1
|
Ellis LA, Sarkies M, Churruca K, Dammery G, Meulenbroeks I, Smith CL, Pomare C, Mahmoud Z, Zurynski Y, Braithwaite J. The science of learning health systems: A scoping review of the empirical research (Preprint). JMIR Med Inform 2021; 10:e34907. [PMID: 35195529 PMCID: PMC8908194 DOI: 10.2196/34907] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/07/2021] [Accepted: 01/02/2022] [Indexed: 01/26/2023] Open
Affiliation(s)
- Louise A Ellis
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Mitchell Sarkies
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Kate Churruca
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Genevieve Dammery
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | | | - Carolynn L Smith
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Chiara Pomare
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Zeyad Mahmoud
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Yvonne Zurynski
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| |
Collapse
|
2
|
Nadhamuni S, John O, Kulkarni M, Nanda E, Venkatraman S, Varma D, Balsari S, Gudi N, Samantaray S, Reddy H, Sheel V. Driving digital transformation of comprehensive primary health services at scale in India: an enterprise architecture framework. BMJ Glob Health 2021; 6:bmjgh-2021-005242. [PMID: 34312149 PMCID: PMC8728378 DOI: 10.1136/bmjgh-2021-005242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/02/2021] [Accepted: 04/05/2021] [Indexed: 12/14/2022] Open
Abstract
In its commitment towards Sustainable Development Goals, India envisages comprehensive primary health services as a key pillar in achieving universal health coverage. Embedded in siloed vertical programmes, their lack of interoperability and standardisation limits sustainability and hence their benefits have not been realised yet. We propose an enterprise architecture framework that overcomes these challenges and outline a robust futuristic digital health infrastructure for delivery of efficient and effective comprehensive primary healthcare. Core principles of an enterprise platform architecture covering four platform levers to facilitate seamless service delivery, monitor programmatic performance and facilitate research in the context of primary healthcare are listed. A federated architecture supports the custom needs of states and health programmes through standardisation and decentralisation techniques. Interoperability design principles enable integration between disparate information technology systems to ensure continuum of care across referral pathways. A responsive data architecture meets high volume and quality requirements of data accessibility in compliance with regulatory requirements. Security and privacy by design underscore the importance of building trust through role-based access, strong user authentication mechanisms, robust data management practices and consent. The proposed framework will empower programme managers with a ready reference toolkit for designing, implementing and evaluating primary care platforms for large-scale deployment. In the context of health and wellness centres, building a responsive, resilient and reliable enterprise architecture would be a fundamental path towards strengthening health systems leveraging digital health interventions. An enterprise architecture for primary care is the foundational building block for an efficient national digital health ecosystem. As citizens take ownership of their health, futuristic digital infrastructure at the primary care level will determine the health-seeking behaviour and utilisation trajectory of the nation.
Collapse
Affiliation(s)
- Sunita Nadhamuni
- Digital LifeCare, Dell Technologies, Bengaluru, Karnataka, India
| | - Oommen John
- The George Institute for Global Health, University of New South Wales, New Delhi, Delhi, India
| | - Mallari Kulkarni
- Digital LifeCare, Dell Technologies, Bengaluru, Karnataka, India
| | - Eshan Nanda
- Digital LifeCare, Dell Technologies, Bengaluru, Karnataka, India
| | | | - Devesh Varma
- Piramal Swasthya Management and Research Institute, Hyderabad, Telangana, India
| | - Satchit Balsari
- Emergency Medicine, Beth Israel Deaconess, Harvard Medical School, Boston, Massachusetts, USA
- Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Nachiket Gudi
- The George Institute for Global Health, New Delhi, Delhi, India
| | | | - Haritha Reddy
- BeeHyv Software Solutions, Hyderabad, Telangana, India
| | - Vikas Sheel
- Ministry of Health and Family Welfare, New Delhi, India
| |
Collapse
|