Applying Evaluation Principles to Health Information Systems in PEPFAR Countries: Notes from the Field
Health Information Systems, or eHealth, projects are growing rapidly in scope and scale worldwide to improve health. For many decades the United States (US) Government has been actively involved in working with other nations to improve the health and health information systems. In 2003, the President’s Emergency Plan for AIDS Relief (PEPFAR) was formally authorized and is considered to be the largest commitment by any nation to combat a single disease in history. From the beginning the use of electronic health information systems was a critical component of the PEPFAR implementation. High-quality data are essential to HIV prevention, care and treatment, policy development, resource planning and accountability. Understanding the burden of disease requires functioning surveillance and aggregate indicator monitoring systems. Providing effective patient treatment requires consistent and available patient, laboratory and pharmacy data. As health information infrastructure matured in countries, patient-level data collection systems were implemented to be used for both patient care and for routine health information for surveillance, monitoring and evaluation, and resource planning. Despite this growth in health information systems implementation there is little evidence demonstrating the health information systems effectiveness in gaining user acceptance, improving health services delivery, or improving health outcomes. This presentation will provide some examples of applying informatics-related evaluation principles towards understanding the effectiveness of health information systems in low-resource environments supported by PEPFAR.