An Exploratory Study of the Readiness of Public Healthcare Facilities in Developing Countries to Adopt Health Information Technology (HIT)/e-Health: the Case of Ghana

Readiness of managers and health care workers for e-Health: a cross-sectional study in Khartoum primary health care centers, Sudan

BACKGROUND

e-Health is defined as "the use, in the health sector, of digital data- transmitted, stored and retrieved electronically-for clinical, educational and administrative purposes, both at the local site and at a distance". In Primary health care (PHC), the role of e-Health in promoting PHC systems defines its need to achieve the PHC aims. This literary work aims to study the readiness of managers and healthcare workers for e-Health at Khartoum state PHC centers.

METHODS

This was a facility-based cross-sectional study that took place between February and August 2022. A sample size of 327 was calculated, and multistage cluster sampling was used. A validated questionnaire was used, and the generated data were analyzed using the Statistical Package for Social Sciences (SPSS). Variables were described as n (%) and mean ± SD. Non-parametric tests and Spearman's correlation were used to investigate the association of readiness scores with different categorical and numerical variables, respectively. A standard multiple regression model was used to model the associations.

RESULTS

A total of 262 forms were completed. The overall readiness percentages were low for both managers (52.8%) and healthcare workers (55.3%). Factors associated with e-Health readiness included occupation, doctors' level of expertise, PHC center, and PHC center type.

CONCLUSIONS

This study reports low levels of e-Health readiness as reflected by managers and HCWs in Khartoum State PHC. Project planners need to be aware of the obstacles and threats faced by e-Health initiatives if they are not carefully planned, executed, and monitored. Special attention must be given to addressing health inequities and inequalities to ensure that these projects will contribute to fostering accessibility to health services and narrowing the digital divide.

An evaluation of the risk factors associated with implementing projects of health information technology by fuzzy combined ANP-DEMATEL

BACKGROUND

Application of a Clinical Information System (CIS) like Electronic Patient Record (EPR), PACS system and CPOE has turned into one of the most important criteria of priorities of health care systems. The aims of the clinical information system include improving the physicians' efficiency level, integrating the caring process, and expanding the fuzzy quality of the services offered to patients. Achievement of these benefits in reality is not an easy task, and there are lots of plans in this field which are doomed to failure. About 50% of the implementation plans of clinical information systems in health care organizations have failed, and this trend is significantly affecting industrial countries. Proper implementation of hospital information systems lies in identifying and assessing the relationships among the most important risk factors of fuzzy. The present study aimed to provide an applicable model for identifying, ranking and evaluating the risk factors associated with projects of clinical information technology in hospitals of Shiraz University of Medical Sciences.

METHOD

This is an applied study which evaluates the risk factors associated with implementation of clinical information technology projects in hospitals of Shiraz Medical Sciences University. The participants consisted of professionals and senior experts of clinical information technology. Fuzzy logic was used in this study. We also applied ANP-DEMATEL combined model with fuzzy procedure to provide the analytic model of the study.

RESULTS

According to the study findings, lack of top-executive supports, and unstable organizational environment were the two most important risk factors, while the main organizational factors and technology were also highly important. In addition, the factors associated with technology had the highest influence on the other studied risk factors.

CONCLUSION

Hospital authorities can benefit from this proposed model to reduce the risk of implementing the projects of clinical information technology and improve the success coefficient of the risk of such projects.

Health professionals knowledge of telemedicine and its associated factors working at private hospitals in resource-limited settings

Introduction

The appropriate implementation of telemedicine in the healthcare system has the potential to overcome global problems such as accessibility and quality healthcare services. Thus assessing the knowledge of health professionals before the actual adoption of telemedicine is considered a prominent solution to the problems.

Objective

This study aimed to assess healthcare professionals' knowledge of telemedicine and its associated factors at private hospitals in low-resource settings.

Method

An institution-based cross-sectional study was conducted among 423 health professionals at private hospitals in low-income settings in Ethiopia, from March to April 2021. Data collection was performed by pretested and self-administered questionnaires. This study employed statistical packages for social sciences software. This study employed multivariable logistic regression to determine dependent and independent variables associated with adjusted odd ratio and 95% CI.

Result

in this study about 65.8% of health professionals have good knowledge on Telemedicine .Computer literacy (AOR = 2.9; 95% CI: 1.8, 4.6), computer training (AOR = 2.0; 95% CI: 1.2, 3.3), Internet availability at workplace (AOR = 2.1; 95%CI: 1.3, 3.4), had private laptop (AOR = 1.7; 95% CI: 1.1, 2.9) were significantly associated with knowledge.

Conclusion and recommendation

In general health professionals had good knowledge of Telemedicine. Inclusive packages of capacity by training among health providers are fundamental for the successful implementation of telemedicine.

Assessing organizational health-analytics readiness: artifacts based on elaborated action design method

Purpose

While the adoption of health-analytics (HA) is expanding, not every healthcare organization understands the factors impacting its readiness for HA. An assessment of HA-readiness helps guide organizational strategy and the realization of business value. Past research on HA has not included a comprehensive set of readiness-factors and assessment methods. This study’s objective is to design artifacts to assess the HA-readiness of hospitals.

Design/methodology/approach

The information-systems (IS) theory and methodology entail the iterative Elaborated Action Design Research (EADR)method, combined with cross-sectional field studies involving 14 healthcare organizations and 27 participants. The researchers determine factors and leverage multi-criteria decision-making techniques to assess HA-readiness.

Findings

The artifacts emerging from this research include: (1) a map of readiness factors, (2) multi-criteria decision-making techniques that assess the readiness levels on the factors, the varying levels of factor-importance and the inter-factor relationships and (3) an instantiated system. The in-situ evaluation shows how these artifacts can provide insights and strategic direction to an organization through collective knowledge from stakeholders.

Originality/value

This study finds new factors influencing HA-readiness, validates the well-known and details their industry-specific nuances. The methods used in this research yield a well-rounded HA readiness-assessment (HARA) approach and offer practical insights to hospitals.

Healthcare providers' readiness for electronic health record adoption: a cross-sectional study during pre-implementation phase

BACKGROUND

The adoption of an electronic health record (EHR) in the healthcare system has the potential to make healthcare service delivery effective and efficient by providing accurate, up-to-date, and complete information. Despite its great importance, the adoptions of EHR in low-income country settings, like Ethiopia, were lagging and increasingly failed. Assessing the readiness of stakeholders before the actual adoption of EHR is considered the prominent solution to tackle the problem. However, little is known about healthcare providers' EHR readiness in this study setting. Accordingly, this research was conducted aiming at examining healthcare providers' readiness for EHR adoption and associated factors in southwestern Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted from September 1 to October 30, 2021. A total of 423 healthcare providers working in public hospitals were selected using a simple random sampling technique. Multivariable logistic regression was fitted to identify determinant factors of overall healthcare providers' readiness after the other covariates were controlled.

RESULT

In this study, the overall good readiness level of EHR adoption was 52.8% (n = 204) [95% CI of 47.9% to 56.6%]. Age, computer literacy, computer access at health facilities, attitude towards EHRs, awareness about EHRs, perceived benefit, and perceived technology self-efficacy were significantly associated with the overall health care providers' readiness for the adoption of EHR using a cut point of P-value less than 0.05.

CONCLUSION

Around half of the respondents had a good level of overall healthcare providers' readiness for the adoption of EHR which was considered inadequate. This finding implied that a huge effort is required to improve readiness before the actual implementation of EHRs. The finding implied that younger-aged groups were more ready for such technology which in turn implied; the older one needs more concern. Enhancing computer literacy, confidence building to raise self-efficacy of such technology, addressing the issue of computer availability at health facilities, building a positive attitude, awareness campaign of EHR, and recognizing the usefulness of such systems were the necessary measures to improve EHR readiness in this setting. Additionally, further studies are recommended to encompass all types of EHR readiness such as organizational readiness, technology readiness, societal readiness, and so on. Additionally, exploring the healthcare provider opinion with qualitative study and extending the proposed study to other implementation settings are recommended to be addressed by future works.

Capacity and Readiness Assessment of Healthcare Facilities for Digital Health Interventions Against Tuberculosis and HIV in Addis Ababa, Ethiopia

Background

There is a high level of concern that low-income countries lack the capacity and readiness to effectively adopt, implement, and scale up digital health interventions (DHIs). We aimed to assess the infrastructure and human resource capacity and readiness of healthcare facilities to adopt and implement any new DHI for tuberculosis (TB) and HIV care and treatment in Addis Ababa, Ethiopia.

Method

We carried out a cross-sectional, mixed-methods study in 14 public healthcare facilities that provide TB and HIV care and treatment services. Providers' perceived readiness to adopt and implement digital health was assessed using a self-administered questionnaire designed based on an adapted eHealth readiness assessment model that covers six domains: core readiness, organizational cultural readiness, value proposition readiness, technological readiness, regulatory policy readiness, and operational resource readiness. The infrastructure and human resource capacity were assessed on-site using a tool adapted from the Technology Infrastructure Checklist. Internal consistency was assessed using Cronbach's alpha, and the significant relationship between the composite variables was assessed using Pearson's correlation coefficients (r).

Result

We assessed 14 facilities on-site and surveyed 60 TB and HIV healthcare providers. According to Cronbach's alpha test, all the six technology acceptance domains had a value of >0.8, suggesting a strong interrelatedness between the measuring items. The correlation between technological readiness and operational resource readiness was significant (r = 0.8). The providers perceived their work environment as good enough in electronic data protection, while more efforts are needed in planning, training, adapting, and implementing digital health. Of the 14 facilities, 64.3% lack the plan to establish a functional local area network, and 43% lack skilled staff on payroll to provide maintenance of computers and other digital technologies.

Conclusion

Like many developing countries, there was a modest infrastructure and human resource capacity and readiness of public healthcare facilities in Addis Ababa, Ethiopia, to nurture and strengthen DHIs across the TB and HIV cascades of care. Technological and operational resource readiness, including funding and a Well-trained workforce, are essential for successful implementation and use of digital health against the two infectious diseases of global importance in such settings.