Challenges of implementing E-Health in Bangladesh
E-Health is generally understood to be the application of computer, Internet, mobile phone and other technologies to improve the patients’ health status using information and communication technology (ICT) through telemedicine, internet, electronic health records, mobile technology and clinical decision support.
Present condition in Bangladesh :
Currently, health service through internet and mobile phone, telemedicine service, complaints-suggestions through SMS, pregnancy care advice through SMS, online population health registry, GIS in health service, bulk SMS are available in government hospital in Bangladesh.
Inadequate ICT Infrastructure :Bangladesh has no adequate ICT infrastructural support such as Computers, Internet network, Printers, and electricity for e-Health. Moreover, only few percentage of the total population have access to computers and Internet which has high cost and highly unreliable in Bangladesh. In addition, power supply is not enough and available to support e-Health activities.
Financial Problems :The procurement, implementation and use of e-Health systems are expensive. Most of the times, government has to depend on developed countries, foreign investors or World Bank for implementing large project.
Resistance of Change :Older administrative staff in hospital sectors of Bangladesh is familiar with manual system and nobody wants to implement new ideas in an old setup. This lack of motivation is a well-documented challenge, typically described as resistance to change or reluctance to new technology. There are a number of reasons why administrative staff, policy maker, physician and nurses resist the use of e-Health. Some of the primary reasons are (i) they fear that computerization of different health care activities may make some people redundant; (ii) they are resistant to any kind of change in their familiar working environment.
Usability & User Acceptance :Service provider in Government sector in Bangladesh has good knowledge on e-Health applications. But service recipients are not well-known with e-Health. So their perception about e-Health is not in fine condition. Users not trusting using an e-Health for documenting patient information will negatively influence the will to adopt and use an e-Health. Majority of the people in Bangladesh are unaware about the e-Health service. Only few portions of the people are using the e-Health services. Moreover, most of the people have not enough knowledge of using computers, internet or electronic service delivery.
Lack of Policy and Regulation :Healthcare is a sensitive domain where people’s lives are at risk. If some system is going to be used, proper procedures and rules are needed to be devised and followed to ensure safe practices of healthcare services otherwise it could lead to serious consequences. Although the government of Bangladesh adopted a national ICT policy in 2009, it has not yet had any effect on hospitals. The regulatory/legal framework in Bangladesh has not yet been modernized to accommodate the growing needs of the e-Health in Bangladesh.
Interoperability of Systems :Most of e-Health systems in Bangladesh are isolated because systems developed by different vendors of software, universities, firms and research institutions. Bangladesh government did not design any central database for citizen’s access using through internet. Even there is no available information of any citizen in government hospitals to use any emergency health care situation. For this reason physician in government hospital face many difficulties to identify the patient and their healthcare needs.