A framework for designing sustainable telemedicine information systems in developing countries
| DOI | https://doi.org/10.1108/13287261211255329 |
| Date | 10 August 2012 |
| Pages | 200-219 |
| Published date | 10 August 2012 |
| Author | Kituyi G. Mayoka,Agnes S. Rwashana,Victor W. Mbarika,Stephen Isabalija |
| Subject Matter | Information & knowledge management |
A framework for designing
sustainable telemedicine
information systems in
developing countries
Kituyi G. Mayoka and Agnes S. Rwashana
Department of Business Computing, Makerere University Business School,
Kampala, Uganda
Victor W. Mbarika
InternationalCenter for Info. Tech. andDevelopment, Southern University (USA),
Baton Rouge, Louisiana, USA, and
Stephen Isabalija
Department of Business Computing, Makerere University Business School,
Kampala, Uganda
Abstract
Purpose – The purpose of this paper is to develop a framework for designing sustainable
telemedicine information systems in developing countries.
Design/methodology/approach – Both quantitative and qualitative research methods were used.
Primary data were collected from two hospitals in Uganda using a self-administered questionnaire and
an interview guide. Descriptive statistics were used to analyze survey data, while content analysis
method was used to analyze interview responses. The framework was developed based on
Hevner et al.’s design science framework.
Findings – The key requirements for designing sustainable telemedicine information systems in
developing countries were identified as the need for speed, ease of use and affordability.
Research limitations/implications – This study was theoretical in nature. Although primary
data were used, the researchers were unable to carry out a series of practical tests of this framework
with prototype systems on a cross-section of users.
Practical implications – Design and sustainability of telemedicine information systems is still a
big challenge to most developing countries, despite its wide usage in the developed countries. While
various telemedicine frameworks exist, not much has been done to adequately address the issue of
design for sustainability. This paper proposes an appropriate framework that will guide telemedicine
information systems designers on designing telemedicine systems that are sustainable in local
conditions of developing countries.
Originality/value – Themain contributionof this paper is in the areaof information systemsdesign for
sustainability, from a developingcountry perspective.The paper also extendson the constructs ofdesign
scienceresearch theory andshows how they can be applied in informationsystems designand evaluation.
Keywords Uganda, Developingcountries, Health care, Informationsystems, Telemedicine, E-Health,
Design framework,System evaluation, Design science,Sustainability, Mobile consultation
Paper type Research paper
The current issue and full text archive of this journal is available at
www.emeraldinsight.com/1328-7265.htm
This framework was developed based on Hevner et al.’s design science framework. The authors
therefore acknowledge the scholarly contribution of the authors of design science research theory
towards this framework.
JSIT
14,3
200
Journal of Systems and Information
Technology
Vol. 14 No. 3, 2012
pp. 200-219
qEmerald Group Publishing Limited
1328-7265
DOI 10.1108/13287261211255329
1. Introduction
Developments in the twenty-first century have led to the increased popularity of
information and communication technology (ICT) in all disciplines and professions
including banking, communication, education, health and business among others in
both the developed and developing countries. Services such as e-banking, e-learning,
e-health, e-commerce have now become synonymous in all aspects of humankind
(Kim and Shin, 2008; Awolola and Lawson, 2005). The health system is not left out as
many hospitals are moving towards implementing telemedicine (Olugbemiga and
Tanimowo, 2009). Many researchers have defined telemedicine differently; therefore
there is no universal definition as yet. However, the World Health Organization (WHO)
describes telemedicine as “the practice of medical care using interactive audiovisual
and data communications including medical care delivery, diagnosis, consultation and
treatment, as well as education and the transfer of medical data” (Adler, 2000; WHO,
1997). Although telemedicine is practiced in a diverse manner, the three well known
types of telemedicine in use today include store-and-forward telemedicine, home-based
telemedicine and hospital-based telemedicine (Hersh et al., 2006; Srinivasan et al., 2007).
The framework developed in this study adopts and adapts Adler (2000) and WHO
(1997) definitions of telemedicine without alteration. However, the framework is best
suited for hospital-based telemedicine, i.e. one which is administered in a hospital
environment under the supervision of a trained medical personnel.
Research shows that telemedicine is increasingly being used for purposes of
consulting and/or carrying out remote medical procedures including examination
and treatment (Olugbemiga and Tanimowo, 2009). Because of this, a number of
applications are being developed and deployed in hospitals to support clinical medicine
and medical information sharing via telecommunication links and the internet. Amidst
these developments, there have been a number of challenges with systems design and
sustainability in developing countries. In Uganda for example, the Rural Extended
Services and Care for Ultimate Emergency Relief (RESCUER) project that was aimed at
improving local care and reducing the high maternal mortality rate which stood at
506 per 100,000 people was implemented in Iganga district by the Ministry of Health
with help from the UN (Ssengooba et al., 2008; Dlamini, 2009). Although this system
was timely and could have worked, it heavily relied on VHF radio and walkie-talkies
for information sharing. These technologies did not provide a platform for information
storage for future use.
Despite the challenges associated with telemedicine, this technology remains a
method of choice for delivering cost effective quality healthcare. It has the potential to
significantly impact healthcare in developing countries where there are persistent
shortages of medical personnel (Oladosu et al., 2009a, b; Mbarika et al., 2007). The
WHO urges countries to develop strategies for proper design and implementation
of e-health technologies since it is a cost effective method of healthcare delivery
(Egiebor, 2008; WHO, 2005). By so doing, governments would be able to benefit from
services such as medical education, health surveillance, knowledge sharing and
research among others. This study, therefore, developed a framework that enables the
design of sustainable telemedicine information systems in developing countries using
Hevner et al. (2004) Design Science approach. It is hoped that this paper will make a
scientific contribution towards telemedicine design for sustainability in developing
countries by providing the salient factors that influence telemedicine IS design.
Telemedicine
information
systems
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