Master's theses in telemedicine and e-health

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Master's theses in telemedicine and e-health

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• Current situation and future opportunity of telemedicine in Bangladesh

  Kalam, Abul (Master thesis; Mastergradsoppgave, 15-Aug-2011)

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  Abstract:

  Developing countries are leisurely adopter of new technologies, particularly with regards to the health services of these countries. This study explores the current health information infrastructure and future prospects of information and communication technology in health system of Bangladesh using an interpretative case study approach and proposes apply Telemedicine system to ensure health for all. This study almost certainly the first of its variety in Bangladesh; there have been some inadequate studies of Telemedicine early trials in some developing countries assessing the challenges of implementation. This study briefly mentions one of such; the Indian Telemedicine system. Some confronts that would obstruct the implementation of Telemedicine in Bangladesh are the initial huge start up costs, poor ICT culture of healthcare professionals and people embedding political meanings into the system. The weak state of information infrastructure at the hospital would be another challenge in implementation Telemedicine. Here Telemedicine could potentially reduce waiting times for patients, reduce the cost of the health system’s operations, improve interdepartmental, inter-hospital communication and collaboration, provide opportunity for sharing best practices among physicians within Bangladesh and international hospitals, and enhance better resource allocation.

  URI:

  http://hdl.handle.net/10037/3627

  File(s) in this item: 1

  thesis.pdf   (495.7Kb)
• The path to improving the quality of laboratory documentation : (a case study from Cameroon)

  Wefuan, Fatimatou Kuhmbou (Master thesis; Mastergradsoppgave, 15-May-2011)

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  Abstract:

  Health care systems nowadays are affected by quality problems, most of which occur in developing countries due to the lack of adequate infrastructural, human, and financial resources. This has also caused the data quality generated in developing countries to be often poor. As a result, most governments in developing countries are in the process of improving quality in their health care systems through the introduction of Information Technology (IT) support systems. This thesis explored the challenges and opportunities involved in the path to improving the quality of laboratory documentation in a Cameroonian hospital. The study employed the qualitative research approach whereby interpretive research methods were used during data collection. These consisted of participant observations, interviews, and document analysis. A total of 24 respondents were interviewed comprising of 19 hospital staff and 5 patients. The data was collected at the medical laboratory department of the Regional Hospital Bamenda over a period of two months. The theories of Information Infrastructures and Actor Network guided the study, that is, they were used to discuss the laboratory documentation, and the implementation of the IT support system in the everyday work practice. The study findings primarily revealed certain quality-related lapses in the laboratory documentation. For example, illegible laboratory test orders, common errors in laboratory test ordering and result reporting, just to name a few. It further revealed that IT support systems have great potential to improve upon the quality of the laboratory documentation. Thus, it suggested that a tailored IT support system could be implemented to address this issue. However, the greatest challenge discovered was the lack of resources to make this happen. Based on these findings, it was suggested that if resources are made available to implement this system, the socio-technical approach should be employed in order to ensure success. This is because this approach has proven to be effective since it does not only take into consideration the new technology implemented, but also the interaction between the technology and its users.

  URI:

  http://hdl.handle.net/10037/3546

  File(s) in this item: 1

  thesis.pdf   (3.180Mb)
• Nursing documentation as a communication tool : (a case study from Ghana)

  Johnson, Beatrice Bella (Master thesis; Mastergradsoppgave, 30-May-2011)

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  Abstract:

  Quality patient’s information has been proven to enhance the quality of care the patients receive as well as the guarantee of their safety. This is because information would be available to inform others and subsequently aid appropriate decision making concerning patients care. On the other hand, nurses being the professionals who spend twenty-four hours with the patients have a lot of information to capture from patients observation and care. Hence Nursing Documentation provides a lot of information to guide decision-making, and it therefore needs to be efficient in order to be effective. The purpose of this study was to assess the effectiveness of nursing documentation as a communication tool among health professionals involved in patients care. Other aims were the extent to which nursing documentation fosters communication in the care setting and also to exploit ways in which nursing documentation could be improved upon to enhance efficiency. The study was conducted within a period of two months at the Volta Regional Hospital, Ho, in Ghana. Qualitative research method particularly case study was used to find answers to the research question. Also Actor Network and Information Infrastructures theories guided the study. 27 nurses with different work experience and ranks, 2 physicians and 1 information officer were interviewed to exploit their divergent viewpoints on nursing documentation. In addition, participant observation was done in 4 of the wards on health personnel during work practice. The findings of the study indicated that work overload resulting from scarcity of nurses prevents the nurses from making time for documentation. Also there were too many sources of documentation with some levels of duplication without any definite structure. Further, a standard to guide nursing documentation was absent. In addition, nurses are trained in nursing care plan but had to use other types of documentation style at the work setting. Also the nurses make use and rely more on oral account of patient care than the written documentation. In conclusion the study revealed that at times the information captured was not adequate to communicate to others. However deployment of electronic nursing documentation at the wards was found to be appropriate in addressing this problem. Also the study provides insight into issues in the nursing documentation and accordingly would inform the Nursing Body in Ghana.

  URI:

  http://hdl.handle.net/10037/3545

  File(s) in this item: 1

  thesis.pdf   (3.945Mb)
• "Slow and steady wins the race" : a case study on infrastructural development of telemedicine services at Dhulikhel Hospital, Nepal

  Shrestha, Pritam Lal (Master thesis; Mastergradsoppgave, 15-May-2011)

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  Abstract:

  The use of ICT in the medical field has given rise to a new dimension so called telemedicine. Telemedicine is not a new concept, but the level of use differs between the developed and the developing countries, because of the limited infrastructural development and high expenses of technology in the later case. Though it is certain that using ICT in healthcare will improve health status of the nation, answers to the questions like which technology to choose; and what strategy to follow in order to achieve maximum benefit from minimum investment is still under consideration for developing countries. This study was carried out at Dhulikhel Hospital to explore the infrastructural development of telemedicine, its usage, benefits and users’ perspectives on the stability and sustainability of the services in future with context to hospitals in Nepal. A qualitative method with interpretive research approach was chosen for the study using informal discussions, observation and semi-structured interviews with open-ended questionnaires as data collection tools. The empirical findings have been generalized via Information Infrastructure (II) and Actor Network Theory (ANT) as theoretical framework. The findings from the study indicate that telemedicine is not simply technology; rather it is teamwork which requires good relationship between the users and good understanding of the setup. Furthermore, the study concludes that even a simple technology if implemented with proper vision and strategy can save many lives, and sustainability with telemedicine for developing countries can be achieved through slow and steady progression. Key words: Telemedicine, Nepal, sustainability, strategy, slow and steady progression.

  URI:

  http://hdl.handle.net/10037/3543

  File(s) in this item: 1

  thesis.pdf   (2.063Mb)
• Comparative study on system requirements and success factors of telemedicine solutions in resource-poor settings

  Dawson, Joanna Adobea (Master thesis; Mastergradsoppgave, 01-Jun-2011)

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  Abstract:

  Rationale: Attempts to successfully develop telemedicine solutions by specifying the require-ments and critical success factors of these solutions are on-going in sub-Saharan Africa (SSA) countries as a means of improving access to high-quality healthcare. European Space Agency (ESA) (Dario et al. 2005) have explored the challenges and benefits of telemedicine solutions in these regions in the domains of eGovernment such as billing and administrative data management to support the healthcare process, aggregation and reporting of administrative data including quality, clinical outcomes, improving decision making through access to information and ad-vocacy through modern technology. This thesis builds on from the comparative analysis of the healthcare systems in Ghana and Nigeria, in order to specify the system requirements for teleme-dicine solutions supporting health governance in these countries. Motivation: Relevant literature in the domains of public health and information systems (IS) which studies requirements and success factors of telemedicine solutions in SSA countries sug-gests specific attention to be paid to the ability of such solutions to support health system gover-nance. This is due to the complex institutional context involving technical, legal, organizational, and financial issues to be solved which makes it difficult to transfer decision-making, planning, budgeting, management and resource allocation from the national level to the country-regional, district, sub-district and community levels (Braa et al. 2001). Method: This thesis performs a thorough review of published evidence to acquire information on the governance structures of healthcare systems in Ghana and Nigeria as well as successful operative telemedicine applications and services in these countries. UML modeling of the struc-tures is used to describe the processes which link the national level to the level of the (Regional Economic Communities) RECs of which these two countries are part. The open source District Health Information System 2 (DHIS 2) developed by Jørn Braar and collaborators is analyzed to assess functionalities it has to support health governance and health system management. The system is also analyzed in terms of what it stores, its extensibility and scalability by functions. A structured interview on health system governance in Ghana and Nigeria is conducted with key respondents such as health workers, persons dealing with statistics and training, system users, Health Information System (HIS) managers and planners. The research questions are tailored towards decision making processes in the running of healthcare system from national level to community level. Issues around funds, budgets and resource allocations are discussed. Decisions made with regard to the implementation of health policies such as the implementation of new types of healthcare services (i.e. eHealth services) are also discussed. Results: A main finding in the thesis is that the development of information systems at district and Primary Health Care (PHC) levels in Ghana and Nigeria needs to be an integrated effort across health sectors. With this focus, requirements and critical success factors of telemedicine solutions for Ghana and Nigeria have been specified by assessing the governance structures of health services in the two countries and by analyzing the DHIS 2 to identify scenarios in health-care that need telemedicine support. In the case of Ghana, the local control and empowerment of information at lower levels should be embedded into PHC. This is due to the fact that the man-agement of the source of healthcare information is usually a top-down approach (from national level to lower level) toppled with the differences that exists in the collection of healthcare data. This causes delays in healthcare decision making and duplications and omission of key data sets for performance assessment by the government. As such, the DHIS 2, although being used for information reporting in the Ghanaian healthcare system extended in terms of functionalities it is proposed as a system to support healthcare governance. In the case of Nigeria, there exists a Na-tional Health Management Information System (NHMIS) as a management tool for informed decision making at all the levels of government in Nigeria. However, there is no clearly defined role of the different tiers of government which affects the proper functioning of the NHMIS in terms of data input and data quality. As such, integrating the DHIS 2 to be used alongside the NHMIS at the Local Government Areas (LGAs) may enhance data quality and improved infor-mation reporting in healthcare decisions. Conclusion: Telemedicine and eHealth activity around developing countries is increasing, and this fact cannot be denied. Although such activities could be a daunting task, they are emerging as a promising means for achieving quality healthcare. The specific healthcare situations in Ghana and Nigeria have resulted in the specification of seven requirements regarding to the utili-zation of a HIS (specifically the DHIS 2). This is hoped to assist in the effective governance of healthcare systems in these countries.

  URI:

  http://hdl.handle.net/10037/3522

  File(s) in this item: 1

  thesis.pdf   (2.804Mb)

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