Public health informatics : designing for change

Public Health Informatics: Positioning Within an Informatics FrameworkPublic Health Within an Informatics FrameworkOur Point of DepartureA Historical Overview of Developments in Computer Science and InformaticsA note on terminologyComputer science and informaticsA historical overview of developments in health informaticsHealth informatics developments in high-income countriesHealth Informatics Developments in Low and Middle-Income CountriesSummarizing Trends in Informatics and Health InformaticsPrimary orientation towards health and medical informaticsStrongly positivistic orientation towards practice and academics of health informaticsNeglect of informatics for primary healthcare systems in rich countriesNeglect of low and middle-income countries in the study of health informatics evolutionA Case For a More Expanded Public Health Informatics Focus in Low and Middle-Income CountriesConclusionsReferencesUnderstanding Public Health Informatics in Context of Health in Low and Middle-Income CountriesPublic Health Informatics in the Context of Health in Low and Middle-Income CountriesDefining Public HealthPublic Health and Primary HealthcareA Health Systems Understanding of Public HealthInformation Needs of Public Health Systems: Transcending Primary and Medical Care DomainsUnderstanding Health Status: Sourcing Real Time Morbidity and Mortality DataMeasuring Health Coverage: Data on Service Delivery and Organization of ServicesOn the Nature of Population-based Information Systems and Health ServicesInformation for Health Governance and Public Health Management: Cross-cutting Health Systems-based AnalysisPublic Health as Never Before: 'Health in All'The Interface with Clinical InformaticsFor creating a continuum between clinical and population-based approachesFor ease of recordingFor continuity of careFor assuring access to careFor ensuring patient rights and autonomy in clinical careEvolution and Path Dependence of Public Health InformaticsOrigins in monitoring vertical programmes and health sector reformsOrigins in building primary care systemsOrigins in insurance-based systems—mainly in developed nationsEstablishing Principles of Design for the 'Expanded PHI' Approach for Low and Middle-Income CountriesMultidisciplinary and systems-based approachesBuilding open architectures—not stand-alone systemsMultidisciplinary—certainly, but with public health at its coreContextualizationPlurality of methods for development with action research at the coreConclusionsReferencesThe 'Information-Use Problematic' in Health Information SystemsThe 'Use of Information' Problematic in GeneralUse of information in healthAnalysing the case: Understanding information needs and systems designData Quality Issues: Beyond False ReportingLearnings from the Himachal case studyLearnings from the Zanzibar case studyThe Politics of Information Use: Beyond Traditional RationalitiesThe Way Forward: How the Expanded PHI Approach Engages with the Use of Information ProblematicReferencesThe Challenge of Integration: (In)adequacy of Technical Solutions to Institutional ChallengesIntegration in Public Health InformaticsThe Problematic of IntegrationThe Why (or not) of IntegrationNational integration efforts in IndiaPrimary Health Centre Online SystemInstitutional Service Monitoring ReportPregnancy and Infant Cohort Monitoring System of TamilnaduHospital Information System in Tamilnadu's public hospitalsLearnings from the case studiesThe How of Integration: Modern Efforts of the Open Health Information ExchangeWhat is the Open Health Information Exchange?Health interoperability layerPoint of service applicationsLearnings from the case studyContemporary Global Integration Priorities and Approaches to Address ThemIntegration of parallel systems into the national health management information systemIntegrating community health data with the national health management information systemDeveloping standardized dashboards linked to guidance and training materialIntegrating patient-based and aggregate data to support continuity of careDeveloping and implementing case-based mortality reportingDeveloping and implementing tracking systems for case-based disease surveillanceDeveloping and implementing tracking systems for case-based malaria controlIntegrating logistics and drug management in district health information systems and health management information systemsDeveloping a facility register combined with an infrastructure dashboard and access systemThe Way Forward: Informed by an Expanded PHI ApproachUnderstanding the different whys and wherefores of integrationAdopting evolutionary approaches for flexible integrationAdopting bottom-up design supported by good governance for integrationAllowing for time to embed integration solutionsConclusionsReferencesDecentralized Information Use: Are The Cloud and Big Data Supporting This?The Cloud, Big Data, and Data AnalyticsWhat is Cloud Computing?Defnition and components of cloud computingDeployment modelsPrivate cloudCommunity cloudPublic cloudHybrid cloudTechnical configurations and business modelsCloud Infrastructure for Health in Low and Middle-Income Countries: Becoming Increasingly 'Autonomous'?Cloud Infrastructure: Moving from 'Closer to Machine' Applications to Further AwayLeveraging Cloud Infrastructure: Health Applications in Low and Middle-Income CountriesReflecting on Paradoxes of the Cloud and Local Use of DataCloud Infrastructure: Leveraging Big Data and Bigger ExpectationsBig data possibilities in low and middle-income countriesChallenges and Opportunities for Health in Low and Middle-Income CountriesKey challengesPrivacy and securityOwnershipEpistemological dilemmasInfrastructureCapacity strengtheningKey opportunitiesSupporting transitions in models of healthcare deliveryAddressing the challenge of scaleAbility to access low-cost and community-based software solutionsEnabling more effective surveillance of diseasesInductive Building of Design Principles: Use of the Cloud in Low and Middle-Income CountriesEnable a more sensitized engagement of development partnersBuild mutual synergies between national health information systems and cloud initiativesSupport the establishment of cloud and data science expertise in low and middle-income countriesBuild regulatory frameworks to protect ethical and legal issuesReferencesInstitutions as Barriers and Facilitators of Health Information Systems ReformThe Need to Describe the Institutional PerspectiveBuilding an Institutional Perspective to Understand Expanded PHIAn introduction to the institutional perspectiveFrom a macro-institutional perspectiveA micro-level institutional perspectiveInstitutions in Which Health Information Systems Are EmbeddedThe logic of healthcare institutionsThe logic of healthcare information managementThe institution of procurement: A key constraint to health management information systems reformThe logic of public health decision-making institutionsThe logic of donor institutionsDesign Principles for Building Institutions to Support Expanded PHITreat information and communications technologies' introduction and use as a process of negotiationEnable incentives from the system for allRedefine rules of procurementDecentralized systems are more effective than centralized onesReferencesComplexity and Public Health Informatics in Low and Middle-Income CountriesDefining ComplexityUnderstanding complexity in low and middle-income countriesComplexity and Fragmentation in Health Information SystemsAnalytical conceptsInformality and Fuzzy Complexity in Public Health Information Systems and Low and Middle-Income CountriesFormalization and general developmentFrom a Stand-Alone System to Central Server and the CloudData Quality and Data Access in the New SystemDHIMS 2 as Attractor for ChangeFormalization in medicine and public healthData quality and population-based systemsModels of Complexity, Big Data, and ServiceBig data and service modelsA model for analysing complexityThe context-sensitive versus context-free dichotomyThe more or less networked and interdependent dichotomyOutsourcing of services from the south to the northExamples from the Gambia and UgandaComplexity: Can health data and systems be black-boxed in service models?Concluding remarks on black-boxing services and big dataApproaches to Handling Complexity in Public Health Information Systems in Low and Middle-Income CountriesReferencesMeasuring Progress Towards Universal Health Coverage and Post-2015 Sustainable Development Goals: The Informational ChallengesIntroduction: Scope of Contemporary Informational ChallengesUnderstanding Universal Health Coverage: Implications for Information SupportOrigins and definitionCurrent discourses on universal health coverage in the global health community and its relation to providing information supportMeasurement of universal health coverageHealth informatics-related challengesMeasuring service coverage on the x-axisMeasuring financial protection on the y-axisMeasuring the Post-2015 Sustainable Development GoalsHealth Data Collaborative—International Partnership for Health Information and Tracking Health-related Sustainable Development GoalsData SourcesExisting situationRethinking and restructuring data sourcesHousehold surveysPrimary healthcare dataHospital-related dataReporting morbidity and mortalityEnabling continuity of careSupporting purchase of careCivil registration and vital statisticsAligning Information Flows: The Architecture ProblematicThe centralized electronic health record approachThinking about alternative architectureConclusionReferencesHealth Information Systems Governance and Standards: The Challenges of ImplementationDefining GovernanceHealth governance and IT governanceGovernance as power and politicsGovernance in Public Health InformaticsThe Political Economy of StandardsGovernance of IT standardsStandards for IT GovernanceLearnings from the Philippines case studyCreating New InstitutionsOriginsTriggers and Pain PointsAdopting an IT Governance FrameworkExpert GroupsOther Expert GroupsData Sharing AgreementsMonitoring and EvaluationBottom-up GovernanceConclusionReferencesStrengthening Healthcare Systems and Health Information Systems: Building SynergiesIntroductionHealth Reforms and Potential Implications on National Health Information SystemsThe path to universal health coverageImprovement of civil registration and vital statistics systemsAccelerating the Expanded Programme on Immunization to meet global and regional targetsSaving the lives of mothers and childrenMonitoring the core set of indicatorsHealth information systems challenges with health in the post-2015 development agendaUN political declaration on prevention and control of non-communicable diseasesComplying with International Health Regulations (2005)Health systems strengthening in countriesMeasurement and accountabilityInterdependence and Synergies: Health Sector Reform and Reform of National/Public Health Information SystemsMoving Forward: At the Level of Policy, Academics, and PracticeCreating an enabling policy environment to guide health information systems developmentData policyWidening the scope and content of information disseminationHuman resources policies and capacity developmentImplications for research and academia: Establishing theoretical foundations for Expanded PHIFormulating research challenges around Expanded PHIChoice of technology and innovationInstitutions of governanceGuiding theoretical approachesGuiding methodological approachesEstablishing communities of practice and activist networksConclusionReferences
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