Abstract
BackgroundeHealth—the proficient application of information and communication technology to support healthcare delivery—has been touted as one of the best solutions to address quality and accessibility challenges in healthcare. Although eHealth could be of more value to health systems in low- and middle-income countries (LMICs) where resources are limited, identification of a competent workforce which can develop and maintain eHealth systems is a key barrier to adoption. Very little is known about the actual or optimal states of the eHealth workforce needs of LMICs. The objective of this study was to develop a framework to characterize and assess the eHealth workforce of hospitals in LMICs.MethodsTo characterize and assess the sufficiency of the workforce, we designed this study in twofold. First, we developed a general framework to categorize the eHealth workforce at any LMIC setting. Second, we combined qualitative data, using semi-structured interviews and the Workload Indicator of Staffing Needs (WISN) to assess the sufficiency of the eHealth workforce in selected hospitals in a LMIC setting like Ghana.ResultsWe surveyed 76 (60%) of the eHealth staff from three hospitals in Ghana—La General Hospital, University of Ghana Hospital, and Greater Accra Regional Hospital. We identified two main eHealth cadres, technical support/information technology (IT) and health information management (HIM). While the HIM cadre presented diversity in expertise, the IT group was dominated by training in Science (42%) and Engineering (55%), and the majority (87%) had at least a bachelor’s degree. Health information clerk (32%), health information officer (25%), help desk specialist (20%), and network administrator (11%) were the most dominant roles. Based on the WISN assessment, the eHealth workforce at all the surveyed sites was insufficient. La General and University of Ghana were operating at 10% of required IT staff capacity, while Ridge was short by 42%.ConclusionsWe have developed a framework to characterize and assess the eHealth workforce in LMICs. Applying it to a case study in Ghana has given us a better understanding of potential eHealth staffing needs in LMICs, while providing the quantitative basis for building the requisite human capital to drive eHealth initiatives. Educators can also use our results to explore competency gaps and refine curricula for burgeoning training programs. The findings of this study can serve as a springboard for other LMICs to assess the effects of a well-trained eHealth workforce on the return on eHealth investments.
Highlights
EHealth—the proficient application of information and communication technology to support healthcare delivery—has been touted as one of the best solutions to address quality and accessibility challenges in healthcare
Recognizing the impact that eHealth could have on healthcare delivery, in low- and middle-income countries (LMICs) with limited resources and rising populations, the World Health Organization (WHO) called on member states in LMICs, in sub-Saharan Africa, to adopt and implement effective eHealth strategies to improve their health systems [9]
We developed a framework based on eHealth job definitions, roles, and competencies recommended by key organizations including Canada’s Health Informatics Association (COACH), the U.S Office of the National Coordinator for Health Information Technology (ONC), the American Medical Informatics Association (AMIA), and the Health Information and Management Systems Society (HIMSS) [17,18,19,20,21,22,23]
Summary
EHealth could be of more value to health systems in low- and middle-income countries (LMICs) where resources are limited, identification of a competent workforce which can develop and maintain eHealth systems is a key barrier to adoption. Very little is known about the actual or optimal states of the eHealth workforce needs of LMICs. The objective of this study was to develop a framework to characterize and assess the eHealth workforce of hospitals in LMICs. Health systems in low- and middle-income countries (LMICs) have faced considerable challenges in providing high-quality, affordable, and universally accessible care. Recognizing the impact that eHealth could have on healthcare delivery, in LMICs with limited resources and rising populations, the WHO called on member states in LMICs, in sub-Saharan Africa, to adopt and implement effective eHealth strategies to improve their health systems [9]. To move towards electronic records and reporting systems [14]
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