Status of Resources for Information Technology to Support Health Information Exchange in Resource-constrained Settings

Abstract

Various resources exist to support health information exchange (HIE). Both computerised and uncomputerized communication resources continue to be used in resource-constrained environments, like the Uganda health system to support HIE. Despite the rapid shift to the digital health environment, the resource capabilities of health systems in LMICs to support robust HIE is unknown. This study surveyed the status of resources for ICT to support ehealth communication in a resource-constrained setting. The study was conducted in three districts, representing the urban, peri-urban and rural settings of Uganda. The qualitative data collected was analysed with QSR NVivo 10. Results show major resource challenges including financial constraints, funders restrictions, human resource limitations, isolated computer systems, lack of support from management, legacy/outdated systems, intermittent/limited network bandwidth, limited hardware, misuse/poor maintenance of the available hardware, and power outages among others. In addition, results show a great disparity in their distribution across the healthcare sector. Therefore, we argue that much improvement is needed if the benefits of ehealth are to be attained in LMICs. Recommendations include specifying minimum resources for ICT required to support HIE, supervising implementation and monitoring compliance to the standards, establish a mechanism for periodic review of the minimum standards, and finally, align ICT funding within the mainstream funding for healthcare services. It should uniformly apply across the board (i.e., facilities located in urban, peri-urban and urban) for the full benefits of ICT in health to be achieved in LMICs.