Abstract
BackgroundSignificant investments have been made towards the implementation of mHealth applications and eRecord systems globally. However, fragmentation of these technologies remains a big challenge, often unresolved in developing countries. In particular, evidence shows little consideration for linking mHealth applications and eRecord systems. Botswana is a typical developing country in sub-Saharan Africa that has explored mHealth applications, but the solutions are not interoperable with existing eRecord systems. This paper describes Botswana’s eRecord systems interoperability landscape and provides guidance for linking mHealth applications to eRecord systems, both for Botswana and for developing countries using Botswana as an exemplar. MethodsA survey and interviews of health ICT workers and a review of the Botswana National eHealth Strategy were completed. Perceived interoperability benefits, opportunities and challenges were charted and analysed, and future guidance derived.ResultsSurvey and interview responses showed the need for interoperable mHealth applications and eRecord systems within the health sector of Botswana and within the context of the National eHealth Strategy. However, the current Strategy does not address linking mHealth applications to eRecord systems. Across Botswana’s health sectors, global interoperability standards and Application Programming Interfaces are widely used, with some level of interoperability within, but not between, public and private facilities. Further, a mix of open source and commercial eRecord systems utilising relational database systems and similar data formats are supported. Challenges for linking mHealth applications and eRecord systems in Botswana were identified and categorised into themes which led to development of guidance to enhance the National eHealth Strategy.ConclusionInteroperability between mHealth applications and eRecord systems is needed and is feasible. Opportunities and challenges for linking mHealth applications to eRecord systems were identified, and future guidance stemming from this insight presented. Findings will aid Botswana, and other developing countries, in resolving the pervasive disconnect between mHealth applications and eRecord systems.
Highlights
Significant investments have been made towards the implementation of Mobile health (mHealth) applications and electronic record (eRecord) systems globally
The aspects of the Electronic health (eHealth) Strategy related to interoperability were summarised and charted to align aspects of the survey and key informant interviews (KII) findings with the proposed development of an interoperability platform for the country
Respondents in the public sector were more aware of the National eHealth Strategy and the proposed interoperability platform than their counterparts in the private sector, whilst the opposite was true for understanding of interoperability concepts
Summary
Significant investments have been made towards the implementation of mHealth applications and eRecord systems globally Fragmentation of these technologies remains a big challenge, often unresolved in developing countries. Botswana is a typical developing country in sub-Saharan Africa that has explored mHealth applications, but the solutions are not interoperable with existing eRecord systems. Whilst sub-Saharan Africa (SSA) has been a focal point for many formal mHealth projects, informal use appears common [11, 12]. Such trends are likely to be spurred by recent global awareness and application of eHealth, including mHealth, due to the COVID-19 pandemic [13]
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