An ICT framework to support a patient-centric approach in public healthcare : A case study of Malawi

vital:59285The proliferation of Information and Communication Technologies (ICTs) worldwide has enhanced the amelioration of the quality of healthcare services. There is evidence that the adoption of electronic health (e-health) and mobile health (m-health) technologies has transformed the healthcare domain by improving the efficiency of healthcare service delivery. Digitising health ecosystems has culminated in increased access to healthcare services, even for remote rural areas. The application of ICTs in the healthcare sector has reduced the overall costs of healthcare services. However, developing countries, such as Malawi, face a plethora of challenges in implementing ICT initiatives in the public health sector. Although Malawi deploys several e-health systems, most are fragmented and, therefore, not interoperable. In addition, many m-health interventions are still in the pilot phase, and the Government does not manage them centrally. These challenges are further exacerbated by a lack of appropriate policy and regulatory framework, insufficient human capacity and development, inadequate financial resources, and poor ICT governance in the public healthcare sector. Furthermore, the current provider-centred approach to healthcare service delivery does not fully meet the needs of health consumers. It is, therefore, not surprising that the dearth of an ICT framework for patient-centric healthcare services has made coordination and management of ICT interventions less sustainable, less health consumer-centric and less cost-effective. Unlike the provider-centred approach, patient-centric healthcare empowers health consumers with health information to control their own health and well-being. A patient-centric healthcare approach provides treatment and care to health consumers based on their preferences, values, and beliefs. It is, therefore, cost-effective as it takes a preventive approach rather than a curative one. An ICT framework is proposed to support patient-centric healthcare services in the public healthcare sector in Malawi. A comprehensive literature review and analysis was succinctly conducted to gain an understanding of the Malawi health landscape and patient healthcare approaches. Semi-structured interviews were also undertaken to solicit information from various key v stakeholders such as policymakers, software developers, health consumers, and healthcare providers. Design science research paradigm coupled with pragmatism was then followed to develop the ICT framework, which will ultimately support patient-centric healthcare services in the public sector in Malawi. This methodology assists in solving social problems in a specific context by providing technology-based solutions in the form of an artefact. Experts in various disciplines domiciled in Malawi validated the ICT framework, as an artefact, for its relevance and applicability. The results showed that the framework is appropriate and relevant in the public healthcare sector in Malawi. This study contributes to design science research methodology as it addressed the improvement quadrant described by Gregor and Hevner. It also contributes to the existing body of knowledge by providing a design science artefact in the form of an ICT framework. It is envisaged that the proposed ICT framework will assist the Ministry of Health and other key stakeholders in providing quality patient-centric healthcare services in the public healthcare in Malawi.Thesis (PhD) -- Faculty of Engineering, the Built Environment, and Technology, 202

An ICT framework to support a patient-centric approach in public healthcare : A case study of Malawi

The proliferation of Information and Communication Technologies (ICTs) worldwide has enhanced the amelioration of the quality of healthcare services. There is evidence that the adoption of electronic health (e-health) and mobile health (m-health) technologies has transformed the healthcare domain by improving the efficiency of healthcare service delivery. Digitising health ecosystems has culminated in increased access to healthcare services, even for remote rural areas. The application of ICTs in the healthcare sector has reduced the overall costs of healthcare services. However, developing countries, such as Malawi, face a plethora of challenges in implementing ICT initiatives in the public health sector. Although Malawi deploys several e-health systems, most are fragmented and, therefore, not interoperable. In addition, many m-health interventions are still in the pilot phase, and the Government does not manage them centrally. These challenges are further exacerbated by a lack of appropriate policy and regulatory framework, insufficient human capacity and development, inadequate financial resources, and poor ICT governance in the public healthcare sector. Furthermore, the current provider-centred approach to healthcare service delivery does not fully meet the needs of health consumers. It is, therefore, not surprising that the dearth of an ICT framework for patient-centric healthcare services has made coordination and management of ICT interventions less sustainable, less health consumer-centric and less cost-effective. Unlike the provider-centred approach, patient-centric healthcare empowers health consumers with health information to control their own health and well-being. A patient-centric healthcare approach provides treatment and care to health consumers based on their preferences, values, and beliefs. It is, therefore, cost-effective as it takes a preventive approach rather than a curative one. An ICT framework is proposed to support patient-centric healthcare services in the public healthcare sector in Malawi. A comprehensive literature review and analysis was succinctly conducted to gain an understanding of the Malawi health landscape and patient healthcare approaches. Semi-structured interviews were also undertaken to solicit information from various key v stakeholders such as policymakers, software developers, health consumers, and healthcare providers. Design science research paradigm coupled with pragmatism was then followed to develop the ICT framework, which will ultimately support patient-centric healthcare services in the public sector in Malawi. This methodology assists in solving social problems in a specific context by providing technology-based solutions in the form of an artefact. Experts in various disciplines domiciled in Malawi validated the ICT framework, as an artefact, for its relevance and applicability. The results showed that the framework is appropriate and relevant in the public healthcare sector in Malawi. This study contributes to design science research methodology as it addressed the improvement quadrant described by Gregor and Hevner. It also contributes to the existing body of knowledge by providing a design science artefact in the form of an ICT framework. It is envisaged that the proposed ICT framework will assist the Ministry of Health and other key stakeholders in providing quality patient-centric healthcare services in the public healthcare in Malawi.Thesis (PhD) -- Faculty of Engineering, the Built Environment, and Technology, 202

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