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1 – 9 of 9Augustino Mwogosi and Stephen Kibusi
This study aims to identify the barriers that hinder the effective implementation of electronic health records (EHR) systems in developing countries while also uncovering the…
Abstract
Purpose
This study aims to identify the barriers that hinder the effective implementation of electronic health records (EHR) systems in developing countries while also uncovering the critical success factors (CSFs) that can facilitate their implementation. This study focused on the sociotechnical and environmental challenges that influenced the implementation of EHR systems.
Design/methodology/approach
This study used a systematic literature review methodology guided by the modified sociotechnical theory. It followed PRISMA guidelines to identify barriers and CSFs. This review included a comprehensive search of academic databases such as Taylor & Francis, Google Scholar, Emerald and PubMed, covering studies published between 2012 and mid-2024. The studies were screened and analysed using thematic analysis.
Findings
The review identified several barriers to EHR implementation, including a lack of information and communication technology infrastructure, inadequate training, and limited government support. It also highlighted CSFs such as enhancing training programmes, improving technical infrastructure, fostering government support and addressing privacy and security concerns. This study concluded that a holistic approach addressing technical, social and environmental factors was critical for the success of EHR systems in low-resource settings.
Practical implications
This study offered actionable recommendations for policymakers and health-care leaders in developing countries. These include strategies for enhancing user training, improving technical infrastructure, ensuring government support and addressing data privacy and security issues, which are crucial for successfully adopting EHR systems.
Originality/value
This research comprehensively examined the factors influencing EHR implementation in developing countries, offering a unique perspective by applying the modified sociotechnical theory. It bridged a significant gap in the literature by focusing on the specific challenges faced in resource-constrained environments.
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Augustino Mwogosi, Cesilia Mambile, Deo Shao and Nyaura Kibinda
This study aims to explore how artificial intelligence (AI) can enhance mental health care in Tanzania, focusing on its potential to enhance mental health services and address…
Abstract
Purpose
This study aims to explore how artificial intelligence (AI) can enhance mental health care in Tanzania, focusing on its potential to enhance mental health services and address challenges in a low-resource setting.
Design/methodology/approach
A qualitative case study approach was used, with data collected through semi-structured interviews and focus group discussions involving key stakeholders in mental health and AI, including policymakers, technical experts, health-care providers and patient advocacy groups. Thematic analysis was used to identify key themes related to the opportunities and barriers to AI integration in mental health care.
Findings
This study identified several benefits of AI in mental health care, including improved diagnostic accuracy, personalised treatment and the potential for real-time monitoring of patients. However, significant barriers to AI adoption remain, such as infrastructure limitations, data privacy concerns and the need for training and resources to effectively integrate AI into mental health services.
Originality/value
This study contributes to the growing literature on AI in health care by focusing on its application in mental health care in Tanzania, a low-resource setting. The research provides valuable insights into how AI can bridge gaps in mental health service delivery, particularly in underserved regions, while highlighting the challenges that must be addressed for successful implementation.
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Cesilia Mambile and Augustino Mwogosi
This study aims to explore AI’s potential impact on the broader landscape of higher education in Tanzania. This study contributes to the ongoing discussion of AI’s potential to…
Abstract
Purpose
This study aims to explore AI’s potential impact on the broader landscape of higher education in Tanzania. This study contributes to the ongoing discussion of AI’s potential to transform higher education and highlights the ethical considerations and challenges that must be addressed to ensure its successful implementation. This study informs future research and policy decisions in education and technology by providing a detailed understanding of AI’s perceived benefits and challenges in higher education.
Design/methodology/approach
A mixed-methods approach was used, which involves collecting and analyzing quantitative and qualitative data to understand the research problem comprehensively. This approach allowed data triangulation and led to a more robust and detailed understanding of this study.
Findings
In this study, it was discovered that enhanced assessment, time-saving, personalized learning, improved accessibility and detecting cheating are the perceived benefits of AI as a tool for enhancing learning in higher education, while cost and infrastructure, academic misconduct, data privacy and security, bias and ethical concerns and lack of human interaction are the perceived challenges of AI as a tool for enhancing learning in higher education. Further, it was revealed that students are more accepting of using AI tools in the classroom because they think they are more effective and engaging. On the other hand, faculty were more cautious and skeptical about employing AI tools in the classroom because they worried about how it would affect their teaching methods and job security.
Research limitations/implications
The data collection was not conducted face-to-face. To fully capture respondents’ emotional responses, feelings, facial expressions, reactions, or body language was challenging. However, a sufficient number of individuals who participated were very cooperative, and their knowledge was very beneficial in understanding the topic.
Originality/value
A unique view of this study is a clear understanding of the perceived benefits and challenges of using AI as a tool for enhancing learning in higher education, as well as the variations in these perceptions among students and faculty. By examining the perspectives of both groups, this study provides a comprehensive understanding of the complex role of AI in higher education. Understanding the broader implications of AI in higher education can inform policy decisions and ensure that AI is used responsibly and ethically.
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This study aims to explore how artificial intelligence (AI) can be used to overcome the challenges associated with implementing electronic health record (EHR) systems in primary…
Abstract
Purpose
This study aims to explore how artificial intelligence (AI) can be used to overcome the challenges associated with implementing electronic health record (EHR) systems in primary health-care facilities in Tanzania. It aims to assess the technological, organisational and environmental barriers to EHR system implementation and investigate the role of AI in optimising these systems for more effective health-care delivery.
Design/methodology/approach
The study adopts a qualitative approach, using case studies from five regions in Tanzania: Dar es Salaam, Mwanza, Morogoro, Singida and Pwani. Data were collected through 26 semi-structured interviews with health-care providers, including medical doctors, nurses, pharmacists and IT personnel. The study applied the diffusion of innovation (DOI) theory and the technology-organisation-environment framework to assess the factors affecting EHR implementation and the potential integration of AI to enhance these systems.
Findings
Key challenges include unreliable network connectivity, frequent power outages, insufficient training and complex system usability issues. Despite these challenges, EHR systems have improved patient data accessibility and workflow efficiency. AI presents opportunities to address these challenges, mainly through predictive analytics, AI-driven encryption for data security and personalised training modules. AI integration can enhance system reliability, usability and security, ultimately improving health-care outcomes.
Originality/value
This study provides valuable insights into integrating AI to optimise EHR systems in resource-constrained environments like Tanzania. It addresses a gap in the literature by focusing on how AI can be adapted to low-resource settings and provides a framework for future EHR system implementations in similar contexts. The findings contribute to the global discourse on health-care informatics and the role of AI in improving health-care systems in developing countries.
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Augustino Mwogosi and Stephen Kibusi
This study aims to evaluate healthcare practitioners’ perceptions of electronic health record (EHR) systems and their effectiveness in supporting clinical decision-making in…
Abstract
Purpose
This study aims to evaluate healthcare practitioners’ perceptions of electronic health record (EHR) systems and their effectiveness in supporting clinical decision-making in Tanzanian Primary Healthcare (PHC) facilities.
Design/methodology/approach
A mixed-methods approach was employed, combining quantitative data from structured questionnaires and qualitative insights from open-ended responses. The study was conducted in the Dodoma region of Tanzania, focusing on a diverse representation of PHC facilities, including district hospitals, health centres and dispensaries. Data were analysed using multiple linear regression for quantitative data, and thematic analysis was applied to qualitative responses.
Findings
The results revealed that while EHR systems are widely used in Tanzanian PHC facilities, their impact on clinical decision-making remains limited. Only a moderate portion of practitioners perceived EHR systems as effective in decision support, and frequent system use was negatively correlated with user satisfaction. Challenges such as inadequate training and support, system crashes, slow performance and poor usability and integration into clinical workflows were significant barriers to effectively utilising EHR systems.
Originality/value
This study contributes to the limited literature on EHR system implementation in low-resource settings, specifically Tanzania, by focusing on decision-support features within EHR systems. The findings offer valuable insights for healthcare policymakers, system designers and practitioners to optimise EHR implementation and improve healthcare outcomes in resource-constrained environments.
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Augustino Mwogosi and Cesilia Mambile
This study aims to investigate the adoption and use of electronic health record systems (EHRS) in Tanzanian public primary healthcare institutions. The study’s objectives include…
Abstract
Purpose
This study aims to investigate the adoption and use of electronic health record systems (EHRS) in Tanzanian public primary healthcare institutions. The study’s objectives include understanding the factors that affect EHRS adoption, identifying implementation challenges and evaluating the effect of EHRS usage on healthcare delivery. By addressing these research goals, the study aims to contribute insightful information on the current level of EHRS adoption in Tanzanian primary healthcare facilities and contribute to developing strategies to improve EHRS deployment and healthcare in the nation.
Design/methodology/approach
This study combined quantitative and qualitative data using a mixed-methods methodology. Both data types were collected and analysed concurrently using a concurrent triangulation approach. The study aimed to comprehend the variables that affect the adoption and use of EHRS in Tanzanian public primary healthcare institutions. Eleven regions spanning various geographic locations and urban–rural dynamics were chosen as research sites. A survey of 122 healthcare employees was conducted with a sample of 31 healthcare facilities. The questionnaire had closed-ended and open-ended questions to gather quantitative and qualitative data. Descriptive statistics and thematic analysis were used in data analysis. Throughout the investigation, ethical standards and confidentiality precautions were observed.
Findings
Several factors affect the adoption and use of EHRS. Perceived usefulness and use, support and training, interoperability, data security and privacy, business culture and leadership are all factors. Inadequate infrastructure, power interruptions, duplication of effort and a lack of data analytic expertise were among the difficulties. Among the effects were improvements in data management, service delivery and coordination, productivity and efficiency, medical supply inventory control, billing and revenue collection.
Originality/value
This study, which complements earlier research that has concentrated chiefly on specialised healthcare settings, gives new insights by investigating the adoption and utilisation of EHRS, especially in primary healthcare institutions. The findings give policymakers and healthcare professionals in Tanzania and other nations vital information to help them decide whether to embrace and use EHRS in primary healthcare.
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This qualitative case study aims to identify and analyse the factors influencing the implementation and effectiveness of electronic health record systems (EHRS) in primary…
Abstract
Purpose
This qualitative case study aims to identify and analyse the factors influencing the implementation and effectiveness of electronic health record systems (EHRS) in primary health-care (PHC) facilities in Tanzania. This study aims to explore ways to optimize the use of EHRS for better health-care service delivery.
Design/methodology/approach
The study uses a qualitative case study design. Data were collected through interviews and focus groups conducted with health-care workers and information and communication technology officers at the PHC facilities in Tanzania. Purposive sampling and data source triangulation were used to address potential biases and limitations associated with the study’s small sample size.
Findings
This study identifies several key findings related to the implementation and effectiveness of EHRS in Tanzanian PHC facilities. The primary obstacles include inadequate technical infrastructure, poor internet connectivity and insufficient financial resources. The study suggests a comprehensive strategy for improving EHRS, emphasizing patient and health-care professional involvement in system design, investments in technical infrastructure and connectivity, data quality and accuracy and ongoing technical support and training.
Originality/value
This research contributes to the existing body of knowledge by offering a nuanced understanding of the Tanzanian health-care context. It emphasizes the need for tailored solutions and strategies specific to the region’s challenges and opportunities. The study’s originality lies in its focus on EHRS in the Tanzanian context, providing valuable insights for future initiatives. A key policy implication underscores the importance of a supportive regulatory framework, dedicated resources and consistent stakeholder communication for successful EHRS implementation.
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Augustino Mwogosi and Cesilia Mambile
The study aims to explore the utilisation of Clinical Decision Support (CDS) tools in Tanzanian healthcare facilities by identifying the tools used, the challenges encountered and…
Abstract
Purpose
The study aims to explore the utilisation of Clinical Decision Support (CDS) tools in Tanzanian healthcare facilities by identifying the tools used, the challenges encountered and the adaptive strategies employed by healthcare practitioners. It utilises an Activity Theory (AT) approach to understand the dynamic interactions between healthcare providers, CDS tools and the broader healthcare system.
Design/methodology/approach
The research adopts a qualitative approach in two prominent regions of Tanzania, Dar es Salaam and Dodoma. It involves semi-structured interviews with 26 healthcare professionals and key stakeholders across ten healthcare facilities, supplemented by document reviews. The study employs AT to analyse the interactions between healthcare professionals, CDS tools and the broader healthcare system, identifying best practices and providing recommendations for optimising the use of CDS tools.
Findings
The study reveals that Tanzanian healthcare practitioners predominantly rely on non-computerised CDS tools, such as clinical guidelines prepared by the Ministry of Health. Despite the availability of Health Information Systems (HIS), these systems often lack comprehensive decision-support functionalities, leading practitioners to depend on traditional methods and their professional judgement. Significant challenges include limited accessibility to updated clinical guidelines, unreliable infrastructure and inadequate training. Adaptive strategies identified include using non-standardised tools like Medscape, professional judgement and reliance on past experiences and colleagues’ opinions.
Research limitations/implications
The investigation was constrained by access limitations because it was challenging to get some respondents to share information. However, a sufficient number of individuals participated in the interviews, and their knowledge was very beneficial in understanding the procedures and tools for clinical decision support.
Originality/value
This study contributes to AT by extending its application to a low-resource healthcare setting, uncovering new dimensions of the theory related to socio-cultural and technological constraints in healthcare facilities in Tanzania. It provides valuable insights into the practical barriers and facilitators of HIS and CDS tool implementation in developing countries, emphasising the need for context-specific adaptations, robust training programs and user-centred designs. The findings highlight the resilience and imagination of healthcare practitioners in adapting to systemic limitations, offering recommendations to enhance clinical decision-making and improve patient care outcomes in Tanzania.
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Augustino Mwogosi, Deo Shao, Stephen Kibusi and Ntuli Kapologwe
This study aims to assess previously developed Electronic Health Records System (EHRS) implementation models and identify successful models for decision support.
Abstract
Purpose
This study aims to assess previously developed Electronic Health Records System (EHRS) implementation models and identify successful models for decision support.
Design/methodology/approach
A systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The data sources used were Scopus, PubMed and Google Scholar. The review identified peer-reviewed papers published in the English Language from January 2010 to April 2023, targeting well-defined implementation of EHRS with decision-support capabilities in healthcare. To comprehensively address the research question, we ensured that all potential sources of evidence were considered, and quantitative and qualitative studies reporting primary data and systematic review studies that directly addressed the research question were included in the review. By including these studies in our analysis, we aimed to provide a more thorough and reliable evaluation of the available evidence.
Findings
The findings suggest that the success of EHRS implementation is determined by organizational and human factors rather than technical factors alone. Successful implementation is dependent on a suitable implementation framework and management of EHRS. The review identified the capabilities of Clinical Decision Support (CDS) tools as essential in the effectiveness of EHRS in supporting decision-making.
Originality/value
This study contributes to the existing literature on EHRS implementation models and identifies successful models for decision support. The findings can inform future implementations and guide decision-making in healthcare facilities.
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