous information system using an integrated multi-hazard early warning system (MHEWS) as a case study. The proposed model utilizes the inherent security features of blockchain technology to address the security and privacy concerns that arise in data pipelines. The model is designed to ensure data integrity, confidentiality, and authenticity in a decentralized manner. The model is evaluated in a hybrid environment using a prototype implementation and simulation experiments with outcomes that demonstrate advantages over traditional approaches for a tamper-proof and immutable data pipeline for data authenticity and integrity using a confidential ledger.Comment: 13 page

Telemedicine using mobile telecommunication: towards syntactic interoperability in teleexpertise

Telemedicine allows collaborative activities between health professionals for the deployment of medical procedures carried out remotely by means of device using information and communication technologies. This article focuses on the Teleexpertise that allows collaboration between medical professionals in order to share knowledge and expert advices used as explanation elements for decision support. We propose a conceptual model integrating the FIPA (Foundation for Intelligent Physical Agents) Contract Net Protocol which permits to collect medical professionals’ answers for a request for teleexpertise in an efficient manner. Our model satisfies four requirements (coverage, QoS (Quality of Service) guarantees and prioritisation, mobility and roaming, service usability) on the configuration and operation of the underlying network and the services. Therefore, we provide an operational assistance by improvement of the networks quality of service via interoperable web services. Finally, we hope to bring a tangible contribution on the implementation of this suggested conceptualization that will allow to generate relevant and action-oriented finding

Managing as Designing: Transforming Digital Healthcare Interoperability

Digital healthcare transformations promise improved overall quality healthcare and patient continued care among others. However, quality healthcare and continued patient care can be hampered by various challenges including insufficient collaboration among healthcare centers, and limited data exchanges between health information systems (HIS). Such challenges can be overcome through collaborative digital healthcare initiatives in which, HIS are designed with data exchange capabilities that enable healthcare centers to easily exchange patient information across boundaries. However, several existing initiatives are carried out in isolation, and there is limited practical knowledge on how to collaboratively manage and design HIS’ interoperability. Consequently, this study investigated a managing as designing (MaD) approach taken by a successful HIS interoperability initiative in Sweden. Data was collected mainly through interviews with key informants within the implementation team. Based on study findings, a MaD HIS-interoperability conceptual framework that can guide the management and design of future HIS’ interoperability was developed

An Implementation Process of Interoperability: A Case-Study of Health Information Systems (HIS)

Several advances have been made towards health information systems (HIS) use and implementations. However, these advances have not been matched by equal advances in HIS interoperability implementations. Current challenges in this domain are partly due to lack of implementation knowledge hence resulting into a number of failed HIS interoperability implementations. To gain substantive implementation knowledge on HIS interoperability projects, we have carried out interviews through an interpretive case-study approach to investigate a successful HIS interoperability project. Through this approach we propose an initial set of HIS interoperability implementation best practices comprising of these key processes: discovering interoperability need, projecting outcome, managing change and adopting an appropriate interoperability strategy which together depict a contingence management relationship. We conclude that this initial set of best practices contributes substantive knowledge that can guide future HIS interoperability implementations

The Need for the Establishment of E-records and eHealth Legislation and Policy Framework in the Health Sector in Zimbabwe

Legislation is key to the establishment of eHealth initiatives. Without legislation, authority is not set and the privacy, confidentiality and other threats affecting records and information in electronic platforms are compromised. It is therefore key that legislation for eHealth and e-records be established. Zimbabwe is applying eHealth initiatives in the form of an electronic National Health Information System (NHIS) and other initiatives. However, worrying is the fact that Zimbabwe has not paid attention to the development of legislation and policies for eHealth and e-records management in general. This study sought to make a case for the establishment of e-records and eHealth legislation in order to smoothen the implementation of eHealth systems in the health sector. The study applied a literature review research as literature on eHealth, e-records management and e-health information management was reviewed. The study found that there was no e-records and eHealth legislation in Zimbabwe. The study, thus, recommended the need to enact e-records and eHealth legislation

Toward Business Models for a Meta-Platform: Exploring Value Creation in the Case of Data Marketplaces

Investigating meta-platforms has been a continuing concern within information system literature due to the increasingly complex constellations of platforms in ecologies of ecosystems. A meta-platform is a platform built on top of two or more platforms, hence connecting their respective ecosystems. One promising case to benefit from meta-platforms is data marketplaces: a particular type of platform that facilitates responsible (personal and non-personal) data sharing among companies. Given that business models for meta-platforms are largely unexplored in this emerging case, how they can create value for data marketplaces remain speculative. As a starting point toward business model investigations, this paper explores value creation of a meta-platform in the case of data marketplaces. We interviewed fourteen data-sharing consultants and six meta-platform experts. We identify three potential value creation archetypes of a meta-platform. The discovery aggregator archetype emphasizes searching and dispatching value, while the brokerage one focuses on promoting and supporting value. Finally, the one-stop-shop archetype creates value by standardizing, regulating, sharing, and experimenting. This study is among the first that explore value creation archetypes for a meta-platform, thus identifying core value as a base for further business model investigations

Systems Interoperability Types: A Tertiary Study

Interoperability has been a focus of attention over at least four decades, with the emergence of several interoperability types (or levels), diverse models, frameworks, and solutions, also as a result of a continuous effort from different domains. The current heterogeneity in technologies such as blockchain, IoT and new application domains such as Industry 4.0 brings not only new interaction possibilities but also challenges for interoperability. Moreover, confusion and ambiguity in the current understanding of interoperability types exist, hampering stakeholders' communication and decision making. This work presents an updated panorama of software-intensive systems interoperability with particular attention to its types. For this, we conducted a tertiary study that scrutinized 37 secondary studies published from 2012 to 2023, from which we found 36 interoperability types associated with 117 different definitions, besides 13 interoperability models and six frameworks in various domains. This panorama reveals that the concern with interoperability has migrated from technical to social-technical issues going beyond the software systems' boundary and still requiring solving many open issues. We also address the urgent actions and also potential research opportunities to leverage interoperability as a multidisciplinary research field to achieve low-coupled, cost-effective, and interoperable systems.Comment: 33 page

The implementation of an electronic patient healthcare record system : a South African case study

Establishing an e-health infrastructure forms a fundamental building block of the National Health Insurance (NHI) initiative; directed at transforming the South African healthcare infrastructure. Currently patient healthcare records constitute paper-based files that result in numerous difficulties in making patient related information available to healthcare practitioners. This research study was directed at determining the typical difficulties encountered in implementing an electronic healthcare record (EHR) system and how they could be addressed. A literature review and a narrative enquiry formed the basis of the research study. The empirical study was conducted at a Pretoria based clinic, where an EHR system was being implemented to learn from the practitioners’ first-hand experience. A multi-disciplinary literature review was undertaken and the insights gained from the empirical study were correlated with the findings emanating from the literature review. Findings emanating from the research study indicate that the human socio-technology factors involved in the change management process need to be actively managed. The technology concerns found to play a critical role in the systems deployed; relate to network connectivity and bandwidth. The finding emanating from the research could serve as a source of information for management involved in implementing and managing similar projects.http://www.journals.co.za/ej/ejour_jcman.htmlam201

Factors that Influence Potential Success of eHealth Standards Adoption in a Low- and Middle-Income Country: a review.

BACKGROUND: Assessing the potential success of adopted technology, innovation, or standard in a Low and Middle Income Country like Uganda continues to focus on outcomes of adoption. This study aimed to investigate the potential success of eHealth standards adoption that may arise from the adoption process as well as outcomes of such adoption. METHODS: PubMed and Google Scholar were searched using alternate terms for “eHealth”, “standards”, “adoption” “success” and “theory”. On screening and assessing the quality of publications, only nineteen peer-reviewed publications were included in the review. Both quantitative and qualitative analysis was used to synthesize evidence from the included literature. Thematic analysis was used to develop themes regarding the success of standards/technology adoption. RESULTS: Constructs from the theories of Diffusion of Innovation Theory (DOI), Unified Theory of Acceptance and Use of Technology (UTAUT), and Internet Standards Adoption (ISA) were used to extend the Success Model of Innovation Adoption. The Success Model for Innovation contributed to the foundational concepts aligned to categorical factors of the adoption process, organizational, environment, and user context that influence the potential success of eHealth standards adoption in healthcare systems. The study identified 13 factors that contribute to the successful adoption of standards for eHealth. CONCLUSION: Since the review showed that success of standards adoption starts with assessing readiness to adopt the standards, followed by the standards adoption process and assessment of the lasting outcomes, the study proposes a model for assessing the potential success of eHealth standards adoption. The model has pre-adoption, actual adoption, and post-adoption phases. The proposed model and identified factors have not been evaluated and therefore may not in the current form support eHealth standards adoption processes. Future work is needed to evaluate/validate the model and factors of eHealth standards adoption success. Notwithstanding, the study believes any assessment of the success of standards adoption that uses the identified factors over all three phases of the model is comprehensive to present a true picture of any potential success of standards adoption