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| 2. |
- Bakunzibake, Pierre, 1977-, et al.
(författare)
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E-government implementation and monitoring : The case of Rwanda ‘one-stop’ E-government
- 2019
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Ingår i: The Electronic Journal of Information Systems in Developing Countries. - : John Wiley & Sons. - 1681-4835. ; 85:5
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Tidskriftsartikel (refereegranskat)abstract
- Taking the case of the “one‐stop” e‐government initiative in Rwanda, the present study aims to find out how the “one‐stop” e‐government initiative is monitored at different government levels and stages and the extent to which the initiative is monitored. Furthermore, the study also aims to identify potential areas for improvement in the monitoring process. An exploratory qualitative study was undertaken in Rwandana gencies. The findings show that the monitoring of the process of implementing and improving one‐stop e‐government is partly formal at central government level and informal at local government level. Furthermore, the focus of the monitoring at the stage of use and maintenance leans more towards the benefits of end users as service consumers than those of the service providers. Incorporating formal methodological approaches at local government level and in all stages of the implementation and improvement process at central government level, as well as paying increased attention to back‐end process performance aspects, could introduce additional improvements into the monitoring practice and, in turn, increase project benefits.
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| 3. |
- Bakunzibake, Pierre, 1977-, et al.
(författare)
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E-Government Implementation in Developing Countries : Enterprise Content Management in Rwanda
- 2016
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Ingår i: Electronic Government and Electronic Participation. - Amsterdam : IOS Press. - 9781614996705 - 9781614996699 ; , s. 251-259
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Konferensbidrag (refereegranskat)abstract
- E-Government is now on the rise in developing countries. While developing countries can "leapfrog" technology generations, the necessary organizational change is another matter. In industrialized countries technical systems have been developed over long time in parallel with institutional development; developing countries hope to make that journey faster. Most of the e-Government implementation research focuses on developed countries. It is important to explore the relation between the literature and the findings in the context of developing countries as to come up with a gap to reduce. An interview study with 56 people in 10 government organizations involved in implementing a government-wide enterprise content management system was conducted to find out how critical success factors found in literature on implementation of information management systems relate to the situation in the Rwanda public sector to discover the step forward in Rwanda. We find a large gap between expectations and results due to a strong focus on the technical tool and little concerns about issues related to organizational change.
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| 4. |
- Bakunzibake, Pierre, 1977-, et al.
(författare)
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E-Government Implementation Process in Rwanda : Exploring Changes in a Socio-technical Perspective
- 2019
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Ingår i: Business Systems Research Journal. - : De Gruyter Open. - 1847-8344 .- 1847-9375. ; 10:1, s. 53-73
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Tidskriftsartikel (refereegranskat)abstract
- Background: Failures in e-government projects to deliver expected results are frequent in the context of developing countries. These are partly attributed to the lack of balanced attention to both technical and social aspects in the implementation. However, there has been limited research on these aspects in the least Developed Countries.Objectives: Taking a socio-technical perspective, this study aims at exploring the extent of changes and effects in the implementation of e-government service-oriented initiatives in Rwanda, one of the Least Developed Countries.Methods/Approach: An empirical investigation was conducted, via interviews at 8 agencies during the period from January 2017 to May 2018. This involved two case projects, an Enterprise Content Management System and a One-Stop e-government system. Furthermore, government documents and online material were analyzed.Results: A number of changes in technology, processes and people aspects were faced in both projects. However, those changes are coupled with secondary effects; there is a need for a better fit between technical systems and social systems of organizations implementing e-government; a larger gap was identified in the first case project.Conclusions: Addressing the issues as a socio-technical system would contribute to improved work systems of agencies and better services.
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| 5. |
- Bakunzibake, Pierre, 1977-, et al.
(författare)
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Organisational Challenges in the Implementation of ‘one-stop’ e-Government in Rwanda
- 2019
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Ingår i: Electronic Journal of e-Government. - : Academic Conferences Limited. - 1479-439X. ; 17:1, s. 1-19
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Tidskriftsartikel (refereegranskat)abstract
- One-stop e-government holds potential benefits in all contexts and especially in the context of developing countries and in the Least Developed Countries (LDCs). Implementation of one-stop e-government can be challenging as it normally requires addressing a number of organisational issues including those related to the integration of the individual government information systems of different departments which traditionally function as silos; tackling organisational issues can be difficult due to the nature of the public sector. However, the contemporary literature paints a picture of scarce research on the organisational issues that impede the implementation of one-stop e-government initiatives in LDCs. This paper explores the organisational issues underlying the implementation of ‘one-stop’ e-government initiatives in Rwanda, an LDC. The study explores the status of these elements as of and up to March 2017. The qualitative case study methodology used for this study involved data collection by means of documents and interviews with key managers from central government organisations, from a private company, and from local government service clerks. Template analysis was used as a method for data analysis. Even though the number of online services for citizens, businesses, and other agencies is growing rapidly and easy payment of service fees is available, a number of organisational issues were identified. These include the lack of a clear plan of ‘to-be’ service processes and a corresponding change management strategy. Service re-design was taking place very much ad hoc. There were also unclear systematic organisational learning mechanisms and unclear operational goals in the local government. Addressing these issues would contribute towards improving the implementation of one-stop e-government and its corresponding services in such a context. The paper contributes to research by providing insights into organisational issues in a country currently in an early stage of e-government development. For Rwandan e-government professionals, the paper suggests a way forward. It also helps decision makers in Rwanda and similar countries undertaking one-stop initiatives to understand the problem context of actions taken towards IT-driven institutional reform.
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| 6. |
- Chen, Rong, et al.
(författare)
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Archetype-based conversion of EHR content models : pilot experience with a regional EHR system
- 2009
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Ingår i: BMC Medical Informatics and Decision Making. - : BMC. - 1472-6947. ; 9:33
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Tidskriftsartikel (refereegranskat)abstract
- Background: Exchange of Electronic Health Record (EHR) data between systems from different suppliers is a major challenge. EHR communication based on archetype methodology has been developed by openEHR and CEN/ISO. The experience of using archetypes in deployed EHR systems is quite limited today. Currently deployed EHR systems with large user bases have their own proprietary way of representing clinical content using various models. This study was designed to investigate the feasibility of representing EHR content models from a regional EHR system as openEHR archetypes and inversely to convert archetypes to the proprietary format. Methods: The openEHR EHR Reference Model (RM) and Archetype Model (AM) specifications were used. The template model of the Cambio COSMIC, a regional EHR product from Sweden, was analyzed and compared to the openEHR RM and AM. This study was focused on the convertibility of the EHR semantic models. A semantic mapping between the openEHR RM/AM and the COSMIC template model was produced and used as the basis for developing prototype software that performs automated bidirectional conversion between openEHR archetypes and COSMIC templates. Results: Automated bi-directional conversion between openEHR archetype format and COSMIC template format has been achieved. Several archetypes from the openEHR Clinical Knowledge Repository have been imported into COSMIC, preserving most of the structural and terminology related constraints. COSMIC templates from a large regional installation were successfully converted into the openEHR archetype format. The conversion from the COSMIC templates into archetype format preserves nearly all structural and semantic definitions of the original content models. A strategy of gradually adding archetype support to legacy EHR systems was formulated in order to allow sharing of clinical content models defined using different formats. Conclusion: The openEHR RM and AM are expressive enough to represent the existing clinical content models from the template based EHR system tested and legacy content models can automatically be converted to archetype format for sharing of knowledge. With some limitations, internationally available archetypes could be converted to the legacy EHR models. Archetype support can be added to legacy EHR systems in an incremental way allowing a migration path to interoperability based on standards.
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| 7. |
- Chen, Rong, et al.
(författare)
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Julius : a template based supplementary electronic health record system
- 2007
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Ingår i: BMC Medical Informatics and Decision Making. - London, United Kingdom : BioMed Central. - 1472-6947. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Background: EHR systems are widely used in hospitals and primary care centres but it is usually difficult to share information and to collect patient data for clinical research. This is partly due to the different proprietary information models and inconsistent data quality. Our objective was to provide a more flexible solution enabling the clinicians to define which data to be recorded and shared for both routine documentation and clinical studies. The data should be possible to reuse through a common set of variable definitions providing a consistent nomenclature and validation of data. Another objective was that the templates used for the data entry and presentation should be possible to use in combination with the existing EHR systems.Methods: We have designed and developed a template based system (called Julius) that was integrated with existing EHR systems. The system is driven by the medical domain knowledge defined by clinicians in the form of templates and variable definitions stored in a common data repository. The system architecture consists of three layers. The presentation layer is purely web-based, which facilitates integration with existing EHR products. The domain layer consists of the template design system, a variable/clinical concept definition system, the transformation and validation logic all implemented in Java. The data source layer utilizes an object relational mapping tool and a relational database.Results: The Julius system has been implemented, tested and deployed to three health care units in Stockholm, Sweden. The initial responses from the pilot users were positive. The template system facilitates patient data collection in many ways. The experience of using the template system suggests that enabling the clinicians to be in control of the system, is a good way to add supplementary functionality to the present EHR systems.Conclusion: The approach of the template system in combination with various local EHR systems can facilitate the sharing and reuse of validated clinical information from different health care units. However, future system developments for these purposes should consider using the openEHR/CEN models with shareable archetypes.
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| 8. |
- Coorevits, Pascal, et al.
(författare)
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Electronic health records : new opportunities for clinical research
- 2013
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Ingår i: Journal of Internal Medicine. - : Wiley-Blackwell. - 0954-6820 .- 1365-2796. ; 274:6, s. 547-60
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Tidskriftsartikel (refereegranskat)abstract
- Clinical research is on the threshold of a new era in which electronic health records (EHRs) are gaining an important novel supporting role. Whilst EHRs used for routine clinical care have some limitations at present, as discussed in this review, new improved systems and emerging research infrastructures are being developed to ensure that EHRs can be used for secondary purposes such as clinical research, including the design and execution of clinical trials for new medicines. EHR systems should be able to exchange information through the use of recently published international standards for their interoperability and clinically validated information structures (such as archetypes and international health terminologies), to ensure consistent and more complete recording and sharing of data for various patient groups. Such systems will counteract the obstacles of differing clinical languages and styles of documentation as well as the recognized incompleteness of routine records. Here, we discuss some of the legal and ethical concerns of clinical research data reuse and technical security measures that can enable such research while protecting privacy. In the emerging research landscape, cooperation infrastructures are being built where research projects can utilize the availability of patient data from federated EHR systems from many different sites, as well as in international multilingual settings. Amongst several initiatives described, the EHR4CR project offers a promising method for clinical research. One of the first achievements of this project was the development of a protocol feasibility prototype which is used for finding patients eligible for clinical trials from multiple sources.
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| 9. |
- Dalal, Koustuv, 1969-, et al.
(författare)
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Do electronic and economic empowerment protect women from intimate partner violence (IPV) in India?
- 2022
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Ingår i: BMC Women's Health. - : BioMed Central (BMC). - 1472-6874. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Intimate partner violence (IPV) is a major public health problem. Electronic empowerment has several positive impacts on health. No study has examined whether electronic empowerment prevents intimate partner violence. Economic empowerment has positive and negative effects on IPV victimization. The current study was conducted to investigate whether economic and electronic empowerment of women act as protective factors against IPV in India.METHODS: A national representative sample of 66,013 ever-married women from 36 member states and union territories of India has been used from the National Family Health Survey 2015 to 2016. Emotional, physical and sexual violence against women by husbands were target variables. We used bivariate and multivariate analyses. RESULTS: The prevalence of emotional violence was 13%, physical violence was 28% and sexual violence was 7%. IPV against women was as follows: The prevalence was higher among women living in rural areas, belonging to Hindu religion and those belonging to Scheduled Castes. Higher education and higher socio-economic status were found to be protective factors against IPV. The prevalence of IPV was higher among the working women, among those having knowledge of business loans for women and the recipients of such business loans. Exposure to media was found to reduce IPV. The women who used mobile phones and SMS facility experienced less violence.CONCLUSION: Economic independence of women was found to be a risk factor for IPV in India, whereas electronic empowerment was a protective factor. In the Indian context, policymakers should make use of mobile phones and support SMS use in the IPV awareness programs. Women empowerment, combined with gender equity, can reduce the prevalence of violence against women.
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| 10. |
- Despotou, George, et al.
(författare)
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Localisation, Personalisation and Delivery of Best Practice Guidelines on an Integrated Care and Cure Cloud Architecture : The C3-Cloud Approach to Managing Multimorbidity
- 2020
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Ingår i: Digital Personalized Health and Medicine. - : IOS Press. - 9781643680835 - 9781643680828 ; , s. 623-627
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Konferensbidrag (refereegranskat)abstract
- BACKGROUND: C3-Cloud is an integrated care ICT infrastructure offering seamless patient-centered approach to managing multimorbidity, deployed in three European pilot sites. Challenge: The digital delivery of best practice guidelines unified for multimorbidity, customized to local practice, offering the capability to improve patient personalization and benefit.METHOD: C3-Cloud has adopted a co-production approach to developing unified multimorbidity guidelines, by collating and reconciling best practice guidelines for each condition. Clinical and technical teams at pilot sites and the C3-Cloud consortium worked in tandem to create the specification and technical implementation.RESULTS: C3-Cloud offers CDSS for diabetes, renal failure, depression and congenital heart failure, with over 300 rules and checks that deliver four best practice guidelines in parallel, customized for each pilot site.CONCLUSIONS: The process provided a traceable, maintainable and audited digitally delivered collated and reconciled guidelines.
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