Health Science

Communication

Biosci. Biotech. Res. Comm. 10(4): 597-600 (2017)

Challenges and perspectives of health informatics

and its management in developing Asian countries

Shaima S. Ali Miraj, PhD

Department of Public Health Management, College of Health

Sciences, Saudi Electronic University Riyadh, Saudi Arabia

ABSTRACT

The health care industry has generated large amounts of complex and diverse data, driven by record keeping, compli-

ance and regulatory requirements and patient care, however in absence of proper management and judicious use of

health informatics and data generated through it, the vital information is not being used for the bene t of patients.

Studieshave shown that costs can be dramatically reduced in health care by using health informatics and data col-

lected over long periods of time, like patient’s history, recurrence of pathologies, genetic trends, in heritance, and

many other statistical tools, which can be used for huge bene ts of patients. But all these require huge funds, proper

training, judicious and honest use of such collected information, brilliant research - updated physicians, experts and

managers can make wonders in health care delivery, bene tting both the government and the patients by synergistic

use of health information system generated data. The literature indicates that these systems and their implementation

is limited and at times spasmodic in developing as well as low-income countries, largely because of the  nancial

and implementation challenges these countries face. These challenges are likely due to technological, organizational,

 nancial or human resources barriers. With no signs of improvement, despite several governments claiming to soothe

balms on the self-in icted injuries, the health insurance sector, NGOs, WHO,IMF, World Bank and other benevolent

rich nations will have to come together to ful l the future vision of Health For All especially in poor and developing

countries. To tackle the problems of corruption, malpractices in health care where health informatics data in such

situations can be exploited for fraud and malpractices, better role of governments, sincere controlling and regula-

tory authorities in association with International Agencies is recommended to streamline these issues. Data analytics

and applications in healthcare are at a nascent stage of development, but rapid advances in platforms and tools with

proper management and control can accelerate their maturing process in developing nations as well.

KEY WORDS: DATA INFORMATICS, MANAGEMENT, SYNERGISTIC USE FOR PATIENT CARE

597

ARTICLE INFORMATION:

*Corresponding Author: shaima.s.ali@gmail.com

Received 27

Oct, 2017

Accepted after revision 12

Dec, 2017

BBRC Print ISSN: 0974-6455

Online ISSN: 2321-4007 CODEN: USA BBRCBA

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NAAS Journal Score 2017: 4.31 Cosmos IF: 4.006

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Online Contents Available at:

http//www.bbrc.in/

DOI: 10.21786/bbrc/10.4/1

598 CHALLENGES AND PERSPECTIVES OF HEALTH INFORMATICS IN DEVELOPING COUNTRIES BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS

Shaima S. Ali Miraj

INTRODUCTION

Healthcare industry has always been in a complex situation

of handling or rather mishandling huge data of patients or

in using health informatics, over a long period of time,

as data collected but not judiciously used is as good as

data wasted. The health careindustry has generated large

amounts of complex and diverse data, driven by record

keeping, compliance and regulatory requirements, and

patient care, the latter seldom in priority. Looking to the

recent computerisation of health care centres worldwide

including the poor and developing nations, the current

trend is toward rapid digitization of these large amounts of

data.New data analytic tools to facilitate scalable, acces-

sible and sustainable data infrastructure for effective man-

agement of large, multiscale, multimodal, distributed and

heterogeneous data sets and convert data into knowledge

for support cost-effective decision aids, disease manage-

ment, and care delivery need to be developed, especially

in health care centres of developing nations.

Driven by necessity, and the potential to improve the

quality of healthcare delivery along with reducing the

costs, these massive quantities of data (known as ‘big

data’) hold the promise of supporting a wide range of

medical and healthcare functions, including among other

clinical decision support, disease surveillance, and popu-

lation health management.They also include initiatives

that enable use of data analytics in health systems for

improved clinical decision making, enhanced ef ciency

of care provision, policy development and policy imple-

mentation, (Burghard 2012, Dembosky 2012, Feldman et

al., 2012Fernande et al., 2012 and Raghupati & Raghu-

pati 2014 Andreau Perez et al 2015 and Sweeney 2017).

Reports demonstrate that data from the U.S. health-

care system alone reached, in 2011, 150 exabytesthat’s

enough data to  ll a stack of DVDs that would reach

from Earth to Mars (NCBI, 2017). Remarkably, that vol-

ume continues to double every two years. At this rate

of growth, data for U.S. healthcare will soon reach the

zettabyte (10

 gigabytes) scale and, not long after, the

yottabyte (10

gigabytes), (IHTT (2013). By de nition, big

data in healthcare refers to electronic health data sets so

large and complex that they are dif cult (or impossible)

to manage with traditional software and/or hardware; nor

can they be easily managed with traditional or common

data management tools and methods. Big data in health-

care is overwhelming not only because of its volume but

also because of the diversity of data types and the speed

at which it must be managed, (Frost and Sullivan 2016).

Developed nations which have huge amount to spend

on health care both government and insurance based, can

think of proper use of such technologies, infrastructure

and latest developments in synergistic use of big data.

Various studies in these countries have shown that costs

can be dramatically reduced in health care by using

health informatics and data collected over long periods

of time, like patient’s history, recurrence of pathologies,

genetic trends, in heritance, and many other statistical

tools, which can be used for huge bene ts of patients. But

all these require proper training, judicious and honest use

of such collected information, brilliant research - updated

physicians, experts and managers can make wonders in

health care delivery, bene tting both the government and

the patients by synergistic use of health information sys-

tem generated data.

In one very famous example, California-based Kai-

ser Permanente associated clinical data with cost data

to generate a key data set, the analytics of which led

to the discovery of adverse drug effects and subsequent

withdrawal of Vioxx from the market. Researchers at

the Johns Hopkins School of Medicine discovered they

could use data from Google Flu Trends to predict sud-

den increases in  u-related emergency room visits at

least a week before warnings from the Centre for Disease

Control. Likewise, the analysis of Twitter updates was as

accurate as (and two weeks ahead of) of cial reports at

tracking the spread of cholera in Haiti after the January

2010 earthquake,(IHTT 2013).

These electronic based health record systems like, Elec-

tronic Medical Record (EMR) Health Information Sys-

tem (HIS ) are considered essential components of any

healthcare organization, (Mitchell and Yaylacicegi 2013).

Healthcare providers such as physicians and nurses spend

long periods of time during their workday collecting

information from patients, (Conrick, 2006). On the other

hand, developing countries have tended to lag behind in

the adoption and implementation of HIS and EMR sys-

tems, or even a basic health data system, (Sinha et al.,

2013). The literature indicates that these system and their

implementation is limited and at times spasmodic inde-

veloping as well as low-income countries, largely because

of the  nancial and implementation challenges these

countries face. These challenges are likely due to tech-

nological, organizational,  nancial or human resources

barriers, (Luna et al., 2014, Naseem et al., 2014).

In developed countries like Saudi Arabia, initiatives

for implementing Health Information System and other

EMR systems have been occurring over the last four

decades, (Altuwaijri 2008 and Hasanian et al., 2014).

Over these past decades Saudi Arabia has spent billions

of dollars to develop and improve the quality of health

care. As well as funds to assist EMR implementation,

the Saudi Ministry of Health (MOH) has made clear its

intention to implement HIS nation-wide, (Altuwaijri

2008). Previous research showed that HIS implementa-

tion was low within Saudi public hospitals in its early

stages, but Saudi Arabia is a developing country, it has

made remarkable progress and achievements in health

BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS CHALLENGES AND PERSPECTIVES OF HEALTH INFORMATICS IN DEVELOPING COUNTRIES 599

Shaima S. Ali Miraj

care and its management, (Aldosari 2014, Alkhamis

2012, 2017). There are a number of major hospitals

and healthcare organizations that have attained distin-

guished achievement in use of health informatics and

other high technology gadget implementation in Saudi

Arabia and many more well equipped public hospitals

and centres have been developed, (Hasnain et al., 2014,

2015 and Alkahmis 2012, 2017).

Unfortunately, situation in poor and developing

Asian countries like Bangla Desh, Afghanistan, Pakistan,

Sri Lanka and India is in stark contrast and is seriously-

alarming with reference to the use of health care infor-

matics and data of patients collected for improving and

reducing cost of healthcare. Leaving aside most of the

state of the art private and few government hospitals

in metro cities like Delhi, Mumbai, Bangalore, Chennai,

Kolkata which are beyond access to general population,

majority of hospitals serving thge public are in sorry

state of affairs with regard to use of HIS, EMR and other

state of the art technology based health informatics

tools. Where it is extremely dif cult to run heath care

centres owing to severe shortage of funds, manpower,

infrastructure, medicines and other bare necessities, how

we can collect, generate and maintain health care data

and keep it alive for better future use?

Health care data in such situations can be exploited for

personal gains, or it can go waste for want of mismanage-

ment, corruption, legal battles, fraud and malpractices in

several sectors like the insurance, corporate health policy

claims, government reimbursements and many others.

Health, being one of the most essential and basic needs of

an individual makes it a lucrative soft target for corrup-

tion worldwide especially in developing countries where

poor or no control exists on health administration and

management. Health having unique dimensions is sus-

ceptible to both economic and political in uences and

its corruption not only involves monetary incentives, but

also involves corruption of knowledge, experience and

other practices, thus use of advance technologies like

health informatics, data collection and its maintenance

in this sector warrant lot of sincerity, dedication, sacri-

 ce and character, both from the government agencies

and other parties.In this present scenario, where 50 % of

world’s population cannot afford essential health services,

where each year about 100 million people including in

India, are being pushed into poverty because they have to

pay for health care out of their own pockets, (OOPs) we

can only expect a miracle for better health for all in future

by use of health informatics.

Tracking Universal Health Coverage: (2017) Global

Monitoring recent Report by the World Bank and the

WHO-TUHC (2017), it has been revealed that currently

800 million people spend at least 10 % of their earnings

on health expenses for themselves, a sick child or other

family member. For almost 100 million, these expenses

are high enough to push them into extreme poverty,

forcing them to survive on a meagre 1.90 US dollars

or less a day. The report looks at catastrophic spending

on health on the basis of out of pocket expenditures

exceeding 10 % and 25 % of house hold total income

or consumption. About one sixth of households in India

(exceeding 10 % household income) and 3.9 % (exceed-

ing 25% household income) bear such spending exceed-

ing a household’s ability to pay without reimbursement

by a third party, WHO UHC (2017).

FUTURE PERSPECTIVES

With no signs of improvement, despite several governments

claiming to soothe balms on the self-in icted injuries, the

health insurance sector, the Third Party Assurances, (TPAs),

NGOs, WHO,IMF, World Bank and other benevolent rich

nations along with the OOPs will have to come together to

ful l the future vision of Health For All especially in poor

and developing countries. To tackle the problems of corrup-

tion, malpractices in health care where health care data in

such situations can be exploited for fraud and malpractices,

the role of sincere controlling and regulatory authorities

in association with International Agencies can be recom-

mended. Health, being one of the most essential and basic

needs of an individual makes it a lucrative soft target for

corruption worldwide especially in developing countries

where poor or no control exists on health administration

and management. Health having unique dimensions is sus-

ceptible to both economic and political in uences and its

corruption not only involves monetary incentives, but also

involves corruption of knowledge, experience and other

practices, thus use of advance technologies like health

informatics, data collection and its maintenance in this sec-

tor warrant lot of sincerity, dedication, sacri ce and char-

acter, both from the government agencies and other parties.

However in the years to come we cannot keep our eyes

closed and get into the ground to hide, let us start doing the

innovations with a zeal enthusiasm and dedication amidst

the challenges which are many and look like mountains.

At minimum, health information analytics platform in

healthcare we must support the key functions necessary for

processing the health related data of patients. The criteria

for platform evaluation may include availability, continu-

ity, ease of use, scalability, ability to manipulate at differ-

ent levels of granularity, privacy and security enablement,

and quality assurance. In addition, while most platforms

currently available are open source, the typical advantages

and limitations of open source platforms apply.

To succeed, big data analytics in healthcare needs to be

packaged, so it is menu-driven, user-friendly and transpar-

ent. Real-time big data analytics is a key requirement in

healthcare. The lag between data collection and processing

600 CHALLENGES AND PERSPECTIVES OF HEALTH INFORMATICS IN DEVELOPING COUNTRIES BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS

Shaima S. Ali Miraj

has to be addressed. The dynamic availability of numerous

analytics algorithms, models and methods in a pull-down

type of menu is also necessary for large-scale adoption. The

important managerial issues of ownership, governance and

standards have to be considered. And woven through these

issues are those of continuous data acquisition and data

cleansing. Health care data is rarely standardized, often

fragmented, or generated in legacy IT systems with incom-

patible formats. This great challenge needs to be addressed

as well, (Raghupath and Raghupath 2014).

Health informatics pertaining to huge data analyt-

ics has the potential to transform the way healthcare

providers use sophisticated technologies to gain insight

from their clinical and other data repositories and make

informed decisions. In the future we’ll see the rapid,

widespread implementation and use of big data analyt-

ics across the healthcare organization and the healthcare

industry. To that end, the several challenges highlighted

above, must be addressed. As big data analytics becomes

more mainstream, issues such as guaranteeing privacy,

safeguarding security, establishing standards and govern-

ance, and continually improving the tools and technolo-

gies will garner attention. Governments as participants

and NGOs as watch dogs along with funding of help-

ing hands like the IMF, WHO, UN and other philanthropic

foundations like Bill Gates and others can make it possi-

ble with  rm determination and will power to do it.

Big data analytics and applications in healthcare are

at a nascent stage of development in Asian nations, but

rapid advances in platforms and tools can accelerate their

maturing process. Modern health sector has a questionable

history, driven by hunger of pro t through the inhibition

and discouragement of less pro table therapies and treat-

ments. There are many areas inhealth care system which

on given occasions allow dubious practices including cor-

ruption to pierce in. It’s important we have a check on these

malpractices, which can disturb all the good work being

carried out in this noble profession of serving humanity.

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