Health Information Technology (HIT) in

Developing Countries

Current Use, Obstacles, and Future Development

Issues to be addressed by HIT in developing countries

HIT can help correct the health disparities and disadvantages of low- to middle-income countries.4

• Lack of health care providers

• Increase of elderly population

• Increased incidence of chronic and communicable diseases

• Limited access and continuity of health care

• Increase of communicable diseases

Benefits of HIT in developing countriesHIT will help resource-constrained countries in the following ways:

• Improve patient care and outcomes5

• Increase productivity5

• More effectively manage resources5

• Improve training of health care providers5

• Reduce the need for clinic visits6

• Prevent health care fraud2

• Streamline finances to prevent losses and expedite payments2

• Improve sharing of information6

• Overcome geographic limitations of rural areas1

• Aid in the problems created by language barriers2

Types of HIT used in developing countries

• Voice technologies such as hotlines, voice over IP, etc.2

• Text messaging between providers/patients, and provider/provider to encourage compliance in treatment protocols6

• PDAs to collect and organize data6

• Videoconferencing for live consults with specialists or higher-level providers in a different location4

• Electronic health records7

• Ancillary department information management systems including laboratory and pharmacy 6

• Patient registration, scheduling, patient tracking10

• Clinical decision support7

• GPS to track and find patients6

Main interests of providers using HIT in developing countries

Providers are most interested in technologies that:

• Improve communication with patients and other providers including education2

• Extend geographical boundaries2

• Improve quality of diagnosis and treatment2

Current utilizations of HIT in developing countries

Strengths Weaknesses

Extensive health information management system for refugee camps 10

Surveillance of services, conditions, and disease states for 1.5 million refugees in 85 camps

• Unable to distinguishrefugees from nationals receiving care

• Language barriers of collection tools vs. people collecting data

Hotlines for patients with chronic diseases4

• Reduction of inpatient admissions

• Frequently used

Text messaging, phonecalls to patients between personal contacts with health care providers6

• Increased compliance of patients in medication regimens and keeping appointments

• Cost-effective• Improved patient outcomes

• Language Barriers• Literacy Barriers

Current utilizations of HIT in developing countries (continued)

Strengths Weaknesses

GPS6 Ability to more quickly locate known patients

Patient data mostly unavailable

Videoconferencing4 • Rapid and more economical consults with providers separated by large distance.

• High quality of care provided• Greater patient satisfaction

Cost of technology

• PDAs for datacollection6

• Electronic picture archiving for radiology7

• Portable• Doesn’t use resources in short

supply (paper, ink, printers, etc.• High data quality

Internet health interventions for health promotion 8

• smoking cessation• weight reduction• management of chronic

medical and mental health conditions

• Resource is readily available, convenient, and is not depleted as it is used

• Cost-effective

• Language barriers

• Literacy barriers

Current utilizations of HIT in developing countries (continued)

Strengths Weaknesses

Pharmacy and lab information systems6

• Reduction of errors• Speed of processing• Ability to accurately

forecast needs for supplies

Clinical decision support tools

• Improved patient outcomes

• Not well researched

Open medical record system with access to programming codes for personnel to alter as needed1

• Flexibility• Encourages

independent workability

• Allows insight into needs of different environments

Barriers to HIT in developing countries

• Lack of HIT standards and policies (ethics, privacy of information, etc.)4

• Inconsistent legalities from country to country (taxes, insurance issues, medical legislation, etc.)4

• Lack of interoperability of systems1

• Insufficient data on use of HIT, needs, cost, etc.2

• Unreliable infrastructure so that power and internet access are intermittent7

• Lack of dedicated financial and staffing support6

Future of HIT in developing countries• Organizations and events formed to offer authority,

development and networking 4

• The International Society for Telemedicine and eHealth

• Med-e-Tel: yearly international conference

• Points regarding formation of programs and technology• Systems need to be lightweight, portable, and practical in a crisis10

• The humanitarian community should have input10

• Plans for evaluation methods and data dissemination need to be built into new systems1

• Security measures must be considered3

• Programs should be implemented gradually7

• Live follow-up will need to be planned when interventions are automated or over the internet5

(Continued)

Future of HIT in developing countries (Cont.)

• Policies and legislation formation• mutual recognition and reciprocity for providers between countries is

necessary3

• Limits to medical licenses should be placed3

• Guidelines for the HIT workforce11

• Future research7

• focus on the adaptability and relevance of technologies in a variety of settings

• include participation of communities

• smaller studies, although less definitive, are preferable as they are less expensive and produce quicker results

• Increase data about financial impact of implementing new technologies

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International Conference on E-Health and Bioengineering. E-Health and Bioengineering Conference.2011; 1, 6, 24-26. http://ieeexplore.ieee.org.jproxy.lib.ecu.edu/stamp/stamp.jsp?tp=&arnumber=6150373&isnumber=6150308. Accessed 4/15/13.5 Vogel L, Perreault, L. Management of Information in Healthcare Organizations. In: Shortliffe E, Cimono J., eds. Biomedical Informatics: Computer Applications in Health Care and Biomedicine 3rd

Edition. New York, NY: Springer Science + Business Media; 2006: 489-490.6Blaya,J., Fraser, H., Holt, B. E-Health Technologies Show Promise in Developing Countries. Health Aff. 2010; 29(2): 244-251.7 Piette, J., Lun,K., Moura,L., Fraser, H., Mechael, P., Powell, J., Khoja, S. Impacts of e-health on the outcomes of care in low- and middle- income countries: where do we go from here? Bull World Health Organ. 2012; 90(5): 365-372. doi: 10.2471/BLT.11.099069.8Geraghty, A., Toress, L., Leykin, Y., Perez-Stable, E., Munoz, R. Understanding attrition from international internet health interventions: a step towards global eHealth. Health Promot Int. 2012. doi: 10.1093/heapro/das029.9Sturgess,P., Philips,C. Enhancing internet literacy as a health promotion strategy for refugees and migrants. Health Promotion Journal of Australia. 2009;20 (3):247.10 Haskew, C., Spiegel, P., Tomczyk, B., Cornier, N., Hering, H. A standardized health information system for refugee settings: rationale, challenges, and the way forward. Bull World Health Organ. 2010; 88: 792-794. doi: 10.2471/BLT.09.074096.11Dentzer, S. E-Health’s Promise for the Developing World. Health Aff. 2010; 29(2): 229. doi: 10.1377/hlthaff.2010.0006