In the previous assignment, we looked into the development of health informatics in the Philippines – the idea of a country recognizing the role of information technology (IT) systems in the practice of health.
What most of us would usually think is, can the Philippines successfully sustain, or even install, such a system, knowing that we are a third-world or, more appropriately, a developing country?
That was actually my first question.
As we are well aware of, advancements in technology don’t usually come without investments, majority of which usually involves money. Something that is of great disparity between developed/industrialized countries and developing countries. This is one of the reasons why strategies in development and even sustainability of health information systems vary between industrialized and developing countries.
The Mind Map of HIS
Like what was mentioned before, successful installment (I believe) involves INITIATIVE, collaboration, imposing REGULATIONS, implementation and acceptance. This is especially true with developing countries who might require a bit of a “push” from key stakeholders such as the government in order for health information system to be created and be sustained.
In summary, a health information system (in developing countries) usually undergoes three phases: (1) realizing there is an irrefutable need for the system (ESTABLISHING THE NEED), (2) creating the framework and the details of that system (PROJECT PHASE) and, most especially as it is the topic of this assignment, (3) continuously enhancing it and its implementation to maintain the system (MAINTENANCE PHASE).
These three phases collaborate to produce a viable health information system with the extent of the “NEED” being the roots that shall rouse the components of the creation and sustainability of the system. Of course, there will always be challenges in every step, especially for such big endeavors. As such, each component may experience its own hindrance along the way.
One major problem being experienced by health information systems today is the considerable “design-reality gap” between what is ideally wanted by developers, and sometimes clients or government, and what is supposedly needed by the community it shall cater.
For a closer look into the these aspects and challenges, full mind map as follows:
WJS.
For further readings, you may look into the case studies of developing countries, Mozambique and Tanzania, below.
References:
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Heeks R. Health information systems: Failure, success and improvisation. Int J Med Informatics 2006;75:125-137.http://www.uio.no/studier/emner/matnat/ifi/INF5761/v12/undervisningsmateriale/Heeks%20-%202006%20-%20Health%20information%20systems%20Failure,%20success%20and%20i.pdf
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Kimaro HC & Nhampossa JL. The challenges of sustainability of health information systems in developing countries: comparative case studies of Mozambique and Tanzania. J Health Informatics in Developing Countries 2007;1(1):1-10http://www.jhidc.org/index.php/jhidc/article/viewFile/6/34
With Joyful Senescence 
I agree with your comment about the “design-reality gap”. Sometimes system designers are not in touch with the people who are its end users. No user satisfaction results in resistance and failure at the implementation and maintenance phase. For HIS, a designer who is both aware of the demands of the health care setting and its people as well as the intricacies of IT systems and design would be the “go to guy”, I guess that’s where you come in after this informatics course 🙂
yes doc, it really is (almost) a must that we consider the end users for these types of projects. this gap is actually my “realization of the week” haha. hopefully through this course, we can be hand-in-hand in sewing piece by piece the fabric of HIS in the country.
and then sooner or later, CSI-mode na ang systems. Just kidding! *wild dream*