Towards a successful eHealth policy and strategy implementation in Uganda: using a collaboration change management process

Abstract

eHealth is a very critical initiative in improving healthcare in Uganda in a heavily stressed healthcare system where there is approximately one doctor and nurse for every 24,725 and 18,000 people respectively. An eHealth Policy and Strategy was developed by the Ministry of Health to support the eHealth agenda however, there were limitations on how change to eHealth practice was to be managed thus successful implementation of eHealth has proved to be a significant challenge within the healthcare sector in Uganda. Studies have shown that successful implementation of eHealth remains a complex task requiring significant change management interventions. Ten (10) case organisations were selected through purposive sampling, these included regional referral hospitals and private health care providers in Uganda. The organisations were selected based on their integration of eHealth into their business processes, these organisations were supervised directly by the Ministry of Health in Uganda. By selecting healthcare organizations directly supervised by the Ministry of Health and implementing eHealth initiatives, the study concentrated on those institutions that have experienced the benefits and challenges of successfully integrating use of technology into their operations/activities for improved service delivery. The study adopted the Design science approach to develop a Collaboration change management process/model that guides organisations into a streamlined approach into identifying strategies and activities leading to successful implementation of eHealth initiatives irrespective of the technology divide. To validate our model, we conducted a case study with two regional referral hospitals in the Eastern and Western region of Uganda. Our results showed that organisations were still experiencing challenges in ensuring successful implementation of eHealth initiatives as per the National eHealth Strategy and Policy. The findings further underscored the need for proper change management as an intervention, the study identified requirements leading to the design of the Collaboration Change Management (ColCM) process. The ColCM was validated at two case study organisations and was found to be usable and acceptable with immense potential to support successful implementation of eHealth initiatives in health organisations and achievement of the Uganda eHealth Policy and Strategy.