UNDERSTANDING THE PRESENT TO PREPARE FOR THE FUTURE: A REVIEW OF HEALTH INFORMATION SYSTEMS RESEARCH IN NIGERIA (7)

Health Information Systems (HIS) present many opportunities to address health challenges in developing countries such as Nigeria. However, in order to leverage the potential of HIS, the opportunities and challenges facing implementation must be explored and understood. This paper conducts an archival analysis of the existing literature on HIS in Nigeria published in premier Information Systems (IS) and Health Informatics outlets; in an effort to provide a comprehensive picture of existing literature by identifying trends, discussing findings, and proposing new research opportunities. The 18 articles meeting the inclusion criteria are reviewed. Current trends are discussed using the framework developed by McLeon et al. (2013) for understanding the factors influencing health IS implementation in developing countries. At present, several challenges face IS implementation in Nigeria such as the lack of policy guidance, resistance among end users, and cultural barriers. In addition, existing studies are limited in scope, theory, and level of analysis applied. The paper contributes to the literature by investigating the status quo, presenting new areas ripe for future investigation including the organisational, financial, and technological issues at play, and illuminating important issues which can guide pilot testing and implementation of new health IS initiatives in Nigeria

Deriving Facilitators for Electronic Health Record Implementation: A Systematic Literature Review of Opportunities and Challenges

Electronic Health Records aim to remove information asymmetries between healthcare providers and contribute to improved healthcare quality and safety. Nevertheless, the successful and comprehensive implementation remains challenging and complex. Recently, increased interest of patients in their healthcare and enhanced technological opportunities led to new challenges and an emerging amount of research. To achieve an overarching overview of facilitators for EHR implementation, the perspectives of relevant stakeholders were considered. Therefore, we conducted a multidisciplinary systematic literature review involving five databases from public health, information systems, and interdisciplinary research. As a result, we first identified opportunities and challenges according to the stakeholder groups, environmental context, and implementation stages. Second, we derived five facilitators (individual stakeholder readiness, change management, accessibility and ownership, EHR structure, and external factors). Therefore, we lay a state-of-the-art foundation for EHR implementation for scientific studies and development activities in practice with our research

Information Systems and Healthcare XXXIV: Clinical Knowledge Management Systems—Literature Review and Research Issues for Information Systems

Knowledge Management (KM) has emerged as a possible solution to many of the challenges facing U.S. and international healthcare systems. These challenges include concerns regarding the safety and quality of patient care, critical inefficiency, disparate technologies and information standards, rapidly rising costs and clinical information overload. In this paper, we focus on clinical knowledge management systems (CKMS) research. The objectives of the paper are to evaluate the current state of knowledge management systems diffusion in the clinical setting, assess the present status and focus of CKMS research efforts, and identify research gaps and opportunities for future work across the medical informatics and information systems disciplines. The study analyzes the literature along two dimensions: (1) the knowledge management processes of creation, capture, transfer, and application, and (2) the clinical processes of diagnosis, treatment, monitoring and prognosis. The study reveals that the vast majority of CKMS research has been conducted by the medical and health informatics communities. Information systems (IS) researchers have played a limited role in past CKMS research. Overall, the results indicate that there is considerable potential for IS researchers to contribute their expertise to the improvement of clinical process through technology-based KM approaches

Using Secondary Data to Tell a New Story: A Cautionary Tale in Health Information Technology Research

Through the growth of big data and open data, new opportunities have presented themselves for information systems (IS) researchers who want to investigate phenomena they cannot easily study using primary data. As a result, many scholars have “retooled” their skills to leverage the large amount of readily available secondary data for analysis. In this confessional account, we share the story about how the first and second authors faced challenges when using secondary data for a research project in the health information technology domain. Through additional analysis of studies on health information technology that have used secondary data, we identified several themes of potential pitfalls that can occur when collecting, appropriating, and analyzing secondary data for a research project. We share these themes and relevant exemplars to help IS researchers avoid mistakes when using secondary data

Internet of Things Architectures, Technologies, Applications, Challenges, and Future Directions for Enhanced Living Environments and Healthcare Systems: A Review

Internet of Things (IoT) is an evolution of the Internet and has been gaining increased attention from researchers in both academic and industrial environments. Successive technological enhancements make the development of intelligent systems with a high capacity for communication and data collection possible, providing several opportunities for numerous IoT applications, particularly healthcare systems. Despite all the advantages, there are still several open issues that represent the main challenges for IoT, e.g., accessibility, portability, interoperability, information security, and privacy. IoT provides important characteristics to healthcare systems, such as availability, mobility, and scalability, that o er an architectural basis for numerous high technological healthcare applications, such as real-time patient monitoring, environmental and indoor quality monitoring, and ubiquitous and pervasive information access that benefits health professionals and patients. The constant scientific innovations make it possible to develop IoT devices through countless services for sensing, data fusing, and logging capabilities that lead to several advancements for enhanced living environments (ELEs). This paper reviews the current state of the art on IoT architectures for ELEs and healthcare systems, with a focus on the technologies, applications, challenges, opportunities, open-source platforms, and operating systems. Furthermore, this document synthesizes the existing body of knowledge and identifies common threads and gaps that open up new significant and challenging future research directions.info:eu-repo/semantics/publishedVersio

Global surgery research collaborations during the COVID-19 pandemic

The COVID-19 pandemic created an unprecedented burden on health systems, including surgical services, which have been indirectly affected by the growing number of cases due to cancellation of operations, delayed screening and a lack of adequate resources such as PPE and ventilators. In addition to logistical challenges, the pandemic also raised imminent clinical questions that required immediate answers. Global collaborations have been vital to identifying challenges by pooling data and collecting evidence to provide critical information to guide clinical and surgical care. Research partnerships have been the driving force behind global surgery research; however, since the pandemic, there has been an increased need for equitable collaboration and innovation between high-income and low-income research institutions to continue making steady progress towards providing access to safe, affordable surgical care. This article explores academic research partnerships formed during the pandemic and identifies challenges and opportunities presented to researchers and institutions. Finally, this paper recommends that further collaborations be made between HIC and LMICs to ensure policies that global surgery ensures that key stakeholders are at the centre of research. Such policies need to focus on the access to education and mentorship, micro-grants for researchers, and publication opportunities

Health information technology and digital innovation for national learning health and care systems

Health information technology can support the development of national learning health and care systems, which can be defined as health and care systems that continuously use data-enabled infrastructure to support policy and planning, public health, and personalisation of care. The COVID-19 pandemic has offered an opportunity to assess how well equipped the UK is to leverage health information technology and apply the principles of a national learning health and care system in response to a major public health shock. With the experience acquired during the pandemic, each country within the UK should now re-evaluate their digital health and care strategies. After leaving the EU, UK countries now need to decide to what extent they wish to engage with European efforts to promote interoperability between electronic health records. Major priorities for strengthening health information technology in the UK include achieving the optimal balance between top-down and bottom-up implementation, improving usability and interoperability, developing capacity for handling, processing, and analysing data, addressing privacy and security concerns, and encouraging digital inclusivity. Current and future opportunities include integrating electronic health records across health and care providers, investing in health data science research, generating real-world data, developing artificial intelligence and robotics, and facilitating public–private partnerships. Many ethical challenges and unintended consequences of implementation of health information technology exist. To address these, there is a need to develop regulatory frameworks for the development, management, and procurement of artificial intelligence and health information technology systems, create public–private partnerships, and ethically and safely apply artificial intelligence in the National Health Service

Challenges and Opportunities in the Integration of HIS : Case Study from Zanzibar

This thesis presents an in-depth theoretically underpinned empirical analysis of the challenges to integrate the fragmented health information systems within the Zanzibar health care system. The research is situated in the broader topic of health sector reforms, which advocate and implement a number of healthcare organizational changes in which decentralization and integration of the disparate health information systems is one of them. The study sought to meet three objectives: 1) to understand the challenges in the processes of achieving integration; 2) to study the challenges and opportunities emanating from the way users received and related to the newly integrated health information system and 3) to study the strategies used to curb the integration challenges. In meeting the stated objectives, the research employed qualitative research methods namely, semi-structured interviews, participant observation in meetings and trainings, and document and software analysis, in an indepth case study. Content analysis was drawn upon to write up and analyze the empirical materials. Theoretically, the study drew on the concept of installed base from the socio-technical conceptualization of large, integrated systems called information infrastructures and the user enactment concept based on the human agency perspective to analyse the empirical materials. In addition, the analysis was informed by the literature from health information systems’ discourse covering integration issues in developing countries. The study identified challenges in two major integration processes as follows. The first is the standardization process, in which the installed base presented the following challenges: heterogeneity of interests among health care stakeholders, inadequate knowledge on indicators and public health issues, and use of multiple languages in the previous data sets and tools standards. The second process is institutionalization of the standards which also faced a number of challenges from the installed base, which included lack of clear management structure, inadequate skills in computer, inadequate human resources, institutionalized work practices hampering training initiatives and relatively low education levels of health workers at the health unit level of the health system. The study found different ways in which users enacted the integrated health information system standards, which in turn presented both challenges and opportunities to the integration initiatives. The challenges came to play as some users such as vertical program managers, district officials and health unit staff enacted limited and non-use technologies in practice towards the new system. Conversely, the opportunities came as some users enacted different applications of the new standards, where some were able to reinvent different ways of using the standards as an attempt to workaround some misfits. Cultivation strategies which advocate on a piecemeal incremental process in the change attempts, to give room for experimentation and revision of strategies were drawn upon to curb the challenges. Specifically, the cultivation strategies included use of participatory approaches and modularization. However, the study suggests the need to build and strengthen communication and collaboration linkages between the stakeholders in the attempt to curb the inertia of the vertical and parallel reporting systems. Theoretically, the study contributes to information systems knowledge base on the use of the installed base and user enactment concepts to analyze the use of the integrated health information system. Furthermore, the research contributes through theoretical implications drawn from the use of the user enactment and user participation. The study shows that user participation does not always lead to compliance due to the power that users have to apply agency and enact different ways to respond to the new technology, irrespective of their participation

Information management to enable personalized medicine: stakeholder roles in building clinical decision support

<p>Abstract</p> <p>Background</p> <p>Advances in technology and the scientific understanding of disease processes are presenting new opportunities to improve health through individualized approaches to patient management referred to as personalized medicine. Future health care strategies that deploy genomic technologies and molecular therapies will bring opportunities to prevent, predict, and pre-empt disease processes but will be dependent on knowledge management capabilities for health care providers that are not currently available. A key cornerstone to the potential application of this knowledge will be effective use of electronic health records. In particular, appropriate clinical use of genomic test results and molecularly-targeted therapies present important challenges in patient management that can be effectively addressed using electronic clinical decision support technologies.</p> <p>Discussion</p> <p>Approaches to shaping future health information needs for personalized medicine were undertaken by a work group of the American Health Information Community. A needs assessment for clinical decision support in electronic health record systems to support personalized medical practices was conducted to guide health future development activities. Further, a suggested action plan was developed for government, researchers and research institutions, developers of electronic information tools (including clinical guidelines, and quality measures), and standards development organizations to meet the needs for personalized approaches to medical practice. In this article, we focus these activities on stakeholder organizations as an operational framework to help identify and coordinate needs and opportunities for clinical decision support tools to enable personalized medicine.</p> <p>Summary</p> <p>This perspective addresses conceptual approaches that can be undertaken to develop and apply clinical decision support in electronic health record systems to achieve personalized medical care. In addition, to represent meaningful benefits to personalized decision-making, a comparison of current and future applications of clinical decision support to enable individualized medical treatment plans is presented. If clinical decision support tools are to impact outcomes in a clear and positive manner, their development and deployment must therefore consider the needs of the providers, including specific practice needs, information workflow, and practice environment.</p