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Addressing the information deficit in global health: lessons from a digital acute care platform in Sri Lanka
  1. Abi Beane1,2,
  2. Ambepitiyawaduge Pubudu De Silva3,
  3. Priyantha Lakmini Athapattu4,
  4. Saroj Jayasinghe5,
  5. Anuja Unnathie Abayadeera6,
  6. Mandika Wijerathne6,
  7. Ishara Udayanga1,
  8. Shriyananda Rathnayake7,
  9. Arjen M Dondorp2,
  10. Rashan Haniffa1,2
  1. 1 Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka
  2. 2 Mahidol Oxford Tropical Research Unit, Bangkok, Thailand
  3. 3 National Intensive Care Surveillance, Ministry of Health, Colombo, Sri Lanka
  4. 4 Ministry of Health, Colombo, Sri Lanka
  5. 5 Department of Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
  6. 6 Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
  7. 7 Information and Communication Technology Agency of Sri Lanka, Columbo, Sri Lanka
  1. Correspondence to Ms Abi Beane; abi{at}nicslk.com

Abstract

Lack of investment in low-income and middle-income countries (LMICs) in systems capturing continuous information regarding care of the acutely unwell patient is hindering global efforts to address inequalities, both at facility and national level. Furthermore, this of lack of data is disempowering frontline staff and those seeking to support them, from progressing setting-relevant research and quality improvement. In contrast to high-income country (HIC) settings, where electronic surveillance has boosted the capability of governments, clinicians and researchers to engage in service-wide healthcare evaluation, healthcare information in resource-limited settings remains almost exclusively paper based. In this practice paper, we describe the efforts of a collaboration of clinicians, administrators, researchers and healthcare informaticians working in South Asia, in addressing the inequality in access to patient information in acute care. Harnessing a clinician-led collaborative approach to design and evaluation, we have implemented a national acute care information platform in Sri Lanka that is tailored to priorities of frontline staff. Iterative adaptation has ensured the platform has the flexibility to integrate with legacy paper systems, support junior team members in advocating for acutely unwell patients and has made information captured accessible to diverse stakeholders to improve service delivery. The same platform is now empowering clinicians to participate in international research and drive forwards improvements in care. During this journey, we have also gained insights on how to overcome well-described barriers to implementation of digital information tools in LMIC. We anticipate that this north–south collaborative approach to addressing the challenges of health system implementation in acute care may provide learning and inspiration to other partnerships seeking to engage in similar work.

  • health services research
  • health systems
  • health informatics

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Handling editor Soumitra Bhuyan

  • Contributors This practice paper describes the experiences and insights of a multidisciplinary collaborative. Each author is a key stakeholder in the collaborative and represents a wider network. All made significant contribution to the learning described. AB and RH were responsible for manuscript preparation.

  • Funding This study was part funded by National Science Foundation, Sri Lanka and by NICST.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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