Electronic health records in developing countries, integrating with mobile technology and legacy systems for community based health workers: Organisational and end-users' issues

The World Health Organisation (WHO) in 2004 called for the use of electronic health record (EHR) systems for the scaling of HIV/AIDS management of United Nations' Millennium Development Goals related diseases. The use of EHR as a means of building the capacity of health workers and the integration of EHR with the legacy health management information system was proposed as a way of building a holistic information system. To achieve this, the provision of internet connectivity and computers in different health settings was recommended. Community Based Health Workers (CBHWs), as important actors in the provision of essential primary healthcare in developing countries, require access to their patients' medical records in order to provide quality and effective health care. Therefore, the distribution of EHR integrated with legacy systems through mobile/wireless information and communication technologies could provide means of providing remote and located access to CBHWs. The use of mobile technologies for extending enterprise knowledge to this group of health workers for supporting their daily activities is recently proposed by the WHO. This paper will build on this proposition through a case study evaluation of a failed implementation and use of a mobile EHR system from a developing country. A major finding of this paper is the need to carry out pre-implementation evaluation before the introduction of integrated mobile EHR with CBHWs in developing countries.