Steps towards the Development of National Health Data Standards in Developing Countries: An Exploratory Qualitative Study in Saudi Arabia

Authors: Abdullah I. Alkraiji, Thomas W. Jackson, Ian R. Murray

Abstract:

The proliferation of health data standards today is somewhat overlapping and conflicting, resulting in market confusion and leading to increasing proprietary interests. The government role and support in standardization for health data are thought to be crucial in order to establish credible standards for the next decade, to maximize interoperability across the health sector, and to decrease the risks associated with the implementation of non-standard systems. The normative literature missed out the exploration of the different steps required to be undertaken by the government towards the development of national health data standards. Based on the lessons learned from a qualitative study investigating the different issues to the adoption of health data standards in the major tertiary hospitals in Saudi Arabia and the opinions and feedback from different experts in the areas of data exchange and standards and medical informatics in Saudi Arabia and UK, a list of steps required towards the development of national health data standards was constructed. Main steps are the existence of: a national formal reference for health data standards, an agreed national strategic direction for medical data exchange, a national medical information management plan and a national accreditation body, and more important is the change management at the national and organizational level. The outcome of this study can be used by academics and practitioners to develop the planning of health data standards, and in particular those in developing countries.

Keywords: Interoperability, Case Study, Health Data Standards, Medical Data Exchange, Saudi Arabia.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1092868

References:

[1] B. Chaudhry, J. Wang, S. WU, M. Maglione, W. Mojica, E. Roth, SC. Morton, and PG. Shekelle, "Systematic review: impact of health information technology on quality, efficiency, and costs of medical care," Annals of Internal Medicine, vol. 144(10), pp. 12-22, 2006.
[2] W.E. Hammond, "The making and adoption of health data standards," Health affairs, vol. 24(5), pp. 1205-1213, 2005.
[3] A. Berler, A. Tagaris, P. Angelidis, and D. Koutsouris, "A roadmap towards healthcare information systems interoperability in Greece," JTIT, vol. 2, pp. 59-73, 2006.
[4] WHO, 2012, "Global Observatory for e-Health series - Volume 5: Legal frameworks for e-Health," http://www.who.int/goe/publications /ehealth_series_vol5/en/index.html, Accessed 20 July 2012.
[5] D.W. Bates, M. Ebell, E. Gotlieb, J. Zapp, and H.C. Mullins, "A proposal for electronic medical records in US primary care," JAMIA, vol. 10(1), pp. 1–10, 2003.
[6] E. Deutsch, G. Duftschmid, and W. Dordaa, "Critical areas of national electronic health record programs: Is our focus correct," International Journal of Medical Informatics, vol. 79(3), pp. 211-222, 2010.
[7] Y. Zhang, Y. Xu, L, Shang, and K. Rao, "An investigation into health informatics and related standards in China," International journal of medical informatics, vol. 76(8), pp. 614-620, 2007.
[8] C. Lin, I. Lin, J. Roan, and J. Yeh, "Critical Factors Influencing Hospitals’ Adoption of HL7 Version 2 Standards: An Empirical Investigation," Journal of Medical Systems, doi:10.1007/s10916-010-9580-2, 2010.
[9] J. Braa, O. Hanseth, A. Heywood, W. Mohammed, and V. Shaw, "Developing Health Information Systems in Developing Countries: The flexible standards strategy," MIS Quarterly, vol. 31(2), pp. 381-402, 2007.
[10] E. Jacucci, V. Shaw, and J. Braa, "Standardization of health information systems in South Africa: the challenge of local sustainability," ITD, vol. 12(3), pp. 225-239, 2006.
[11] M. Smith, S. Madon, and A. Anifalaje, "Integrated health information systems in Tanzania: experience and challenges," EJISDC, vol. 33(1), pp. 1-21, 2008.
[12] J. Halamka, J.M. Overhage, L. Ricciardi, W. Rishel, C. Shirky, and C. Diamond, "Exchanging health information: local distribution and national coordination," Health affairs, vol. 24(5), pp. 1170-1179, 2005.
[13] E.J. Hovenga, "Importance of achieving semantic interoperability for national health information systems," Texto&Contexto-Enfermagem, vol. 17(1), pp. 158-167, 2008.
[14] J.W. Thomas, S. Probets, R. Dawson, and T. King, "A step towards the adoption of standards within the UK Ministry of defence," Journal of IT Standards & Standardization Research, vol. 6(1), pp. 55-69, 2008
[15] K. Kim, 2005, "Clinical Data Standards in Health Care: Five Case Studies," Available from: http://www.kathykim.com/sitebuildercontent/ sitebuilderfiles/ClinicalDataStandardsInHealthCare.pdf, Accessed 6 May 2009.
[16] H Park, and N Hardiker, "Clinical terminologies: a solution for semantic interoperability," KOSMI, vol. 15(1), pp. 1-11. 2009
[17] M. Al-Yousuf, T. Akerele, and Y. Al-Mazrou, "Organization of the Saudi health system," EMHJ, vol 8(4-5), pp. 645–653, 2002.
[18] M. Altuwaijri, "Electronic-health in Saudi Arabia – Just around the corner," Saudi Medical Journal, vol. 29(2), pp. 171-178, 2008.
[19] S.A. Spooner, and D.C. Classen, "Data standards and improvement of quality and safety in child health care," Pediatrics, vol. 123(Supplement), pp. S74-S79, 2009.
[20] T. Sequist, T. Cullen, and J. Ayanian, "Information technology as a tool to improve the quality of American Indian Health Care," American Journal of Public Health, vol. 95(12), pp. 2173-2179, 2005.
[21] S. Szydlowski, and C. Smith, "Perspectives from nurse leaders and chief information officers on health information technology implementation," Hospital Topics, vol. 87(1), pp. 3-9, 2009.
[22] T. Johnson, and R. Ventura, "Applied informatics for quality assessment and improvement," Journal of Nursing Care Quality, vol. 19(2), pp. 100–104, 2004.
[23] M.F. Furukawa, T.S. Raghu,T.J. Spaulding, and A. Vinze, "Adoption of health information technology for medication safety in U.S. Hospitals," Health Affairs, vol. 27(3), pp.865-875, 2008.
[24] C. Ohmann, and W Kuchinke, "Future developments of medical informatics from the viewpoint of networked clinical research," Methods of Information in Medicine, vol. 48(1), pp. 45–54, 2009.
[25] L Luic, and D Striber-Devaja, "The significance of information standards for development of integrated health information system," Archive of Oncology, vol. 14(1-2), pp. 64-66, 2006.
[26] T. Greenhalgh, K. Stramer, T. Bratan, E. Byrne, J. Russell, and H, Potts, "Adoption and non-adoption of a shared electronic summary care record in England: A mixed-method case study," BMJ, vol. 340, pp. c3111, 1-11, 2010.
[27] B.N. Doebbeling, A.F. Chou, and W.M. Tierney, "Priorities and strategies for the implementation of integrated informatics and communications technology to improve evidence-based practice," Journal of General Internal Medicine, vol. 21(2), pp. S50-S57, 2006.