A Health Facility Registry to Aid Health Information Exchange across Uganda’s Health System

Abstract

Introduction: Availability of an accurate and complete health facility list is fundamental in producing quality and timely data that is sufficient to aid evidence-based decision, resource allocation and planning within the healthcare ecosystem. The Uganda eHealth Strategy mentions of the need to establish a Health Facility Registry (HFR) to house and manage the National Master Facility List (MFL). This study aimed at examining the mechanisms used in Uganda to manage data about health facilities and the challenges they are facing; establishing, validating and documenting requirements and features that will aid the development of a HFR; and developing the HFR design models to aid Health Information Exchange (HIE) across Uganda’s health system. Method: A qualitative study was conducted based on the Design Science Research Methodology (DSRM). In-depth interviews were conducted with purposively selected interviewees from the Ministry of Health, government regulatory organizations, district local government, general public, academia, implementing partners and healthcare providers. Each interview was audio recorded and de-identified. An inductive analysis approach was used to analyze the data collected. A study-tailored validation excel document was used to validate the requirements; Business Process Modelling Notation and Unified Modelling Language were used to develop the design models. Results: This study was conducted between April to August 2018 in Uganda’s health system, where 32 respondents participated in the exploratory study; 20 respondents participated in the requirements validation exercise. Four divergent mechanisms that had five common challenges were identified. The challenges included: lack of a health facility unique identifier, non-standardized data attributes, incomplete facility listing, inaccurate data, and difficulty accessing and using data. Validated requirements and features for the desired artefact were established. Design models to aid the development of a HFR were established. Mpango J and Nabukenya J. A Qualitative Study to Examine Approaches used to Manage Data about Health Facilities and their Challenges: A Case of Uganda. AMIA Annual Symposium Proceedings. AMIA Symposium 2019 (in press). (AMIA acceptance letter in Appendix VI of this dissertation) Conclusion: Establishing a central HFR to manage the National MFL would improve patient referrals, facility look-ups, HIE, data curation and access, and aid information systems interoperability across Uganda’s health system.