Jonnagaddala Jitendra, Guo Guan N, Batongbacal Sean, Marcelo Alvin, Liaw Siaw-Teng
School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales, Australia
WHO Collaborating Centre for eHealth, UNSW Sydney, Sydney, New South Wales, Australia.
BMJ Health Care Inform. 2020 Jul;27(1). doi: 10.1136/bmjhci-2020-100136.
Healthcare organisations are undergoing a major transformational shift in the use of information and digital health technologies. Enterprise architecture (EA) has been incrementally adopted in many healthcare organisations globally to facilitate this change. EA can increase the effectiveness of an organisation's digital health capabilities and resources. However, little is known about the status of EA adoption in low-income and middle-income countries. This study aimed to evaluate the challenges, goals and benefits associated with adoption of EA for healthcare in the Asia eHealth Information Network (AeHIN) member countries .
We developed an EA Adoption Evaluation framework with four principal layers: governance, strategy, EA and performance. The framework guided the development of a questionnaire to investigate the goals, challenges and benefits faced before and during EA adoption by healthcare organisations.
26 participants from 18 healthcare organisations in the Asia-Pacific region representing 11 countries. Organisations included Ministries of Health, Universities, Non-Governmental Organisations and Technical Advisory Groups.
Only 5 of the 18 organisations had begun adopting EA. The goals expressed for EA adoption were to address issues such as interoperability, lack of technical infrastructure and poor alignment of business and information technology strategies. Cost reduction was less emphasised. The main challenges to adopting EA was the lack of EA knowledge, leadership and involvement of senior management.
The adoption of EA is incipient in AeHIN member healthcare organisations. To encourage EA adoption, these organisations need to invest in internal capacity building, senior management training and seek independent EA expert advice to systematically identify and address the barriers to adopting EA.
医疗保健机构在信息和数字健康技术的使用方面正在经历重大的转型变革。企业架构(EA)已在全球许多医疗保健机构中逐步采用,以促进这一变革。企业架构可以提高组织数字健康能力和资源的有效性。然而,对于低收入和中等收入国家企业架构采用的现状知之甚少。本研究旨在评估亚洲电子健康信息网络(AeHIN)成员国在医疗保健领域采用企业架构所面临的挑战、目标和益处。
我们开发了一个企业架构采用评估框架,该框架有四个主要层次:治理、战略、企业架构和绩效。该框架指导了一份调查问卷的制定,以调查医疗保健机构在采用企业架构之前和期间所面临的目标、挑战和益处。
来自亚太地区11个国家的18个医疗保健机构的26名参与者。这些机构包括卫生部、大学、非政府组织和技术咨询小组。
18个机构中只有5个开始采用企业架构。采用企业架构所表达的目标是解决诸如互操作性、缺乏技术基础设施以及业务与信息技术战略不一致等问题。成本降低较少被强调。采用企业架构的主要挑战是缺乏企业架构知识、领导力以及高级管理层的参与。
AeHIN成员国的医疗保健机构中企业架构的采用尚处于初期阶段。为鼓励采用企业架构,这些机构需要投资于内部能力建设、高级管理层培训,并寻求独立的企业架构专家建议,以系统地识别和解决采用企业架构的障碍。