Application of Enterprise Architecture to Guide the Integration of Health Information Systems in Namibia

Application of Enterprise Architecture to Guide the Integration of Health Information Systems in Namibia

Laizah Mutasa (Edith Cowan University, Australia), Martin Mabeifam Ujakpa (University of KwaZulu-Natal, South Africa), Wandisa Nyikana (Cape Peninsula University of Technology, South Africa), Irja N. Shaanika (Namibia University of Science and Technology, Namibia), and Tiko Iyamu (Cape Peninsula University of Technology, South Africa)
Copyright: © 2025 |Pages: 22
DOI: 10.4018/IRMJ.367274
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Abstract

Namibia is characterized by a fragmented health-care system that has led to data inconsistencies and duplication of efforts. It has also become costly to health-care institutions to maintain these fragmented, standalone systems. This study examined how enterprise architecture (EA) can be applied to guide the integration of health information systems (HISs) in the Namibian health-care context. A qualitative approach was applied to collect data from two cases using semi structured interviews and an interpretive approach in the analysis. From the analysis, the constructs of requirements clarity, information systems and technology (IS/T) project management, systems documentation, and communication were discovered to influence the development and integration of HISs. Applying these constructs, the study developed an EA guide for the development and integration of HISs. The study recommends that future studies consider developing similar architecture using a quantitative approach and possibly validating the developed guide using a quantitative approach.
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Introduction

The advancement of information and communication technology has influenced the growth of HISs (Adeniyi et al., 2024; Shao et al., 2022). HIS refers to comprehensive systems that integrate information technology (IT) and health-care practices to manage, process, store, and exchange health-related data (Epizitone et al., 2023; Winter et al., 2023). An HIS consists of, but is not limited to, electronic health records, clinical decision support systems, health information exchange, telemedicine, health information management, electronic medical records (EMRs), and other specific biomedical, administrative, and financial systems that generate, transmit, and store health-care information (Higman et al., 2019; Ngafeeson, 2014; Winter et al., 2023). According to Bagayoko et al. (2020), HISs have resulted in great improvements to both patient care and workflow by providing huge opportunities to reduce clinical errors such as medication and diagnostic errors and to support health-care professionals by offering up-to-date patient information (Adeniyi et al., 2024). However, health-care facilities still face the challenges of exchanging and managing data due to lack of integrated functionality among the supporting HISs (Fennelly et al., 2024; Guo et al., 2024; Mutasa & Iyamu, 2021; Ojeyinka & Omaghomi, 2024).

HIS integration is considered important because it provides effective communication and improves the performance and service delivery within the health organization (Fennelly et al., 2024; Guo et al., 2024; Organization for Economic Co-operation and Development, 2022;). The integration of HISs minimizes redundancy and the need to input the same information on the stand-alone systems. However, HIS integration is not as easy as it seems. The Organization for Economic Co-operation and Development (2022) highlights that HIS integration is a complex, expensive, and time-consuming process. The use of disparate health-care systems adversely affects service delivery, resulting in the loss of patient data and delays in accessing critical information. According to Popescu et al. (2022), HIS integration and standardization efforts are critical for the improvement of health-care services. Mutasa and Iyamu (2022) explain that HIS integration challenges could be owing to the complexity of health-care processes and the number of actors involved in those processes and that, despite efforts from practitioners, governments, and developers, HISs continue to lack acceptable levels of adoption, particularly in developing countries.

Across Namibia, there are over 400 health-care facilities managed by a variety of authorities, including the Ministry of Health and Social Services (MoHSS), missionary groups, nongovernmental organizations, the Ministry of Defense, private for-profit organizations, and the Namibian police services. Despite the diversity in management, all facilities are required to report to the MoHSS, which oversees and is responsible for all health-related matters across the country (Dlodlo & Hamunyela, 2017).

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