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      Health Informatics in Developing Countries: Going beyond Pilot Practices to Sustainable Implementations: A Review of the Current Challenges

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          Abstract

          Objectives

          Information technology is an essential tool to improve patient safety and the quality of care, and to reduce healthcare costs. There is a scarcity of large sustainable implementations in developing countries. The objective of this paper is to review the challenges faced by developing countries to achieve sustainable implementations in health informatics and possible ways to address them.

          Methods

          In this non-systematic review of the literature, articles were searched using the keywords medical informatics, developing countries, implementation, and challenges in PubMed, LILACS, CINAHL, Scopus, and EMBASE. The authors, after reading the literature, reached a consensus to classify the challenges into six broad categories.

          Results

          The authors describe the problems faced by developing countries arising from the lack of adequate infrastructure and the ways these can be bypassed; the fundamental need to develop nationwide e-Health agendas to achieve sustainable implementations; ways to overcome public uncertainty with respect to privacy and security; the difficulties shared with developed countries in achieving interoperability; the need for a trained workforce in health informatics and existing initiatives for its development; and strategies to achieve regional integration.

          Conclusions

          Central to the success of any implementation in health informatics is knowledge of the challenges to be faced. This is even more important in developing countries, where uncertainty and instability are common. The authors hope this article will assist policy makers, healthcare managers, and project leaders to successfully plan their implementations and make them sustainable, avoiding unexpected barriers and making better use of their resources.

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          Most cited references59

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          To Err Is Human : Building a Safer Health System

          (2000)
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            Crossing the Quality Chasm: A New Health System for the 21st Century

            B. Bloom (2002)
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              Crossing the Quality Chasm. A New Health System for the 21st Century

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                Author and article information

                Journal
                Healthc Inform Res
                Healthc Inform Res
                HIR
                Healthcare Informatics Research
                Korean Society of Medical Informatics
                2093-3681
                2093-369X
                January 2014
                31 January 2014
                : 20
                : 1
                : 3-10
                Affiliations
                Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
                Author notes
                Corresponding Author: Daniel Luna, MD, MSc. Chief Information Officer, Hospital Italiano de Buenos Aires, Pte. Perón 4190, C1181ACH, Buenos Aires, Argentina. Tel: +54-1149590507, Fax: +54-1149590507, daniel.luna@ 123456hospitalitaliano.org.ar
                Article
                10.4258/hir.2014.20.1.3
                3950262
                24627813
                5f322e4a-6b76-4c2b-8154-728eb2ec05d4
                © 2014 The Korean Society of Medical Informatics

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 November 2013
                : 15 January 2014
                : 15 January 2014
                Categories
                Review Article

                Bioinformatics & Computational biology
                medical informatics,developing countries,public health informatics,health planning,health manpower

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