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Health Information Systems (HIS) in Uganda always fail to achieve the organizational objectives and yet little research has been conducted to study the strategic alignment of HIS in the country. This study therefore set out to examine the antecedents and dynamics that influence strategic alignment of HIS in Uganda with the aim of adequately addressing the complex IS design issues a total of 296 respondents were purposively selected from 39 health facilities across the country to participate in the survey. Data was analyzed using descriptive statistics. Findings from the study revealed that HIS are used to locate substitute sources for medical commodities, reduce costs of handling orders as well as minimize uncertainty in ordering lead time. In addition, HIS provide information to clients, add value to existing health services and are used to target health service needs with accuracy as well as identify groups of clients whose needs are not being met. HIS are used to minimize the cost of designing services, adding features to existing services and population grouping services at the health unit level. In the area of internal health facility efficiency, HIS help in ensuring efficiency and enable informed decision making, provide efficiency in internal meetings and discussions, co-ordination among facility departments, and provide good evaluation on annual budget. Further, HIS are used by health workers to provide evaluation on capital, maximize organizational performance, population coverage and strategic planning efficiency. Despite the above, the study revealed that health units do not have standards, frameworks and policies for the strategic alignment of HIS and the funding to support them. For better alignment of HIS, there should be proper planning and training of health workers on the importance of strategic alignment of HIS. Further, health facilities should be encouraged to adopt electronic information systems to improve their efficiency and effectiveness. There should also be policies, frameworks and or standards for guiding strategic alignment of Health Information Systems in health facilities. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

PurposeThe purpose of this paper is to develop a framework for designing sustainable telemedicine information systems in developing countries.Design/methodology/approachBoth quantitative and qualitative research methods were used. Primary data were collected from two hospitals in Uganda using a self‐administered questionnaire and an interview guide. Descriptive statistics were used to analyze survey data, while content analysis method was used to analyze interview responses. The framework was developed based on Hevner et al.'s design science framework.FindingsThe key requirements for designing sustainable telemedicine information systems in developing countries were identified as the need for speed, ease of use and affordability.Research limitations/implicationsThis study was theoretical in nature. Although primary data were used, the researchers were unable to carry out a series of practical tests of this framework with prototype systems on a cross‐section of users.Practical implicationsDesign and sustainability of telemedicine information systems is still a big challenge to most developing countries, despite its wide usage in the developed countries. While various telemedicine frameworks exist, not much has been done to adequately address the issue of design for sustainability. This paper proposes an appropriate framework that will guide telemedicine information systems designers on designing telemedicine systems that are sustainable in local conditions of developing countries.Originality/valueThe main contribution of this paper is in the area of information systems design for sustainability, from a developing country perspective. The paper also extends on the constructs of design science research theory and shows how they can be applied in information systems design and evaluation.

This paper demonstrates how qualitative System Dynamics methodology can be used to provide a better understanding of health systems thus facilitating better development and design of computer-based health information systems. In an earlier paper by the same authors, system dynamics modeling and field study research methods are used to capture the complex and dynamic nature of the immunization process, to enhance the understanding of the immunization health care problems and to generate insights that may increase the immunization coverage effectiveness. Through qualitative modeling, causal loop diagrams which are used to show the key issues that need to be addressed when developing health information systems are drawn with the aim of improving the immunization services. The paper shows the benefits of using System Dynamics to understand systems with complex interactions thus facilitating the development of information systems that meet the stakeholder requirements.