Introduction: Healthcare stakeholders hold diverse opinions and needs. Different Inputs, opinions and concerns of the stakeholders are essential to build a sustainable and successful digital health strategy. Successful digital initiatives are based on the understanding of the user characteristics, needs and challenges. Collaborating with stakeholders, sharing information and insights, sharing strategies and resources across projects/organizations leads to increased efficiency and impact. The aim was to assess the national to subnational level digital health needs of the government health sector stakeholders as a preliminary step of the national digital health strategy development. Methods: A consultative process was carried out for stakeholders at the national and subnational level to capture high level digital health needs of the government health sector in Sri Lanka. Stakeholders were gathered for a consultative workshop and divided according to their institutional level and influential capacity. Stakeholder needs were captured through structured discussions. The needs were analysed according to the eHealth building blocks of WHO National eHealth strategy toolkit. Results: Majority of the national level administrator and policy maker needs were the processes and solutions addressing legislation, policy and compliance (40%). Requirements of PDHS/RDHS were primarily concentrated on digital health services and applications (69%) which are essential for their institutions. Hospital sector was predominantly concerned about services and applications (71%). Programmes and campaigns were concerned mainly about the overarching digital health standards and interoperability (33%) and service-related applications (33%). Professional bodies required systems and applications on human resource management (53%). Conclusions: The digital health needs of the policy makers were more focused in the direction of legislation, policy and compliance while provincial, preventive and curative institutions were focusing on services and applications. Even though there are multiple vertical solutions running independently, suboptimal interoperability between the systems was highlighted. Hence, there is a necessity of a national digital health strategy to align services, solutions, guidelines and standards addressing the national to sub-national digital health needs.
Introduction: Over the past years, the state health sector witnessed the development and deployment of many intuitional based, electronic Health Information Systems (eHIS) in Sri Lanka. These eHIS have been implemented with varying degree of maturity and some show the potential to be scaled-up. However, some initiatives had been limited to pilot implementations and failed to scale up for sub-national to national level. The objectives of the evaluation were to assess the scaling up potential of the eHIS, provide recommendations to the national digital health strategy and enlist the systems in a global digital health marketplace i.e. Digital Health Atlas, for higher visibility and review. Methods: The MAPS toolkit was used as the primary evaluation tool, owing to its strong focus on digital health interventions scale-up. It was mapped with the eleven guiding principles of the National Health Information Policy strategic action plan which was assumed to be the closest available digital health strategy at the time of this evaluation, as there was no explicit digital health strategy for the country. Furthermore, the MAPS toolkit was logically mapped to the Principles for Digital Development for interpretation. The questionnaire was adopted with minor changes to suit local settings and validated by a panel of experts. The tool was administered to the managers of the currently implemented eHIS by three trained Interviewers. Data were randomly verified for quality assurance. Evaluated systems were enlisted in Digital Health Atlas, Sri Lanka country page. Results: 22 data points of 18 exclusive systems participated in the evaluation. Majority of the systems evaluated had a national scope (75%), and a very few projects had a subnational (12.5%) and institutional level scope (12.5%) but implemented at the institutional level. Nearly 60% of them had a financial contribution from the Ministry of Health while 25% had both financial as well as human resources. Nearly 91% of the systems have tested their products for usability with anticipated user groups. Further 86% of the systems had a demonstrated efficacy with 96% stating that the system has demonstrated effectiveness. Therefore, it was assumed that the slow scale-up progress was due to implementation issues rather than usability issues. Majority of the systems had a formal partnership with the Ministry of Health/Government entities. However, the formal partnerships with implementing partners, technology partners and service providers were not up to the standards. The formal partnership with marketing (communications) partner and evaluation (or research) partner was not identified by many systems. Majority of the systems have considered potential economic costs for scaling up the eHealth project. Nearly 46% (22.7% documented) have identified the total cost of ownership over the next five years, to reach their projected scale. Another 46% (18.2% documented) have identified key elements of the cost associated with scaling up the project. With regards to strategic choices rega...
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