Enterprise Architecture in Healthcare and Underlying Institutional Logics: a Systematic Literature Review of IS Research

This paper reports on a systematic literature review of empirical studies in the information systems literature focusing on Enterprise Architecture (EA) in healthcare. 30 papers were selected for extended analysis. We utilized institutional logics as a theoretical lens and focused on the logics of IT professionalism, medical professionalism and managerialism. According to this lens, we identified three foci of interests. In addition, we utilized the institutional level as an analytical dimension. The logics of IT professionals and the purpose of organizational implications of EA were dominating. Generally, there is a need for more in-depth understanding for all logics, however, the logics of managerialism and medical professionalism need particularly more attention. Moreover, there is a need for more empirical research to understand how institutional logics for similar professions may differ across institutions. Finally, few studies on EA apply theoretical lenses, and EA research is immature in sense of theoretical contributions

Pengembangan rencana strategis sistem informasi dan teknologi informasi (renstra si/ti) pada dinas kesehatan kabupaten bima menggunakan model zachman framework

Latar Belakang : Perencanaan Strategis Sistem Informasi bertujuan untuk keselarasan antara rencana kegiatan sistem informasi dengan rencana strategi organisasi. Untuk mengatasi resiko yang timbul terkait perubahan organisasi, perubahan kebijakan, perubahan posisi, diperlukan alat kontrol yang efektif dalam mengontrol performa dan keberhasilan implementasi SI/TI. Tujuan penerapan Renstra SI/TI di Dinas Kesehatan adalah agar tercapai eHealth yang terintegrasi dan interoperabilitas system bisa berjalan dengan baik. SI/TI di bidang kesehatan meliputi pelayanan kesehatan perorangan, pelayanan kesehatan masyarakat, dan administrasi kesehatan. Perencanaan strategis SI dibutuhkan dengan harapan permasalahan di Dinas Kesehatan dapat teratasi sehingga penerapan SI/TI menjadi efektif dan pelayanan kesehatan bisa lebih produktif. Pengembangan Rencana Strategis SI/TI Dinas Kesehatan memerlukan dukungan, keterlibatan dan komitmen Stakeholder agar tercapai tujuan dan sasaran sesuai visi dan misi organisasi.Tujuan: Penelitian ini bertujuan untuk menyusun Rencana Strategis SI/TI menggunakan model Zachman Framework yang digunakan sebagai acuan pengembangan Rencana Strategis Sistem Informasi di Dinas Kesehatan Kabupaten Bima dengan berpedoman pada pencapaian Visi dan Misi Organisasi.Metode: Jenis penelitian bersifat Kualitatif dan desain penelitian menggunakan Action Research. Identifikasi permasalahan dan analisis kebutuhan menggunakan analisis SWOT, Value Chain, dan Mc.Farlan GirdHasil: Sistem Informasi di Dinas Kesehatan Kabupaten Bima cukup memadai, tetapi belum terintegrasi sehingga butuh pengembangan dengan peningkatan sumber daya manusia TI, infrastruktur, jaringan, tatakelola SI, Standar Operational Procedure (SOP) SI/TI sebagai protap, komitmen stakeholder, dukungan dana, regulasi/kebijakan yang tepat melaui penyusunan portofolio perencanaan, kebijakan, infrastruktur, dan aplikasi sesuai kebutuhan. Kesimpulan: Berdasarkan hasil analisis lingkungan internal dan eksternal bahwa Dinas Kesehatan Kabupaten Bima masih dibutuhkan pengembangan SI baru atau pengembangan SI yang sudah ada untuk menunjang kegiatan pelayanan organisasi. Oleh karena itu Rencana Strategis SI/TI pada Dinas Kesehatan Kabupaten Bima disusun dalam 3 tahapan dengan jangka waktu 5 tahun (20162020) yang meliputi pengembangan data center, sistem informasi, infrastruktur, kemananan jaringan, SDM, organisasi, manajemen dan proses kerja. Tujuannya agar selaras dengan visi dan misi SI/TI yang telah dirumuskan.

Towards interoperable e-Health system in Tanzania: analysis and evaluation of the current security trends and big data sharing dynamics

This research article published by the International Journal of Advanced Technology and Engineering Exploration (IJATEE), Volume-6 Issue-59 October-2019In this paper an insight on various e-health interoperable systems was reviewed to discover strengths and challenges faced during sustainable implementation. It covered local, national and regional coverage of integrated systems towards implementation of a single unified e-health system. Peer reviewed and grey literatures were consulted to discover global and local trend and efforts towards implementations of e-health interoperable systems. The available systems and frameworks from the European Union, Asia, America, Oceania and Africa were analyzed for their strengths and challenges. Various policies, guides as well as free and proprietary standards associated with e-health interoperability was reviewed to understand the common standards adopted by the majority of existing systems. The findings of the analysis are useful for policy makers on the best ways to implement interoperable systems in developing countries by focusing on the existing infrastructures and the environment. Similarly, the strengths and challenges encountered by interoperable systems were also examined to provide recommendations for future studies

Digital Re-imagination Colloquium 2018: Preparing South Africa for a Digital Future through e-Skills

The theme of the 2018 colloquium, "Digital Re-imagination: Preparing South Africa for a Digital Future through e-Skills" sought to establish an innovative research network through providing a platform for government, academia, industry, education and civil society to share research, data and trends that will contribute to refining the mandate to develop the necessary e-skills capacity of South Africa With the dawn of every new age, the nature of work and our relationships change. The impact of these changes to the digital economy affect entire systems of production, management, and governance. For example, government is currently designed as linear and mechanistic yet the digital economy is made up of adaptive systems. William Gibson has famously been quoted for the phrase: "The future is already here — it's just not very evenly distributed." Given the extant amount of data available today, it is now possible to predict (within some margins of error) how people will behave in certain situations. Data is increasingly becoming better structured and easy to access. The question is, are we ready for the future? Are we ready to harness the opportunities that the digital economy has brought? Can the digital economy make a better South Africa for all? Technology today is able to perform exponentially better than we can; how then can we create new industries and new forms of governance? It is critical to re-think how systems are being implemented. Creativity and innovation is big business in the digital economy. Creativity and innovation moves contributions to beyond the individual and the group - to societal, disciplinary, national and global level. The prevalent economic paradigm of a winner who takes it all means that the lower income earners are increasingly more dissatisfied. One of the symptoms of any illness is pain. Pain can be seen in our society in the form of unemployment, poverty and the dissatisfaction with the status quo. The challenges in our society cry out for change - a new way of thinking about employment, wealth creation and governance. What are the real opportunities that the digital economy presents to the people of South Africa? Real opportunities are those which are not only available substantively, but are also achievable by the people for who they are created. The opportunities presented by the digital economy can only become real if we e-skill people to take advantage of those opportunities. Countries in the East have been able to adapt technologies without giving up the cultural values they hold dear. While the challenges we face in South Africa may be seen as a problem, they also present an opportunity to make a difference with Digital Skills. It is no longer enough to have a skill; technology, talent and insight are becoming critical as well. The colloquium received 13 submissions. These submissions include four full papers, one concept note and eight abstracts. The submissions were all blind peer reviewed by at least two reviewers. None of the authors nor editors were involved in reviewing their own submissions.ICT4D Flagship, University of South Africa National Electronic Media Institute of South Africa (NEMISA)School of Computin

Lack of adoption of electronic Medical Records Systems in developing countries. A case study of Zimbabwe

This study explored the phenomenon of electronic medical records systems in Zimbabwean primary healthcare institutions. The goal of the study was to investigate the lack of adoption of electronic medical records systems by primary healthcare institutions in developing countries using an interpretative case study approach focusing on the Zimbabwean context. Despite the positive benefits that are associated with EMRs, developing countries have been reluctant in implementing this technology within their primary healthcare institutions. A number of studies have been conducted on EMR systems but only a few have investigated the reasons for the limited use of EMR technology in developing countries particularly within the Zimbabwean context. This study primarily adopted a case study approach and was qualitative in nature. The study made use of in-depth interviews to obtain its data, and purposive sampling method was used to identify participants for the study. The study made use of a sample size of fourteen respondents who were identified based on their knowledge and could assist explore this particular topic relevant to the research. The targeted population for this research were key staff members privy to patients’ medical records management within the primary healthcare facilities. The data collected was analysed using thematic analysis soon after the transcription process. The results of the study show that EMRs technology in Zimbabwe has been implemented on a limited scale within its public hospitals. The technology is being used mostly in HIV/AIDS management or in particular departments. The study reveals that although healthcare institutions in Zimbabwe have adopted EMRs technology, most of the information is still being archived on the paper based system. The findings of the study show that Zimbabwe hasn’t adopted EMRs due to challenges such as lack of proper infrastructures, resistance in the use of EMRs, remoteness, shortages in skilled labour and concerns of confidentiality and privacy. Furthermore, the study shows that though the application of the EMR system is limited in Zimbabwean hospitals, the study found that its benefits have been noticeable. EMR technology has made it easy to access information, averted redundant expenditure and has made time improvements. However, the study revealed that EMR systems come with their own shortcomings such as lack of access to patient documents due to network faults and the need for familiarity with computer systems

Smartphone application architecture and security for patient vital signs sensors and indicators

South Africa is a developing country with great potential to be leaders in technology and research, especially in the medical field. Rural areas in many countries do not have access to basic healthcare services due to the distance and inaccessibility of these services. Currently people living in the rural areas in South Africa are required to rely on the people within the area, who may not be trained; on doctors who make house calls, who may not be able to access the patient in time or on finding transport to the nearest hospital, which may be hundreds of kilometres away. This leads to many rural residents not seeking aid for aliments thereby often lowering life expectancy. South Africa has many world-renowned medical practitioners who would be able to assist the residents in these areas if there were methods for observation and recording of health statuses without the need for either party to travel. This dissertation studied and developed a method to assist not only the residents in rural areas, but also urban residents to record their vital signs without the assistance of a licenced medical practitioner, to upload the data to a database and to then allow the data to be viewable by the medical practitioner who may be situated elsewhere in South Africa or the world. This system allows for the elimination of human error when recording vital sign data as recording is not done through human intervention. Through the use of communications technologies such as Bluetooth, NFC and Wi-Fi a system was designed which ensures that a patient can record medical data without the presence of a medical practitioner, the patient can access previous health records and readings and the patient can give a new medical practitioner a full medical history. The patient's data has been secured using AES and RSA encryption as well as verification through hash values at all points of transfer and access is granted to the patients' medical data only through the patient or a licenced medical practitioner. The data recording and transfer has been completed taking into consideration all the medical legislation and laws in South Africa. This system allows the South African medical health sector to service all South Africa residents, including the residents in rural areas.Dissertation (MEng)--University of Pretoria, 2016.Electrical, Electronic and Computer EngineeringMEngUnrestricte

Resource extraction projects and health: evidence from cross-national and national data sources

Implementation of resource extraction projects often triggers a series of complex environmental and social-ecological changes. These changes may include alterations in land use (i.e., from forestry and vegetation to infrastructure and mining), an increase in construction activities (new buildings such as houses, schools and hospitals), population increase (more people, more road traffic), urbanization, movement and installation of heavy machinery, increases in employment and business opportunities and household resettlements. These changes can positively or negatively affect health of the population living within mining areas and beyond. For instance, one common and most visible contribution of resource extraction projects is the impact on income generation. This has been widely studied in the economic literature, showing both positive and negative effects between natural resources activities and income generation. Positively, governments can benefit from the generated resource rents and royalties. Individually, people can earn income from employment and business opportunities. The revenue generated can help governments to re-invest in other sectors, including health, education and infrastructure. Negatively, the sharp increase in economic development in one sector can hamper growth in other sectors causing what is known as the Dutch disease. The presence of resource-income dependency can as well fuel local conflicts, political instability, weak institutions and corruption, and ultimately result in a slow development process causing the resource curse. One major aspect of resource extraction projects which is often under-represented is its implication on health. Health is influenced both directly and indirectly through activities involved in resource extraction projects. Evidence suggests that resource extraction projects can positively or negatively affect health and well-being of the population therein. This directly relates to the Sustainable Development Goal (SDG) number 3 (SDG3) of the SDGs 2030 agenda. SDG3 aims to ensure healthy lives and promote well-being for all at all ages. Health has a central place in SDG3, and it is also central to the three dimensions of sustainable development: environment, society and economy. Resource extract projects can act on determinants of health and ultimately contribute to improve lives and well-being. An increase in income can promote access to better care, construction of health care post and hospitals can contribute to improving healthcare delivery, constructions of water points can improve the availability of clean water, and lastly but not least, the provision of health education can contribute to knowledge and disease prevention. On the other hand, resource extraction projects can cause environmental disruption linked to air, water and land pollution. This can further result in disease outcomes. Combustion activities associated with the extraction process can result in the presence of small particulate matter (PM2.5) in the atmosphere and further lead to respiratory and cardiovascular diseases. Toxic substances often used in the extraction process can leak into the environment and result in cancer diseases. The presence of both positive and negative health outcomes in resource extraction areas present an opportunity to systematically study the contribution of resource extraction projects to health outcomes. This PhD thesis embarked on this particular opportunity and studied the association between resource extraction projects and population health indicators in three layered perspectives: global, national and subnational

An analysis of approaches for developing national health information systems : a case study of two sub-Saharan African countries.

Master of Science in Mathematics, Statistics and Computer Science. University of KwaZulu-Natal, Durban, 2016.Health information systems in sub-Saharan African countries are currently characterized by significant fragmentation, duplication and limited interoperability. Incorporating these disparate systems into a coherent national health information system has the potential to improve operational efficiencies, decision-making and planning across the health sector. In a recent study, Coiera analysed several mature national health information systems in high income countries and categorised a topology of the approaches for building them as: top-down, bottom-up or middle-out. Coeria gave compelling arguments for countries to adopt a middle-out approach. Building national health information systems in sub-Saharan African countries pose unique and complex challenges due to the substantial difference between the socio-economic, political and health landscapes of these countries and high income countries. Coiera’s analysis did not consider the unique challenges faced by sub-Saharan African countries in building their systems. Furthermore, there is currently no framework for analysing high-level approaches for building NHIS. This makes it difficult to establish the benefits and applicability of Coiera’s analysis for building NHIS in sub-Saharan African countries. The aim of this research was to develop and apply such a framework to determine which approach in Coiera’s topology, if any, showed signs of being the most sustainable approach for building effective national health information systems in sub-Saharan African countries. The framework was developed through a literature analysis and validated by applying it in case studies of the development of national health information systems in South Africa and Rwanda. The result of applying the framework to the case studies was a synthesis of the current evolution of these systems, and an assessment of how well each approach in Coiera’s topology supports key considerations for building them in typical sub-Saharan African countries. The study highlights the value of the framework for analysing sub-Saharan African countries in terms of Coiera’s topology, and concludes that, given the peculiar nature and evolution of national health information systems in sub-Saharan African countries, a middle-out approach can contribute significantly to building effective and sustainable systems in these countries, but its application in sub-Saharan African countries will differ significantly from its application in high income countries

Investigating factors that hinder the adoption and use of primary healthcare information systems (phcis) in the western cape of South Africa

Magister Commercii (Information Management) - MCom(IM)In the past, the Western Cape Department of Health had no formal or technologically enabled system for patient administration. This resulted in an administrative burden, increased waiting times for patients and doctors who needed results back from other sections, and missing patient files within the community health institutions such as clinics and hospitals. The Primary Healthcare Information System (PHCIS) was developed to solve this problem. However, it was later discovered that even though the PHCIS had been installed across the Western Cape clinics, there was a limited adoption and use of the PHCIS. Hence, the aim of this study was to investigate the factors that hinder the adoption and use of PHCIS by healthcare workers in the public healthcare clinics in the Khayelitsha sub-district in the Western Cape Provinc