Critical Review 2: Technology and health information systems

Source of the article

Lewis, D., Hodge, N., Gamage, D & Whittaker, M. (2011) Understanding the role of technology in health information systems. Retrieved from the University of Queensland Health Information Systems Knowledge Hub: http://www.uq.edu.au/hishub/wp17

(Burbach et. al, 2012)

Introduction

Information-communication technology (ICT) plays a major role to improve isolated developing countries’ health system in aspects includes: communication and data-sharing between different health centres (close to Web 2.0), supporting health workers, providing visual tool to locate disease-outbreak regions, storing (close to Web 1.0) and interpreting medical data in databases. Medical ICT projects were introduced in Pacific region, as medical care system became a concern and projects aimed at improving health service qualities in the region. Some projects were successful but the others failed for various region. The article discussed about opportunities and benefits of introducing ICT for medical care system and evaluated the effectiveness of ICT medical projects, giving reasons for success or failure of projects.

Important issues

"ICT always improves health system" was  assumed, but flawed, as one-directional information received by medical entity is not enough for decision making: no feedback mechanism from clients and other medical institutions, making it difficult for isolated managers to decide critical factors like effectiveness, cost, social and ethics before enacting medical programs. Four questions were arisen:

Opportunities and gains ICT potentially pave for health system

With ICT, patients’ health conditions were recorded in databases, which were assessed by public institutions. Also, records can be retrieved by private clinics upon patients’ agreements. Therefore, patients’ health history could be tracked down and diseases are traced out easily. Without physical records, patients’ data were transferred electronically through large distance with little time and transportation cost. PDAs allowed data to be assessed in remote directions, which increased efficiency especially in cases of disease outbreak. Multimedia were used for video-conferencing of medical professionals, reducing transportation cost.

Outcomes of medical ICT projects

Similar to other ICT projects in developing world, about half of medical service ICT projects failed due to information sensitive nature, which both people, process and technology are critical (as cited in Steinmuller 2001, Cleverley 2009, UNAPCICT 2010). Resources were mismatched such as insufficient senior management; clients were unmotivated such as lack of will to learn about how to use electronic medical systems. Non-standardized system led to difficulties to handle and possible break down due to network and electrical problems, forcing staffs and patients to switch back to paper work and other traditional methods. Open standard of ICT system may relieve the problem (Saldanha & Krishnan, 2012, p. 308).

Common medical communication language was difficult to be set as different dialects were spoken for different communities in Pacific countries. Standardization was hindered by dispersed population. In contrast, communication language was standardized for library communication.

Tools, models and frameworks for evaluation of health system.

Case studies of Uganda and Solomon and Marshall Islands were used for evaluation, using 12 factors judging degree of success of ICT implementation. Seven stages of health information system was introduced as framework for future ICT development.

Shortcomings

The article discussed about ICT in Pacific region, consisting of various isolated island countries, located at tropical areas. As challenges of hygiene conditions vary inside Pacific countries, more researches have to be done to conclude about ICT situation. Furthermore, the experience may not be useful in large countries with plenty of manpower and intense transportation network, e.g. China and Australia, or densely populated region, e.g. Sydney and Hong Kong (IETHK, 2014), or information literate developed region with sufficient capital sustaining advancing medical system.

Conclusion

Although Pacific region consists of middle-low or low income countries, mobile phones have been thriving, overcoming infrastructure inferiority. However, monopoly resulted in high communication cost, hindering Web 2.0 application in medical data sharing.

Though article focused on medical service, library services are also information sensitive (ALA, 2004). Fallacy of medial ICT projects should be noticed so that library information programs are less likely to waste budgets or subsidies. 12-point framework and 7-step stages in developing medical ICT should be taken as reference when libraries develop ICT projects. Librarians should not focus only on technology development but neglect human and cultural factors.