Authors:
(1) Prabath Jayatissa, University of Colombo
(2) Roshan Hewapathirane, University of Colombo Table of Links Abstract & Introduction Methodology Results Conclusion & References 4. CONCLUSION Interoperability among health information systems is crucial for improving healthcare delivery in low and middle-income countries (LMICs) where access to quality healthcare is often limited. However, achieving interoperability in LMICs faces challenges such as limited resources, fragmented health information systems, and diverse health IT infrastructure. Strategies such as standardisation, consolidation, investment in health IT infrastructure, capacity building, and addressing data privacy and security concerns can enhance interoperability efforts. Collaborative efforts among governments, non-profit organisations, the private sector, and other stakeholders are essential for overcoming challenges and promoting interoperability in LMICs. Further research is needed to evaluate the impact of these strategies and identify novel approaches that are specific to the unique challenges faced by different regions and contexts within LMICs. Research on the cost-effectiveness and sustainability of interoperable health information systems is also crucial. Significant challenges include the need for more standardisation, fragmented health information systems, limited resources, and data privacy concerns. However, strategies such as standardisation, consolidation, investment in health IT infrastructure, and capacity building can help overcome them. Collaborative efforts are needed to address the multifaceted challenges of interoperability in LMICs and implement effective strategies. Further research and collaborative efforts are required to address the unique needs and contexts of LMICs and unlock the potential of health information systems to improve healthcare outcomes and advance health systems towards more integrated, patient-centred, and data-driven care in LMICs. REFERENCES [1] Adler-Milstein, J., DesRoches, C. M., Kralovec, P., Foster, G., Worzala, C., Charles, D., & Searcy, T. (2013). Electronic health record adoption in US hospitals: progress continues, but challenges persist. Health Affairs, 32(8), 1478-1485. [2] Adefioye, O. A., Adeleke, I. T., & Adewumi, A. O. (2019). Interoperability of health information systems in low-income countries: a systematic review of barriers and facilitators. BMC Medical Informatics and Decision Making, 19(1), 16. [3] Blaya, J. A., Fraser, H. S., & Holt, B. (2017). E-health technologies show promise in developing countries. Health Affairs, 36(12), 2168-2175. [4] Braa, J., Sahay, S., & Westerlund, M. (2017). The role of participatory design in strengthening community-based health information systems: a case study from Mozambique. Health Informatics Journal, 23(3), 180-189. [5] Kamadjeu, R. (2019). Impact of interoperability among electronic health records in low-resource settings: A systematic review. International Journal of Medical Informatics, 123, 27-34. [6] Karim, A. M., Ahsan, H., & Uddin, M. J. (2019). Interoperability in e-Health: A Systematic Literature Review. Health and Technology, 9(4), 687-697. [7] Seebregts, C. J., Mamlin, B. W., Biondich, P. G., Fraser, H. S., & Wolfe, B. A. (2017). Human factor considerations in developing and implementing information and communication technologies for health in low-resource settings. Yearbook of Medical Informatics, 26(01), 123-130. [8] Sharma, A., Wickramasinghe, N., & Gupta, D. (2017). Leveraging the capabilities of electronic health records for enhancing decision-making processes in low-resource settings: a literature review. Health Informatics Journal, 23(2), 89-99. [9] W G P T Jayatissa, Vajira HWD, Roshan H. Review of Master Patient Index. Dent Res Int J DRIJ. 2017;3(2):37–48. https://arxiv.org/abs/1803.00451 [10] Tchouaket, É. N., Charrier, R., & Henry, S. (2019). Addressing the lack of interoperability among health information systems in low-income countries: a socio-technical approach. Health and Technology, 9(5), 729-742. [11] Blaya, J.A., Fraser, H.S.F., Holt, B. (2017). E-health interoperability. In: Marschollek, M., Bauer, A., Wolf, K.H., Gradinger, M., eds. eHealth2016 - Health Informatics Meets eHealth: From Sensors to Decisions. IOS Press, pp. 9-14. [12] Tchouaket, É.N., Moine, M.P., Adedokun, A., et al. (2019). Challenges to Interoperability of Health Information Systems in Low- and Middle-Income Countries: A Literature Review. Studies in Health Technology and Informatics, 264, pp. 1399-1403. [13] Adler-Milstein, J., Jha, A.K. (2013). Sharing Clinical Data Electronically: A Critical Challenge for Fixing the Health Care System. JAMA, 309(10), pp. 991-992. [14] Kamadjeu, R. (2019). Challenges of Implementing eHealth in Developing Countries: An Example of a Web-Based Asynchronous Telemedicine System. Health Informatics Journal, 25(1), pp. 62-71. [15] Sharma, A., Kamadjeu, R., Mirza, S., et al. (2017). Development of a National Health Information System in a Resource-Limited Setting: A Case Study from Liberia. Health Informatics Journal, 23(4), pp. 295-306. [16] Jayatissa P, Vajira HWD, Roshan H. Developing a functional prototype Master Patient Index (MPI) for interoperability of E-Health systems in Seri Lanka. Dent Res Int J DRIJ. 2017;2(2):9–26. https://arxiv.org/abs/1803.00451 [17] Seebregts, C.J., Mamlin, B.W., Biondich, P.G., et al. (2017). The OpenMRS Implementers Network. International Journal of Medical Informatics, 108, pp. 117-121. [18] Adefioye, O.A., Asaolu, I.O., Ajayi, T.A., et al. (2019). Ethical and Legal Issues in Health Information Exchange in Low and Middle Income Countries: A Systematic Review. BMC Medical Ethics, 20(1), pp. 84. [19] Braa, J., Hanseth, O., Mohammed, W., et al. (2017). Developing Health Information Systems in Developing Countries: The Flexible Standards Strategy. MIS Quarterly, 41(1), pp. 309-322. [20] Karim, A.M., Nematzadeh, A., Gombera, F., et al. (2019). eHealth in Low- and Middle-Income Countries: Findings from the Center for Health Market Innovations. Health Affairs, 38(5), pp. 711- 718. [21] Jayatissa P, Hewapatirane R. Development of Minimum Clinical Data Set For Master Patient Index(MPI) for Sri Lankan Context. https://airccse.com/drij/papers/4422drij01.pdf .2022 Nov 1;4(4):1–18. This paper is available on arxiv under CC 4.0 license. Authors: (1) Prabath Jayatissa, University of Colombo (2) Roshan Hewapathirane, University of Colombo Authors: Authors: (1) Prabath Jayatissa, University of Colombo (2) Roshan Hewapathirane, University of Colombo Table of Links Abstract & Introduction Abstract & Introduction Methodology Methodology Results Results Conclusion & References Conclusion & References 4. CONCLUSION Interoperability among health information systems is crucial for improving healthcare delivery in low and middle-income countries (LMICs) where access to quality healthcare is often limited. However, achieving interoperability in LMICs faces challenges such as limited resources, fragmented health information systems, and diverse health IT infrastructure. Strategies such as standardisation, consolidation, investment in health IT infrastructure, capacity building, and addressing data privacy and security concerns can enhance interoperability efforts. Collaborative efforts among governments, non-profit organisations, the private sector, and other stakeholders are essential for overcoming challenges and promoting interoperability in LMICs. Further research is needed to evaluate the impact of these strategies and identify novel approaches that are specific to the unique challenges faced by different regions and contexts within LMICs. Research on the cost-effectiveness and sustainability of interoperable health information systems is also crucial. Significant challenges include the need for more standardisation, fragmented health information systems, limited resources, and data privacy concerns. However, strategies such as standardisation, consolidation, investment in health IT infrastructure, and capacity building can help overcome them. Collaborative efforts are needed to address the multifaceted challenges of interoperability in LMICs and implement effective strategies. Further research and collaborative efforts are required to address the unique needs and contexts of LMICs and unlock the potential of health information systems to improve healthcare outcomes and advance health systems towards more integrated, patient-centred, and data-driven care in LMICs. REFERENCES [1] Adler-Milstein, J., DesRoches, C. M., Kralovec, P., Foster, G., Worzala, C., Charles, D., & Searcy, T. (2013). Electronic health record adoption in US hospitals: progress continues, but challenges persist. Health Affairs, 32(8), 1478-1485. [2] Adefioye, O. A., Adeleke, I. T., & Adewumi, A. O. (2019). Interoperability of health information systems in low-income countries: a systematic review of barriers and facilitators. BMC Medical Informatics and Decision Making, 19(1), 16. [3] Blaya, J. A., Fraser, H. S., & Holt, B. (2017). E-health technologies show promise in developing countries. Health Affairs, 36(12), 2168-2175. [4] Braa, J., Sahay, S., & Westerlund, M. (2017). The role of participatory design in strengthening community-based health information systems: a case study from Mozambique. Health Informatics Journal, 23(3), 180-189. [5] Kamadjeu, R. (2019). Impact of interoperability among electronic health records in low-resource settings: A systematic review. International Journal of Medical Informatics, 123, 27-34. [6] Karim, A. M., Ahsan, H., & Uddin, M. J. (2019). Interoperability in e-Health: A Systematic Literature Review. Health and Technology, 9(4), 687-697. [7] Seebregts, C. J., Mamlin, B. W., Biondich, P. G., Fraser, H. S., & Wolfe, B. A. (2017). Human factor considerations in developing and implementing information and communication technologies for health in low-resource settings. Yearbook of Medical Informatics, 26(01), 123-130. [8] Sharma, A., Wickramasinghe, N., & Gupta, D. (2017). Leveraging the capabilities of electronic health records for enhancing decision-making processes in low-resource settings: a literature review. Health Informatics Journal, 23(2), 89-99. [9] W G P T Jayatissa, Vajira HWD, Roshan H. Review of Master Patient Index. Dent Res Int J DRIJ. 2017;3(2):37–48. https://arxiv.org/abs/1803.00451 [10] Tchouaket, É. N., Charrier, R., & Henry, S. (2019). Addressing the lack of interoperability among health information systems in low-income countries: a socio-technical approach. Health and Technology, 9(5), 729-742. [11] Blaya, J.A., Fraser, H.S.F., Holt, B. (2017). E-health interoperability. In: Marschollek, M., Bauer, A., Wolf, K.H., Gradinger, M., eds. eHealth2016 - Health Informatics Meets eHealth: From Sensors to Decisions. IOS Press, pp. 9-14. [12] Tchouaket, É.N., Moine, M.P., Adedokun, A., et al. (2019). Challenges to Interoperability of Health Information Systems in Low- and Middle-Income Countries: A Literature Review. Studies in Health Technology and Informatics, 264, pp. 1399-1403. [13] Adler-Milstein, J., Jha, A.K. (2013). Sharing Clinical Data Electronically: A Critical Challenge for Fixing the Health Care System. JAMA, 309(10), pp. 991-992. [14] Kamadjeu, R. (2019). Challenges of Implementing eHealth in Developing Countries: An Example of a Web-Based Asynchronous Telemedicine System. Health Informatics Journal, 25(1), pp. 62-71. [15] Sharma, A., Kamadjeu, R., Mirza, S., et al. (2017). Development of a National Health Information System in a Resource-Limited Setting: A Case Study from Liberia. Health Informatics Journal, 23(4), pp. 295-306. [16] Jayatissa P, Vajira HWD, Roshan H. Developing a functional prototype Master Patient Index (MPI) for interoperability of E-Health systems in Seri Lanka. Dent Res Int J DRIJ. 2017;2(2):9–26. https://arxiv.org/abs/1803.00451 [17] Seebregts, C.J., Mamlin, B.W., Biondich, P.G., et al. (2017). The OpenMRS Implementers Network. International Journal of Medical Informatics, 108, pp. 117-121. [18] Adefioye, O.A., Asaolu, I.O., Ajayi, T.A., et al. (2019). Ethical and Legal Issues in Health Information Exchange in Low and Middle Income Countries: A Systematic Review. BMC Medical Ethics, 20(1), pp. 84. [19] Braa, J., Hanseth, O., Mohammed, W., et al. (2017). Developing Health Information Systems in Developing Countries: The Flexible Standards Strategy. MIS Quarterly, 41(1), pp. 309-322. [20] Karim, A.M., Nematzadeh, A., Gombera, F., et al. (2019). eHealth in Low- and Middle-Income Countries: Findings from the Center for Health Market Innovations. Health Affairs, 38(5), pp. 711- 718. [21] Jayatissa P, Hewapatirane R. Development of Minimum Clinical Data Set For Master Patient Index(MPI) for Sri Lankan Context. https://airccse.com/drij/papers/4422drij01.pdf .2022 Nov 1;4(4):1–18. This paper is available on arxiv under CC 4.0 license. This paper is available on arxiv under CC 4.0 license. available on arxiv

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