The major socio-economic development challenges facing most African countries include economic diversification, poverty, unemployment, diseases and the unsustainable use of natural resources. The challenge of quality healthcare provisioning is compounded by the HIV/AIDS pandemic in Sub Saharan Africa. However, there is a great potential in using electronic healthcare (e-health) as one of the supportive systems within the healthcare sector to address these pressing challenges facing healthcare systems in developing countries, including solving inequalities in healthcare delivery between rural and urban hospitals/clinics. The purpose of this study was to compile a Provincial E-health Framework (PEHF) based on the feedback from electronic healthcare readiness assessments conducted in selected rural and urban hospitals/clinics in the North West Province in South Africa. The e-healthcare readiness assessment was conducted in the light of effective use of ICT in patient healthcare record system, consultation among healthcare professionals, prescription of medication, referral of patients and training of healthcare professionals in ICT usage. The study was divided into two phases which were phases 1 and 2 and a qualitative design supported by a case study approach was used. Data were collected using different techniques to enhance triangulation of data. The techniques included group interviews, qualitative questionnaires, photographs, document analysis and expert opinions. The outcome of the assessment led to the compilation of the PEHF which was based on Service Oriented Architecture (SOA). SOA was chosen to integrate the hospitals/clinics‟ ICT infrastructure yet allowing each hospital/clinic the autonomy to control its own ICT environment. To assist hospitals/clinics integrate their ICT resources, this research study proposed an Infrastructure Network Architecture which clustered hospitals/clinics to share common ICT infrastructure instead of duplicating these resources. Furthermore, processes of the e-health services (e-patient health IV record system, e-consultation system, e-prescription system, e-referral system and e-training system) were provided to assist in the implementation of the PEHF. Finally, a set of guidelines were provided by the research study to aid the implementation of the PEHF.

Text in English / Telehealth makes healthcare services accessible by underserved and resource-constrained rural communities of developing countries such as Ethiopia. However, the limitation of frameworks on telemedicine-based healthcare inequality reduction is a challenge for developing countries. In Ethiopia there are four telemedicine projects; however, there is no evidence that any of these projects have been evaluated by considering contextual issues. This academic research explored telehealth practices in Ethiopia with the aim of developing a comprehensive telehealth evaluation framework for developing countries. Such a conceptual framework could be used to inform health institutes and governmental policy makers and in so doing create a vehicle for the implementation of improved health practices in Ethiopia. A grounded theory approach is used to qualitatively explore the usefulness of telemedicine practices in Ethiopia, in mitigating healthcare inequality. Grounded theory makes use of emerging insights in order to contribute to new knowledge. From the inductive analysis of the study, themes such as barrier removal, service quality, synergetic effect, localization, technical setup, resource utilization and managerial readiness emerged to formulate a framework for evaluating telemedicine-based healthcare inequality reduction in the context of developing countries like Ethiopia. This study contributes to the understanding of the question of how telemedicine practices can be evaluated, to support the healthcare service and reduce the healthcare inequalities in resource constrained communities in Ethiopia. Moreover, the framework could be used during evaluation of telemedicine-based healthcare inequality reduction in the context of developing countries like Ethiopia. / School of Computing / Ph.D. (Information Systems)

Poor health care delivery in rural communities is a major problem facing the health sector in Namibia. Patients who visit rural communities often wait on queues for several hours every day before they can be examined by a medical practitioner. This is detrimental to the health care process and impacts negatively on the efficiency and effectiveness of the sector. Mobile phones can however be employed as tools to improve work processes in such hospitals and as a result improve health care delivery in rural communities. The purpose of this study was to investigate the health care services provided to patients at Outpatient Departments (OPDs) in rural hospitals through the use of data collection instruments such as interviews, questionnaires, document analysis, expert validation and photographs in order to compile a Mobile Health Service Framework (MHSF) to improve healthcare delivery processes in OPDs. From an interpretive paradigm perspective, the qualitative design was used together with a case study approach. Three hospitals in rural communities were used as case studies. These were Okuryangava Hospital, Katutura Hospital and Khomasdal Hospital. Interviews were conducted and questionnaires distributed to the participants. The findings revealed that there is a high concentration of mobile phone usage in rural communities and there is a high usage of the SMS feature on such mobile phones. / Computing / M. Sc. (Computing)

The use of wireless sensor networks for a myriad of applications is increasing. They can be used in healthcare for emergency management. In Florida, hurricanes are the main source of natural disasters. There has been a high incidence of hurricanes over the past decade. When a hurricane warning is issued it is important that people who live in potentially dangerous areas, such as along the coast, evacuate for their safety. Nursing homes and other care facilities for elderly or disabled people experience difficulty with the evacuation as their residents require additional assistance. The characteristics and challenges of a hurricane evacuation are investigated. A patient-centric hurricane evacuation management system is proposed to allow healthcare providers the ability to continuously monitor and track patients. During a hurricane there are usually scarce energy resources and a loss of basic communication services such as cellular service and Internet access. We propose the architecture of the system that allows it to operate in the absence of these services. The hardware and software architectures are also presented along with the main phases of operation. The system was then validated and the performance evaluated via simulation using the OPNET Modeler. / by Arny Isonja Ambrose. / Vita. / Thesis (Ph.D.)--Florida Atlantic University, 2011. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2011. Mode of access: World Wide Web.

The importance of records management to the provision of healthcare services cannot be overemphasised. If medical records are not managed properly, this might result in the provision of poor healthcare services. This is because usually if medical records are not properly managed, the healthcare institutions attain inaccurate, untimely, incomplete and unauthentic records or the records fade completely. Records that are not managed properly are easily lost, modified, altered, misfiled and/or damaged, which results in a struggle to locate them and, eventually, much time is lost. Records of this kind may not support healthcare service providers properly in decision-making, problem-solving, monitoring and evaluation of service for continuous service improvement. This study utilised the five elements of trusted records management (records management governance practice, staff capacity and competencies, recordkeeping system and technology, and records archival processes) to investigate the development of a framework to embed medical records management into the healthcare service delivery practice for effective records management practice. The study predominantly utilised a quantitative approach with some support from a limited scope of qualitative data to augment numeric data. The data was collected using the four different techniques, namely questionnaire, interview, observation and system/documents analysis. The study revealed that the mode of medical record management was not effectively enabling the institution to manage medical records properly due to lack of integrated medical records management framework into the healthcare business process. The medical records management technology also lacked file tracking system, records backup, and audit trail which compromise records safety and security. The study recommended supply of the necessary resources, with a framework that the healthcare institutions may adopt to embed medical records management into the healthcare service delivery. ECM may also be implemented to incorporate electronic records management systems, information management, web content and other add-ons to support the records management framework in ensuring effective discharge of all records management functional requirements on the healthcare business process. A further study was recommended about the development of an online outpatient consultation system and medical records access to avoid patient long turnaround time for service. / Information Science / D. Litt. et. Phil. (Information Science)

The health applications aimed at monitoring patients remotely have reached great proportions with the advancement of wireless networks. This paper presents a study of performance evaluation of biosignal traffic, which was simulated the transmission of patient data in emergency situations. The simulation scenario considered the transmission of signals from an ambulance through wireless network and collected in a medical monitoring center. On the way to the hospital, while the mobile broadcast biosignals moved between areas covered by different network technologies, featuring vertical handover situation. Based on the minimum QoS requirements prevailing in the scientific community, the most important parameters in healthcare applications such as loss rate, delay, throughput and jitter were evaluated. Was still considered a minimum bandwidth required for transmission of vital signs, taking into account rates of known samples to physicians signs such as electrocardiogram (ECG), blood pressure, heart rate, body temperature and rate of oxygen saturation blood. To evaluate the performance, were carried computer simulations using an implementation of the IEEE 802.21 standard for the simulator NS-2. The simulated scenario used the networks of Wi-Fi and WiMAX technologies, mobile with multiple interfaces and nodes cargo, which made transmissions with constant rates. The results showed that the network technologies in use can meet the minimum QoS requirements for medical applications. / As aplicações de saúde voltadas para monitoramento de pacientes a distância têm atingido grandes proporções com o avanço das redes sem fio. Este trabalho apresenta um estudo de avaliação de desempenho do tráfego de biosinais, no qual foi simulado a transmissão de dados de pacientes em situações de emergência. O cenário de simulação considerou a transmissão dos sinais a partir de uma ambulância, através de rede sem fio e coletados em um centro de monitoramento médico. No percurso até o hospital, o móvel transmitiu biosinais enquanto transitou entre áreas cobertas por tecnologias de rede distintas, caracterizando situação de handover vertical. Com base nos requisitos mínimos de QoS praticados na comunidade científica, foram avaliados os parâmetros mais importantes em aplicações de saúde como taxa de perdas, atraso, vazão e jitter. Ainda foi considerada uma largura de banda mínima necessária para transmissão de sinais vitais, levando-se em conta as taxas de amostragens conhecidas para sinais médicos como Eletrocardiograma (ECG), Pressão arterial, Frequência cardíaca, Temperatura do corpo e Taxa de saturação de oxigênio no sangue. Para avaliar o desempenho, foram realizadas simulações computacionais com o uso de uma implementação do padrão IEEE 802.21 para o simulador NS-2. O cenário simulado utilizou as redes das tecnologiasWi-Fi eWiMAX, dispositivo móvel com múltipla interface e nós de carga, os quais realizaram transmissões com taxas constantes. Os resultados mostraram que as tecnologias de rede em uso podem atender aos requisitos mínimos de QoS para aplicações médicas.

The adoption of eHealth is very slow despite evidences showing its benefits. This research examines the individual, clinical, technical and organizational challenges for eHealth adoption from healthcare provider‟s perspectives. A cross-sectional study design with a quantitative paradigm was used. The study was conducted on 312 doctors and nurses randomly selected from ten hospitals in Addis Ababa, Ethiopia. Most respondents viewed eHealth positively with no significant differences in terms of profession or gender. Computer skill, workload, patient interaction, management support, cost and infrastructure were the main concerns. Privacy and security were not the main concerns. Knowledge of eHealth applications and utilization was low, even for evidence-based medicine and online databases. Specialists and males were better aware of eHealth applications. The study showed that eHealth acceptance was good. Increasing eHealth literacy was recommended as a cost effective means for improving access to updated information to improve the quality of healthcare. / Health Studies / M.A. (Public Health (Medical Informatics))

Poor health care delivery in rural communities is a major problem facing the health sector in Namibia. Patients who visit rural communities often wait on queues for several hours every day before they can be examined by a medical practitioner. This is detrimental to the health care process and impacts negatively on the efficiency and effectiveness of the sector. Mobile phones can however be employed as tools to improve work processes in such hospitals and as a result improve health care delivery in rural communities. The purpose of this study was to investigate the health care services provided to patients at Outpatient Departments (OPDs) in rural hospitals through the use of data collection instruments such as interviews, questionnaires, document analysis, expert validation and photographs in order to compile a Mobile Health Service Framework (MHSF) to improve healthcare delivery processes in OPDs. From an interpretive paradigm perspective, the qualitative design was used together with a case study approach. Three hospitals in rural communities were used as case studies. These were Okuryangava Hospital, Katutura Hospital and Khomasdal Hospital. Interviews were conducted and questionnaires distributed to the participants. The findings revealed that there is a high concentration of mobile phone usage in rural communities and there is a high usage of the SMS feature on such mobile phones. / Computing / M. Sc. (Computing)