Going Beyond E-Health Implementation to Adoption for the Attainment of Sustainable Development Goal Three

Going Beyond E-Health Implementation to Adoption for the Attainment of Sustainable Development Goal Three

Author: 
John W. Gachago
Program of study: 
D.H.A.
Abstract: 
The research problem addressed in this manuscript was premised on the impact of going beyond implementation to the activities that define adoption of eHealth and how that could potentially accelerate the attainment of United Nations Sustainable Development Goal 3 for health. The research was conducted from the perspective of healthcare professionals in Kenya working as general practitioners. The purpose of the study was to collect and analyze data that would inform and catalyze the shift from a focus on implementation to adoption of eHealth solutions by policy makers, foundations, donor agencies and stakeholder vested in strengthening Kenyan and similar LMIC health systems through health information technology. Guided by the Technology Adoption Model, the Carayon Systems Engineering Initiative for Patient Safety, Leadership Theory, eHealth strategy and a clear distinction between adoption and implementation, the researcher examined the experiences of EMR/EHR users in Kenya. Based on a qualitative case study design the findings demonstrated that for adoption to become the norm, barriers need to be overcome including additional EMR functionality, health informatics education, and more strategic orientation from the Ministry of Health leaders in developing an enabling environment. Beneficiaries of this research include Kenya’s and other LMIC Ministries of Health (MOH), stakeholders such as the Palladium Group, the Bill and Melinda Gates Foundation, the Rockefeller Foundation, Partners in Health (PIH), the United States Agency for International Development (USAID), and the World Health Organization (WHO). The results, based on medical practitioner feedback, provided the latter organizations with critical information to maximize the return on their investments in eHealth solutions for Kenya and other LMICs and meet SDG3 goals.
Dedication: 
This research is dedicated to God who has deposited in me a passion for transforming the delivery of healthcare in Africa. It is also dedicated to the memory of my father Jesse M. Gachago M.P. E.B.S., who was the first health officer in colonial Nakuru, Kenya and a shining example of servant leadership as lifelong a Member of Parliament. It is equally dedicated to my mother Julie Masa Washika and grandmother Esther Wangari Washika, who exemplified the fortitude of women given their remarkable entrepreneurial spirit that was second to none and to my sons Mwangi and Makori who I hope would recognize their unlimited potential. Finally, it is dedicated to health leaders in Africa who can make sure that Africa is no longer perceived as the continent of pestilence and disease. Africa has embraced the mobile telephony revolution and demonstrated remarkable innovation and growth. E-Health and Blockchain technologies have the potential to transform the delivery of health care and realize the goal of outcome driven universal healthcare. African healthcare leaders must take ownership of their healthcare systems and commit to transforming them to deliver safer, more effective, more efficient, patient-centered, timely, and equitable care. The unsustainable cycle of dependency, where low- and middle-income nations depend on more developed nations and donor agencies to strengthen their healthcare systems, can come to an end by leveraging health information technology to develop evidence based and outcome-driven systems of efficient and affordable health care. Finally, I cannot express sufficient gratitude to my previous chair Dr Mary Wangemann and current chair Dr Edward Paluch who have been invaluable in guiding me towards completion with wise counsel from my committee members Dr. Michael Taku and Dr. Jeffrey Rhoades.