Open Source Software: A Key Component of E-Health in Developing Nations

Open Source Software: A Key Component of E-Health in Developing Nations

David Parry (Auckland University of Technology, Auckland, New Zealand), Emma Parry (National Women’s Health, Auckland District Health Board, New Zealand), Phurb Dorji (Jigme Dorji Wanchuck National Referral Hospital, Thimphu, Bhutan), and Peter Stone (University of Auckland, New Zealand)
DOI: 10.4018/978-1-61692-002-9.ch012
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The global burden of disease falls most heavily on people in developing countries. Few resources for healthcare, geographical and infrastructure issues, lack of trained staff, language and cultural diversity and political instability all affect the ability of health providers to support effective and efficient healthcare. Health information systems are a key aspect of improving healthcare, but existing systems are often expensive and unsuitable. Open source software appears to be a promising avenue for quickly and cheaply introducing health information systems that are appropriate for developing nations. This paper describes some aspects of open-source e-health software that are particularly relevant to developing nations, issues and problems that may arise and suggests some future areas for research and action. Suggestions for critical success factors are included. Much of the discussion will be related to a case study of a training and E-health project, currently running in the Himalayan kingdom of Bhutan.
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This project deals with the intersection of a number of domains, as shown in Figure 1

Figure 1.

Research domains



E-health has become a popular term for the transformation of healthcare that has occurred through the use of electronic communications, in a conscious imitation of “ebusiness”. E-health encompasses more than the traditional electronic health record. It involves the use of information and communications technologies in the widest sense, including telemedicine, web-based health and mobile devices for healthcare. A definition has been proposed, after comprehensive analysis, in (Pagliari et al., 2005)

“e-health is an emerging field of medical informatics, referring to the organization and delivery of health services and information using the Internet and related technologies. In a broader sense, the term characterizes not only a technical development, but also a new way of working, an attitude, and a commitment for networked, global thinking, to improve health care locally, regionally, and worldwide by using information and communication technology”

This definition is actually adapted from a previous one in an editorial(Eysenbach, 2001). The globalised and networked aspects are particularly important in our case study – the emphasis is on communication and collaboration rather than distance

Health Information Systems

Health information systems (HIS) often have three main objectives, to improve patient care, improve management and form part of a quality improvement programme. However, these objectives – as described by (Littlejohns, Wyatt, & Garvican, 2003) are not always achieved. As part of a HIS implementation there are often major changes to workflow and practice, large expenditures on hardware including computing and communications, and system integration, as well as software development, training and implementation. (Littlejohns et al., 2003) Points out that failures occur in HIS development – often due to a lack of understanding of the complexity of the project. Interestingly OSS appears to answer some of these issues by providing more stable – if less feature-rich – software and providing a generally larger pool of developers and users than for proprietary software.

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