Conference Proceedings (Science)

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    Issues of adoption: can health services designed for developed countries be adopted in developing countries?
    (International Network Conference, 2014) Ssembatya, R; Zawedde, S

    Electronic health record (EHR) systems are a popular mechanism for accessing health records in the developed world and have contributed towards improved and cost-effective health care management. However, the development of appropriate and scalable EHR systems in developing countries has been difficult to achieve because of certain limitations inherent in the technological infrastructure. For instance, bandwidth limitations and power outages make it difficult to guarantee dependability in terms of accessibility to the data. This paper presents a comparative study of 19 EHR systems in terms of the security and usability of these systems within the context of the developing world. The evaluation is based on a number of dimensions such as development environment, system platform, type and access control standards found in the National Institute for Standard and Technology (NIST) and Certification Commission for Health Information Technology (CCHIT). Our research indicates that all the systems evaluated require online access control decisions. Access to data on a central server is controlled by a mechanism that verifies/authenticates users or parties wanting to view/modify/edit patient records. However, solely relying on an online access control system is limiting, particularly in developing countries where access to the server can be disrupted by a number of disastrous events. Additionally, literature also reveals that all the evaluated tools were developed with the user contexts in the developed World and therefore do not represent the needs of the patients and medical practitioners in the developing countries.

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    In-Sample Spatio-temporal Predictions by Multivariate Singular Spectrum Analysis
    (Elsevier, 2015) Awichi, Richard
    In this paper, we present a method of utilizing spatial information, usually intrinsic in spatial data sets, to improve the quality of temporal predictions within the framework of singular spectrum analysis (SSA) techniques. Those constitute a model free approach to time series analysis and SSA can be applied to any time series with a notable structure. Indeed it has a wide area of application including social sciences, medical sciences, finance, environmental sciences, mathematics, dynamical systems and economics. The aim of SSA is twofold: i) to make a decomposition of the original series into a sum of a small number of independent and interpretable components such as a slowly varying trend, oscillatory components and a structureless noise; ii) to reconstruct the decomposed series to make a forecast in the absence of the noise component. It has two stages each with two steps. The first stage is the Decomposition Stage with steps comprising: (i) embedding–a usual procedure in time series analysis; the result of which is a called a trajectory matrix in SSA literature; (ii) singular value decomposition step that computes and arranges eigenvalues of this matrix for further analysis. The second stage is the Reconstruction Stage: it comprises two steps of (i) grouping the eigenvalues of the SVD step and (ii) diagonal averaging that works on the grouped matrices to realize a series close to the original series and this series is then used for further analysis. Multivariate Singular Spectrum Analysis (MSSA) is an extension of SSA to multivariate statistics and takes advantage of the delay procedure to obtain a similar formulation as SSA though with larger matrices for multivariate data. In environmental sciences and other areas where spatial data is an important focus of investigation, it is not uncommon to have attributes whose values change with space and time and an accurate prediction is thus important. Spatial dependence subsequently influences data analysis. The usual question asked is whether the location parameters can be of use in the analysis of such data sets. We present a method that can be used to harness the location attributes to enhance prediction of spatial data sets using an MSSA approach. This technique is applied to climate data recordings (particularly rainfall data) from Upper Austria.
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    Secure and efficient mobile personal health data sharing in resource constrained environments.
    (IEEE International conference, 2015) Ssembatya, Richard; Kayem, Anne V.D.M
    Although personal health record (PHR) systems are widely used in the developed world, little has been done to explore the utility of these PHR systems in the developing world. One of the key reasons behind this is the fact that a lot of areas in the developing world suffer from technological impediments that are a result of poor infrastructure, low literacy, intermittent power connectivity, and unstable bandwidth connectivity. In technological resource constrained environments such as these, deploying standard PHR systems is challenging and so it makes sense to redesign these systems to cope with the environmental limitations in order to offer users a usable and reliable platform. Furthermore, healthcare data is inherently privacy and security sensitive so, in re-designing the PHR system the security and privacy requirements need also be taken into consideration. The idea in this case, is to opt for security mechanisms that offer the same levels of security as is the case in the standard PHR systems that are used in the developed world, but that are also lightweight in terms of performance and storage overhead. In this paper, based on the observation that mobile phone use is widely proliferated in developing countries, we propose an access control framework supported by identity-based encryption for a secure Mobile-PHR system. Results from our prototype evaluation (laboratory and field studies) indicate that the proposed IBE scheme effectively secures PHRs beyond the healthcare provider's security domain and is efficient performance-wise.
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    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.
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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.