Development of an evidence-based e-health readiness assessment framework for Uganda

Abstract

Background: While e-health readiness assessment is vital to the successful implementation of e-health innovations, there is little published guidance (i.e. e-health readiness assessment frameworks (eHRAFs)) for institutions and countries. Objective: To develop an evidence-based and locally relevant eHRAF for Uganda. Method: A list of possible e-health readiness domains and constructs was developed through a structured review of the e-health literature. This list was first refined using author experience, insight and reflection. Based on this refined list, an eHRAF questionnaire was developed, which was initially pilot tested for face and content validity. Thereafter, it was distributed to 13 purposively selected study participants who were Ugandan e-health experts from the fields of health, information and communications technology (ICT) and academia. The questionnaire was discussed in a focus group setting for consensus input, where study participants confirmed, rejected or revised proposed domains and constructs suitable to guide e-health readiness assessment at either the national or site-specific level within Uganda. Results: Of 148 identified literature resources, 13 met inclusion criteria. A subjective review highlighted 11 frequently used e-health domains. Further reflection reduced these to nine domains, which were shared with study participants by means of the questionnaire. Based upon prior use of, and familiarity with, a management tool (PESTEL), participants’ consensus on factors essential for readiness assessment in Uganda was aligned with PESTEL’s six domains: political, economic, sociocultural, technological, environmental, and legal and regulatory. The participants considered engagement, and core and societal readiness as optional domains. Based on this input, the authors developed a proposed eHRAF suitable for Uganda, comprised of domains, sub-domains and constructs. Conclusion: The eHRAF developed in this research is an evidence-based framework (literature and cross-sectoral expert opinion) and consists of primary domains, sub-domains and constructs suitable for assessing e-health readiness in Uganda, either nationally or locally, prior to implementation of any e-health system. The process and principles may have utility in other countries. Implications: A national, culturally relevant, context-specific Ugandan eHRAF could facilitate efficient and effective planning and implementation of new e-health programmes across the country and assist policymakers and legislators to develop consistent and reliable guidelines and regulations.

A readiness assessment framework for Blockchain adoption: A healthcare case study

“…The components of the framework were derived from key technology readiness assessment frameworkrelated studies on blockchain (Ozturan et al, 2019;Vlachos et al, 2019), e-health (Li et al, 2012;Rezai-Rad et al, 2012;Kiberu et al, 2019), e-records (Malanga and Kamanga, 2019), cloud computing (Colicchio et al, 2015), enterprise resource planning (Razmi et al, 2009), and e-government (Shareef et al, 2008).…”

“…However, a sector-wide implementation of any disruptive technology (such as blockchain) is challenging. Assessing the "readiness" for new technology projects is critical; unanticipated challenges during implementation may result in failure (Razmi et al, 2009;Kiberu et al, 2019). Given that blockchain is only as strong as its weakest link, understanding the differences in the readiness of the sector's stakeholders is critical (Pólvora et al, 2020).…”

Barriers and Facilitators of eHealth Adoption among Patients in Uganda – A Quantitative Study

“…Lacking digital skills to operate a system can be aggravated by the little or no formal education. As reported in other studies [20], [24], [37], [40] the lack of ICT skills to operate digital technologies was a very big impediment to adoption. Whereas a study conducted in Finland indicated that digital literacy does not have a direct impact on adoption [58], research conducted in Uganda, found out that expectant mothers did not use digital health technologies in their routine antenatal care practices because they lacked technical skills to operate the internet, computers and smartphones [29].…”

“…A structured survey questionnaire formulated in English with three main themes (demographic data, barriers and facilitators) was used to collect data. Barriers and facilitators used in the questionnaire were drawn from existing studies [6], [19], [23], [28], [37]- [39], [21], [27], [29], [16], [22], [32], [30], [40], [41], [20], [33], [42], [10]. All authors designed the questionnaire, however it was specifically tailored to fit the scope of this study.…”

Applying eHealth for Pandemic Management in Saudi Arabia in the Context of COVID-19: Survey Study and Framework Proposal

“…However, these studies are mostly related to normal health care operations. In a few studies [10,11], frameworks were developed for health care management during pandemics; however, these studies are limited in scope, focusing on frameworks for assessing preparedness and readiness but not for managing health care operations during pandemics. These studies focused on readiness strategies, such as resource management, finances, and vaccination; none of them highlighted an operational framework for pandemics that includes eHealth approaches or stakeholders' roles and responsibilities.…”