1 E-Health Unit, Research Department of Primary Care and Population Health, University College London, London, United Kingdom
2 Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
3 Section of General Practice & Primary Care, Centre for Population and Health Sciences, University of Glasgow, Glasgow, United Kingdom

BMC Medical Informatics and Decision Making 2010, 10:61doi:10.1186/1472-6947-10-61
Published: 18 October 2010
Available online PDF [24p.] at: http://bit.ly/9O2DRG
“….The use of Information and Communication Technology (ICT) or e-Health is seen as essential for a modern, cost-effective health service.

However, there are well documented problems with implementation of e-Health initiatives, despite the existence of a great deal of research into how best to implement e-Health (an example of the gap between research and practice).

This paper reports on the development and formative evaluation of an e-Health Implementation Toolkit (e-HIT) which aims to summarise and synthesise new and existing research on implementation of e-Health initiatives, and present it to senior managers in a user-friendly format.

Results
The content of the e-HIT was derived by combining data from a systematic review of reviews of barriers and facilitators to implementation of e-Health initiatives with qualitative data derived from interviews of “implementers”, that is people who had been charged with implementing an e-Health initiative. These data were summarised, synthesised and combined with the constructs from the Normalisation Process Model.

The software for the toolkit was developed by a commercial company (RocketScience). Formative evaluation was undertaken by obtaining user feedback.

There are three components to the toolkit – a section on background and instructions for use aimed at novice users; the toolkit itself; and the report generated by completing the toolkit.

It is available to download from http://www.ucl.ac.uk/pcph/research/ehealth/documents/e-HIT.xls

Conclusions
The e-HIT shows potential as a tool for enhancing future e-Health implementations.

Further work is needed to make it fully web-enabled, and to determine its predictive potential for future implementations.

OpenMRS Implementor’s 2010 Meeting in Cape Town, SA – Evelyn is in Cape Town learning and sharing the work that we have done on eHealth, using OpenMRS, in Nigeria.  You can follows #omrs2010 on Twitter to keep up with the dicussions.

MedInfo 2010 in Cape Town, SA – Look for Evelyn at MedInfo to see her present our paper:

Experience Implementing OpenMRS to Support Maternal and Reproductive Health in Northern Nigeria.
Date/Time: Monday, 13.Sep.2010 (10:30 – 12:15),
Room: 1.6.3 & 1.6.4
Chairman 1: Reti Shane Chairman 2: n/a.

4^th Edition of Nigerian Conference on Telemedicine & eHealth (NICTe) – From September 16th – 17th you should be able to catch both Evelyn and I in Gombe.  I will present about or work on OpenMRS and other upcoming eHealth projects, and lead a hands-on session or two for those wanting a bit more detail on setting up EMRs.

Health sciences major Evelyn Castle (’12) on her last day at the health clinic in Kaduna, Nigeria. The clinic’s new records room includes two computers.

Over at eHealth Nigeria there is a new press release by the UC Santa Cruz Public Relations called “Students forging a new frontier in global health”.

Growing up, Evelyn Castle rarely journeyed beyond California’s borders. Foreign travel was a completely foreign concept.

So the Orange County native and second-year health sciences major at UC Santa Cruz didn’t waste any time on her first trip abroad. During a three-month-long project last summer at a health clinic in Nigeria–part of the UCSC Global Information Internship Program (GIIP)–Castle was instrumental in creating Nigeria’s first electronic medical records system.

Strictly speaking, the effort was part of a field study program, but it resembled more the work of a graduate student, or an international NGO, Castle’s advisors say.

That’s because the pilot project, with financial backing from heavyweights such as the Packard and the Bill and Melinda Gates Foundations, has the potential to be replicated throughout sub-Saharan Africa–and, Castle hopes, it could ultimately revolutionize the way health information is managed, helping millions of women and children with very little extra required in terms of time, resources, and money.

Castle spent her first month hanging around the clinic in Kaduna, seeing how it was run and gaining people’s trust. After that, she hunted down several small, low-cost computers and spent her afternoons converting paper forms into computerized ones using the HTML design skills she learned in class at UCSC.

She taught data entry to the clinic staff, and was rewarded daily with large home-cooked meals and chauffeured rides back home in an ambulance to the Nigerian family she stayed with.

With computerized record keeping, medical histories are clearer and more reliable. Now, for example, if a sonogram shows that the position of a fetus puts the mother at risk during birth, there’s no chance that the information will be lost or illegible when she goes into labor.

Also with electronic records, the process of sending monthly reports to the government is cut from weeks to seconds. Before, filing monthly reports meant sifting through thousands of paper records to tally simple data required by the Ministry of Health.

“It was surprising to see that there was this need that we could fix with pretty simple technology,” said Castle, 21. “It just took a lot of improvisation.”

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