Browsing by Author "Kiwanuka, Achilles"

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Establishing the State of Practice about Data Standards in Monitoring Healthcare Interventions for HIV in Uganda’s EMR-based Health Information Systems
(Science and Technology Publications, 2021-01) Kiwanuka, Achilles; Bagyendera, Moses; Wamema, Joseph; Alunyu, Andrew; Amiyo, Mercy; Kambugu, Andrew; Nabukenya, Josephine
Electronic Health Information Systems (EHIS) in Uganda are characterised by inaccessibility to reliable, timely and integrated data for effectively monitoring and tracking continuity of care for people living with HIV, exacerbated by disparate, fragmented EHIS in varying health system levels that are not interoperable and lack common data standards. In order for data to be comparable, there has to be uniformity in terms of standards that are employed in a uniform manner in all data management processes. In this study, we established the state of current practice regarding data and interoperability standards in monitoring and evaluating healthcare interventions for HIV in Uganda’s EMR-based health information systems. The study findings indicate that there are scanty practices and/or implementation of the eHealth standards (data and interoperability), and limited to noncompliance of monitoring these standards in the implementation of the HIV healthcare interventions. Accordingly, our study recommendations point to the need of designing data and interoperability frameworks to provide for the specific set of standards, protocols, procedures, best practices and policies for eHealth standardisation in Uganda’s health system.
Factors that Influence Potential Success of eHealth Standards Adoption in a Low- and Middle-Income Country: a review
(Journal of Health Informatics in Africa, 2020) Alunyu Egwar, Andrew; Wamema, Joseph; Kiwanuka, Achilles; Bagyendera, Moses
Assessing the potential success of adopted technology, innovation, or standard in a Low and Middle-Income Country like Uganda continues to focus on outcomes of adoption. This study aimed to investigate the potential success of eHealth standards adoption that may arise from the adoption process as well as outcomes of such adoption. PubMed and Google Scholar were searched using alternate terms for “eHealth”, “standards”, “adoption” “success” and “theory”. On screening and assessing the quality of publications, only nineteen peer-reviewed publications were included in the review. Both quantitative and qualitative analysis was used to synthesize evidence from the included literature. Thematic analysis was used to develop themes regarding the success of standards/technology adoption. Results: Constructs from the theories of Diffusion of Innovation Theory (DOI), Unified Theory of Acceptance and Use of Technology (UTAUT), and Internet Standards Adoption (ISA) were used to extend the Success Model of Innovation Adoption. The Success Model for Innovation contributed to the foundational concepts aligned to categorical factors of the adoption process, organizational, environment, and user context that influence the potential success of eHealth standards adoption in healthcare systems. The study identified 13 factors that contribute to the successful adoption of standards for eHealth. Since the review showed that success of standards adoption starts with assessing readiness to adopt the standards, followed by the standards adoption process and assessment of the lasting outcomes, the study proposes a model for assessing the potential success of eHealth standards adoption. The model has pre-adoption, actual adoption, and post-adoption phases. The proposed model and identified factors have not been evaluated and therefore may not in the current form support eHealth standards adoption processes. Future work is needed to evaluate/validate the model and factors of eHealth standards adoption success. Notwithstanding, the study believes any assessment of the success of standards adoption that uses the identified factors over all three phases of the model is comprehensive to present a true picture of any potential success of standards adoption.
Investigating the Impediments to Accessing Reliable, Timely and Integrated Electronic Patient Data in Healthcare Sites in Uganda
(Science and Technology Publications,, 2021-01) Alunyu, Andrew Egwar; Wamema, Joseph; Kiwanuka, Achilles; Bagyendera, Moses; Amiyo, Mercy; Kambugu, Andrew; Nabukenya, Josephine
The purpose of collecting patient data is to support their care and wellbeing. Patient-centred care is attained by securely availing all records about the patient whenever it's necessary to the right persons and at the right time. However, healthcare providers have often failed to share integrated patient data on time due to limitations in accessing reliable patient data required to inform care/treatment decisions. This study aimed to investigate impediments to accessing reliable, timely and integrated patient data through investigating the processes for collection, analysis, and presentation of data across various healthcare sites in Uganda. A cross-sectional study design was followed, and data was collected from purposively selected National level (policymakers) and Sub-national level (health facilities). The field findings indicate various impediments to accessing patient data including but not limited to inadequate mechanisms for electronic health data collection, storage and access, non-standardised health data sharing mechanisms, inadequate Health Information System (HIS) and Information and Communication Technology (ICT) infrastructure, and inadequate skills, knowledge and training. Other impediments included; insufficient security and privacy measures, weak eHealth governance, and inadequate management support. Accordingly, these have negatively impacted on patient data use and quality of patient care in Uganda.