Understanding Health Information Technologies as Complex Interventions With the Need for Thorough Implementation and Monitoring to Sustain Patient Safety

Wienert, Julian

doi:10.3389/fict.2019.00009

Cited by 17 publications

(31 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The culture of using DHIS2 data was limited both within the health ministry and across other ministries (16) . However, global evidence suggests that interdisciplinary coordination is essential for proper functioning of health information technology (IT) (17) . When appropriately designed, digital health technology has proven bene cial in improving the quality of health care through data-driven decisions (17) .…”

Section: Introductionmentioning

confidence: 99%

“…However, global evidence suggests that interdisciplinary coordination is essential for proper functioning of health information technology (IT) (17) . When appropriately designed, digital health technology has proven bene cial in improving the quality of health care through data-driven decisions (17) . Conversely, inappropriate IT design can cause poor human-computer interaction and potential time loss with staff demoralized towards the system (17) .…”

Section: Introductionmentioning

confidence: 99%

“…When appropriately designed, digital health technology has proven bene cial in improving the quality of health care through data-driven decisions (17) . Conversely, inappropriate IT design can cause poor human-computer interaction and potential time loss with staff demoralized towards the system (17) . Periodic evaluations and user feedback are vital to sustain digital technology within a health system (18) .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Perceptions and experiences with district health information system software to collect and utilize health data in Bangladesh: A qualitative exploratory study

Begum

Khan

Adamou

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Accurate and high-quality data are important for improving program effectiveness and informing policy.In 2009 Bangladesh’s health management information system (HMIS) adopted the District Health Information Software, Version 2 (DHIS2) to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality and reporting. We aimed to understand the facilitators and barriers to implementing DHIS2 as a way to retrieve meaningful and accurate data for reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services. Methods: This qualitative study was conducted in two districts of Bangladesh from September 2017 to 2018. Data collection included key informant interviews (n=11), in-depth interviews (n=23), and focus group discussions (n=2). The study participants were involved with DHIS2 implementation from the community level to the national level. The data were analyzed thematically.Results: DHIS2 could improve the timeliness and completeness of data reporting over time. The reported facilitating factors were strong government commitment, extensive donor support, and positive attitudes toward technology among staff. Quality checks and feedback loops at multiple levels of data gathering points are helpful for minimizing data errors. Introducing a dashboard makes DHIS2 compatible to use as a monitoring tool. Barriers to effective DHIS2 implementation were lack of human resources, slow Internet connectivity, frequent changes to DHIS2 versions, and maintaining both manual and electronic system side-by-side. The data in DHIS2 remains incomplete because it does not capture data from private health facilities. Having two parallel HMIS reporting the same RMNCAH indicators threatens data quality and increases the reporting workload. Conclusion: The overall insights from this study are expected to contribute to the development of effective strategies for successful DHIS2 implementation and building a responsive HMIS. Focused strategic direction is needed to sustain the achievements of digital data culture. Periodic refresher trainings, incentives for increased performance, and an automated single reporting system for multiple stakeholders could make the system more user-friendly. A national electronic health strategy and implementation framework can facilitate creating a culture of DHIS2 use for planning, setting priorities, and decision making among stakeholder groups.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Perceptions and experiences with district health information system software to collect and utilize health data in Bangladesh: A qualitative exploratory study

Begum

Khan

Adamou

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Limited DHIS2 use was also found within the health ministry and across other ministries (16) . Yet, global evidence suggest that the success of health information technology (IT) depends on interdisciplinary coordination (17) . When appropriately designed, this digital health technology has proven beneficial in improving the quality of health care through data-driven decisions (17) .…”

mentioning

confidence: 99%

“…Yet, global evidence suggest that the success of health information technology (IT) depends on interdisciplinary coordination (17) . When appropriately designed, this digital health technology has proven beneficial in improving the quality of health care through data-driven decisions (17) . However, inappropriate IT adversely affects the health system from poor human-computer interaction and potential time loss with demoralization of staff towards the system (17) .…”

mentioning

confidence: 99%

Perceptions and experiences with District Health Information System software to collect and utilize health data in Bangladesh: A qualitative exploratory study

Begum

Khan

Adamou

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Accurate and high-quality data are important for improving program effectiveness and informing policy. Bangladesh’s health management information system adopted the District Health Information Software, Version 2 (DHIS2) in 2009 to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality. We aimed to understand the facilitators and barriers of implementing DHIS2 as a way to retrieve meaningful and accurate data for reproductive, maternal and child health (RMCAH) services. Methods: This qualitative study was conducted in two districts of Bangladesh from September 2017 to 2018. Data collection included key informant interviews (n=11), in-depth interviews (n=23), and focus group discussions (n=2). The study participants were individuals involved with DHIS2 implementation from the community level to the national level. The data were analyzed thematically.Results: DHIS2 could improve the timeliness and completeness of data reporting over time. The reported facilitating factors were strong government commitment, extensive donor support, and positive attitudes toward the technology among staffs. Quality checks and feedback loops at multiple levels of data gathering points were helpful to minimize data errors. Introducing a dashboard makes DHIS2 compatible to use as monitoring tool. However, the barriers to effective DHIS2 implementation were lack of human resources, slow Internet connectivity, frequent changes to of DHIS2 versions, and maintaining both manual and electronic system side-by-side. Data in DHIS2 remains incomplete because it does not capture data from private health facilities. Having two parallel management information systems reporting the same RMNCAH indicators threatens data quality and increases the reporting workload. Conclusion: The overall insights from this study are expected to contribute to the development of effective strategies for successful DHIS2 implementation and building responsive health management information system. Focused strategic direction is needed to sustain the achievements of digital data culture. Periodic refresher trainings, incentives for increased performance, and an automated single reporting system for multiple stakeholders could make the system more user-friendly. A national electronic health strategy and implementation framework can facilitate creating a culture of DHIS2 use for planning, setting priorities, and decision making among stakeholder groups.

show abstract

Systems archetypes to investigate the unintended consequences of telehealth in rural Australia: A systems thinking approach to telehealth evaluation and policymaking

Osman,

Churruca,

Ellis

et al. 2023

Health Planning & Management

View full text Add to dashboard Cite

As an alternative model of delivery to standard care, telehealth offers a promising solution to health access issues faced by rural and remote communities in Australia and worldwide. However, research typically focuses on its expected benefits and pitfalls, with little to no consideration of its unintended consequences and factors influencing its better utilisation. Drawing on systems thinking and informed by complexity science, we propose using systems archetypes—systems thinking tools ‐ as a magnifying lens to investigate potential telehealth unintended consequences or outcomes. We conceptualise telehealth implementation in rural and remote Australia as a sociotechnical system whereby the interactions between its various agents shape telehealth implementation and, in turn, are shaped by it. When introducing new policies or interventions to any system, these interactions often lead to outcomes other than those initially planned or intended. Although systems archetypes cannot necessarily predict these outcomes, they are valuable for helping anticipate unintended, unforeseen outcomes and facilitating discussions about them to mitigate their negative impact and maximise their benefits. Outcomes are not necessarily adverse; they can also be positive. So, investigating such outcomes will minimise their negative impact and maximise their benefit. Our method was to review existing research and a selection of complexity and systems informed frameworks. Then, we assessed systems archetypes. And how they can be utilised to investigate unintended consequences. A worked example of what an unintended consequence in the implementation of telehealth in rural and remote Australia is presented.

show abstract

Understanding Health Information Technologies as Complex Interventions With the Need for Thorough Implementation and Monitoring to Sustain Patient Safety

Cited by 17 publications

References 14 publications

Perceptions and experiences with district health information system software to collect and utilize health data in Bangladesh: A qualitative exploratory study

Perceptions and experiences with district health information system software to collect and utilize health data in Bangladesh: A qualitative exploratory study

Perceptions and experiences with District Health Information System software to collect and utilize health data in Bangladesh: A qualitative exploratory study

Systems archetypes to investigate the unintended consequences of telehealth in rural Australia: A systems thinking approach to telehealth evaluation and policymaking

Contact Info

Product

Resources

About