DEVELOPING HEALTH INFORMATION SYSTEMS IN DEVELOPING COUNTRIES: THE FLEXIBLE STANDARDS STRATEGY.

Author List: Braa, JËrn; Hanseth, Ole; Heywood, Arthur; Mohammed, Woinshet; Shaw, Vincent;
MIS Quarterly, 2007, Volume 31, Issue 2, Page 381-402.
The development of appropriate integrated and scalable information systems in the health sector in developing countries has been difficult to achieve, and is likely to remain elusive in the face of continued fragmented funding of health programs, particularly related to the HIV/AIDS epidemic. In this article, we propose a strategy for developing information infrastructures in general and in particular for the health care sector in developing countries. We use complexity science to explain the challenges that need to be addressed, in particular the need for standards that can adapt to a changing health care environment, and propose the concept of flexible standards as a key element in a sustainable infrastructure development strategy. Drawing on case material from a number of developing countries, a case is built around the use of flexible standards as attractors, arguing that if they are well defined and simple, they will be able to adapt to the frequent changes that are experienced in the complex health environment. A number of paradoxes are highlighted as useful strategies, integrated independence being one that encourages experimentation and heterogeneity to develop and share innovative solutions while still conforming to simple standards. The article provides theoretical concepts to support standardization processes in complex systems, and to suggest an approach to implement health standards in developing country settings that is sensitive to the local context, allows change to occur through small steps, and provides a mechanism for scaling information systems.
Keywords: complexity science; developing countries; Health information systems; standards
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#287 0.223 design systems support development information proposed approach tools using engineering current described developing prototype flexible built architecture environment integrated designing
#291 0.119 local global link complex view links particularly need thought number supports efforts difficult previously linked achieving simple poor individual rise
#117 0.116 standards interorganizational ios standardization standard systems compatibility effects cooperation firms industry benefits open interoperability key heterogeneous vertical propose vendors collective
#125 0.097 framework model used conceptual proposed given particular general concept frameworks literature developed develop providing paper developing guidelines concepts appropriate set
#180 0.086 multiple elements process environments complex integrated interdependencies design different developing integration order approach dialogue framework capabilities settings building focus distinct
#164 0.081 countries global developing technology international country developed national economic policy domestic study foreign globalization world government nations innovative technological especially
#196 0.077 health healthcare medical care patient patients hospital hospitals hit health-care telemedicine systems records clinical practices physician electronic physicians longitudinal outcomes
#10 0.056 strategies strategy based effort paper different findings approach suggest useful choice specific attributes explain effective affect employ particular online control