Improving the Methodological Approach to Evaluate the Use of Information and Communication Technologies in Primary Health Care in Cuba

Abstract

Introduction. Primary health care (PHC) in Cuba is supported on community based polyclinics. The economic crisis that began in the early 1990s resulted in a sharp decline in availability of printed literature in Cuba. In this context, national health care telecommunications network and portal -INFOMED- was created to provide access to information resources. In 2004 a “Program to Introduce ICTs in PHC” was established to create local access points to INFOMED in polyclinic libraries. An evaluation accompanied the Phase One of the Program. In 2009, the Program has continued. The methodology developed and validated in the Phase One evaluation needs to be improved. Objective: Identify the situation in polyclinics to improve the methodology for Phase Two evaluation of the use of ICTs in accessing information resources in PHC, Havana City, Cuba, 2009. Material and Methods. This investigation is the first stage of a Service and System Research. The universe is the 83 polyclinics in Havana. Interviews were carried out with decision makers at national and provincial level of the Health System and Health Information System. Three polyclinics were visited. The need to change some Phase One criteria and standards was identified. A new bibliography review was developed. The kind of evaluation method was submitted to expert consultation. Results. Important changes in polyclinics and main characteristics to stratify them were found. Donabedian’s approach in the evaluation was kept. The bibliography review identified the activity theory and the essential functions in scientific and technical information in health systems as a theoretical and methodological framework to modify criteria and standards. Conclusions. The first stage of the Phase Two evaluation of the use of ICTs in PHC found relevant changes in polyclinics. Donabedian’s model was found adequate with criteria and standards modifications. Technique selection and instrument designing will follow this stage.