Sammendrag
Under health reforms for establishing Universal Health Coverage (UHC) in developing countries, it becomes imperative that health care should be made accessible to each and every citizen of the population at affordable costs. This requires a huge shift in building health information systems with a focus on capturing patient data rather than aggregate data which was done in the past. Research on building a patient-centric information system is lacking in the context of a developing country like India. Even in developed countries, the concept of patient centric care is currently evolving and takes on very different forms as compared to that in a developing country. Hence the focus of my thesis is on the analysis of requirements for such a system in primary-health settings in developing countries. This has been empirically studied as part of a research project funded by the Research Council of Norway (RCN) called INTPART (International Partnership), with a focus on “Designing Information Systems for Strengthening Patient Based Care in Resource Constrained Settings”. The understanding of requirements is based on the framework of a “living lab” which was setup in the context where the implementation of the patient-centric information system was carried out. The living lab has been the primary driver of understanding the evolving requirements of the system for this case-study. The research objective of my thesis is to answer the following questions: • What are the requirements to build a patient-centric information system in a primary-health setting? • Analyze different technical solutions to address these requirements and to understand the efficacy of the respective solutions. The living lab has provided important inputs for creating an integrated database covering all the health services required by the population. The requirements have evolved over various “phases” and the requirements build upon the umbrella requirements of UHC which focus on the identification of each patient and follow their care cycle from their homes to the primary care facilities then district hospitals and back. The key requirements identified include data capture for care provided at the community level and at the facility level, generate outputs like reports, workplans and registers from the data captured, perform data analysis at the PHC level by building dashboards, cohort charts and GIS maps, communicate directly with the patient through SMS for follow ups and implement standards to be interoperable with other health information systems.