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. 2019 Jan 29;4(1):e001134.
doi: 10.1136/bmjgh-2018-001134. eCollection 2019.

Addressing the information deficit in global health: lessons from a digital acute care platform in Sri Lanka

Abi Beane  1   2 , Ambepitiyawaduge Pubudu De Silva  3 , Priyantha Lakmini Athapattu  4 , Saroj Jayasinghe  5 , Anuja Unnathie Abayadeera  6 , Mandika Wijerathne  6 , Ishara Udayanga  1 , Shriyananda Rathnayake  7 , Arjen M Dondorp  2 , Rashan Haniffa  1   2
Affiliations

Addressing the information deficit in global health: lessons from a digital acute care platform in Sri Lanka

Abi Beane et al. BMJ Glob Health. .

Abstract

Lack of investment in low-income and middle-income countries (LMICs) in systems capturing continuous information regarding care of the acutely unwell patient is hindering global efforts to address inequalities, both at facility and national level. Furthermore, this of lack of data is disempowering frontline staff and those seeking to support them, from progressing setting-relevant research and quality improvement. In contrast to high-income country (HIC) settings, where electronic surveillance has boosted the capability of governments, clinicians and researchers to engage in service-wide healthcare evaluation, healthcare information in resource-limited settings remains almost exclusively paper based. In this practice paper, we describe the efforts of a collaboration of clinicians, administrators, researchers and healthcare informaticians working in South Asia, in addressing the inequality in access to patient information in acute care. Harnessing a clinician-led collaborative approach to design and evaluation, we have implemented a national acute care information platform in Sri Lanka that is tailored to priorities of frontline staff. Iterative adaptation has ensured the platform has the flexibility to integrate with legacy paper systems, support junior team members in advocating for acutely unwell patients and has made information captured accessible to diverse stakeholders to improve service delivery. The same platform is now empowering clinicians to participate in international research and drive forwards improvements in care. During this journey, we have also gained insights on how to overcome well-described barriers to implementation of digital information tools in LMIC. We anticipate that this north-south collaborative approach to addressing the challenges of health system implementation in acute care may provide learning and inspiration to other partnerships seeking to engage in similar work.

Keywords: health informatics; health services research; health systems.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Existing pathways and bottlenecks for information flow and proposed enhanced systems following mHealth platform implementation for acute and critical care.
Figure 2
Figure 2
Cycle of implementation and co-evaluation.
Figure 3
Figure 3
Network for Improving Critical care Skills Training user interface.
Figure 4
Figure 4
Quality dashboards in the ward setting help nurses improve completeness of vital sign reporting during adoption.
Figure 5
Figure 5
Acute care mHealth platform adopted in an inpatient setting in Sri Lanka.
See this image and copyright information in PMC

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