A unified architecture framework for healthcare mobile systems to improve big data usefulness in a government environment

Abstract

Governments of many countries, including Namibia, build public hospitals to provide healthcare services to its community members. In the process, various types (such as text, image, and video) of data are generated from patients and the facilities. Over the years, the data grow to a point where some of the health facilities struggle to manage it. This includes the use of different techniques and tools, such as mobile systems to store and access data. What makes the situation even more challenging is the lack of flexibility and integration among information systems, such as mobile systems and healthcare big data. The challenges cause difficulties in attempts to access the big data for the purposes of healthcare services delivery. Thus, the study aimed to propose a solution that can be used by the healthcare facility in Namibia, to ease access to patients' big data. Based on the research aim, the following research questions were developed: (1) What are the factors that influence the use of mobile systems in accessing healthcare big data for service delivery in the Namibian environment? and (2) What are the factors that can be used to guide and enable integration between health mobile systems and healthcare big data for improved healthcare service delivery? To achieve the study's aim, a qualitative research strategy was followed. A case study design was employed by using two cases, namely the Ministry of Health (MoH), and Healthbridge Public Hospital (HPH) in Namibia. Data were collected through semi-structured interviews and documentation. The semi-structured interview was considered the main data collection technique. The hermeneutic method was applied in the analysis of the qualitative data, which was guided by the duality of structure from the perspective of Structuration Theory (ST). There were findings from the analysis of data from both organisations used in the study: MoH - communicative tools, network of people, policies compliance, technology Monopolistic, governance, data management system, and lack of interactive systems − and HPH - mobile systems ease of use, systems user training, online consultation, medical history traceability, access to external facilities, and practitioner's collaboration. The Technology Acceptance Model (TAM) was employed as a lens to help make more sense of the findings. This was primarily to gain a deeper understanding of the factors that influence how healthcare big data is accessed, used and managed in the Namibian environment, and how the factors impact the interaction and integration between health mobile systems and healthcare big data towards improving service delivery.Based on the empirical evidence, the findings from the two cases:(1) Ministry of Health which include communicative tools, network of people, policies compliance, technology monopolistic, governance, data management system, and lack of interactive systems, and (2) Healthbridge Public Hospital (HPH), which include mobile systems ease of use, system user training, online consultation, medical history traceability, access to external facilities, practitioner's collaboration, systems decentralisation, and technology infrastructure flexibility were found to be important in the use of health mobile systems. In the end, a Unified Architecture Framework (UAF) was developed. The UAF is therefore proposed as a solution to improve the use of mobile systems in gathering, storing, accessing, and managing patients' big data in Namibian health facilities. The UAF provides governance and standards that guide the selection, development, and implementation of Information systems/Information Technologies solutions for healthcare purposes. This is primarily to improve efficiency and effectiveness of healthcare service delivery in the country. The contributions of this study come from theoretical, practical, and methodological perspectives. The study is intended to benefit academics, IT specialists, and healthcare practitioners as follows: To the academics: the study adds to the existing literature. In literature, much has been researched and written on big data. However, research on big data in the area of healthcare, especially in developing countries, have been lagging. The study also brings forth a new perspective from the application of two different theories, Structuration Theory and Technology Acceptance Model. The complimentary use of theories is always a challenge especially their order of use. IT specialists and Healthcare practitioners: this study will contribute to enterprise architecting as there are only a few studies related to architecture in the healthcare domain. The findings will also enable policy developers and decision makers to understand how mobile systems can be integrated and used as a tool for data management in healthcare. Moreover, management will benefit from the study's findings in terms of the factors that contribute to, or impact, system adoption and resistance. Based on that, management will be in a better position to assess both technical and non-technical factors before implementing information systems and supporting technologies as solutions.