Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
eHealth Research Unit, Department of Computer Science, University of Botswana, Gaborone, Botswana.
JMIR Res Protoc. 2024 Oct 9;13:e52411. doi: 10.2196/52411.
Botswana has made significant investments in its health care information infrastructure, including vertical programs for child health and nutrition, HIV care, and tuberculosis. However, effectively integrating the more than 18 systems in place for data collection and reporting has proved to be challenging. The Botswana Health Data Collaborative Roadmap Strategy (2020-24) states that "there exists parallel reporting systems and data is not integrated into the mainstream reports at the national level," seconded by the Botswana National eLearning strategy (2020), which states that "there is inadequate information flow at all levels, proliferation of systems, reporting tools are not synthesized; hence too many systems are not communicating."
The objectives of this study are to (1) create a visual representation of how data are processed and the inputs and outputs through each health care system level; (2) understand how frontline workers perceive health care data sharing across existing platforms and the impact of data on health care service delivery.
The setting included a varied range of 30 health care facilities across Botswana, aiming to capture insights from multiple perspectives into data flow and system integration challenges. The study design combined qualitative and quantitative methodologies, informed by the rapid assessment process and the technology assessment model for resource limited settings. The study used a participatory research approach to ensure comprehensive stakeholder engagement from its inception. Survey instruments were designed to capture the intricacies of data processing, sharing, and integration among health care workers. A purposive sampling strategy was used to ensure a wide representation of participants across different health care roles and settings. Data collection used both digital surveys and in-depth interviews. Preliminary themes for analysis include perceptions of the value of health care data and experiences in data collection and sharing. Ethical approvals were comprehensively obtained, reflecting the commitment to uphold research integrity and participant welfare throughout the study.
The study recruited almost 44 health care facilities, spanning a variety of health care facilities. Of the 44 recruited facilities, 27 responded to the surveys and participated in the interviews. A total of 75% (112/150) of health care professionals participating came from clinics, 20% (30/150) from hospitals, and 5% (8/150) from health posts and mobile clinics. As of October 10, 2023, the study had collected over 200 quantitative surveys and conducted 90 semistructured interviews.
This study has so far shown enthusiastic engagement from the health care community, underscoring the relevance and necessity of this study's objectives. We believe the methodology, centered around extensive community engagement, is pivotal in capturing a nuanced understanding of the health care data ecosystem. The focus will now shift to the analysis phase of the study, with the aim of developing comprehensive recommendations for improving data flow within Botswana's health care system.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/52411.
博茨瓦纳在医疗保健信息基础设施方面进行了大量投资，包括儿童健康和营养、艾滋病毒护理和结核病等垂直项目。然而，有效地整合现有的 18 个以上用于数据收集和报告的系统已被证明具有挑战性。博茨瓦纳卫生数据协作路线图战略（2020-24 年）指出，“存在并行报告系统，数据未纳入国家一级的主流报告”，博茨瓦纳国家电子学习战略（2020 年）也表示，“各级之间的信息流不足，系统泛滥，报告工具没有综合，因此太多系统无法进行沟通”。
本研究的目的是：(1) 以可视化的方式展示数据在每个医疗保健系统层面的处理过程以及输入和输出；(2) 了解一线工作人员如何看待现有平台上的医疗保健数据共享以及数据对医疗保健服务提供的影响。
研究地点包括博茨瓦纳的 30 个不同医疗保健机构，旨在从多个角度深入了解数据流和系统集成挑战。该研究结合了定性和定量方法，以快速评估流程和资源有限环境下的技术评估模型为指导。研究采用参与式研究方法，从一开始就确保利益相关者的全面参与。调查工具旨在捕捉医疗保健工作者之间数据处理、共享和集成的复杂性。采用目的性抽样策略，以确保不同医疗保健角色和环境的参与者有广泛的代表性。数据收集既使用了数字调查，也使用了深入访谈。初步分析主题包括对医疗保健数据价值的看法以及数据收集和共享方面的经验。已全面获得伦理批准，反映了在整个研究过程中维护研究诚信和参与者福利的承诺。
该研究共招募了近 44 个医疗保健机构，涵盖了各种医疗保健机构。在招募的 44 个机构中，有 27 个机构对调查做出了回应并参加了访谈。共有 75%（112/150）的参与医疗保健专业人员来自诊所，20%（30/150）来自医院，5%（8/150）来自卫生所和流动诊所。截至 2023 年 10 月 10 日，该研究已收集了 200 多份定量调查，并进行了 90 次半结构化访谈。
到目前为止，这项研究得到了医疗保健界的积极参与，这突显了这项研究目标的相关性和必要性。我们相信，以广泛的社区参与为核心的方法对于捕捉医疗保健数据生态系统的细微理解至关重要。现在将重点转移到研究的分析阶段，旨在为改善博茨瓦纳医疗保健系统内的数据流动提出全面建议。
国际注册报告标识符（IRRID）：DERR1-10.2196/52411。
