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Healthcare delivery systems around the world are facing a crisis precipitated by ever-escalating costs due to the epidemiologic transition, increasing costs of pharmaceuticals and medical technology, and an aging demographic. Perhaps the world’s best opportunity to meet these challenges can be found by adopting and implementing health management information systems (HMIS) to increase accessibility, improve productivity and, finally, last but not least, to provide better quality health care. Until recently the “developing world” could not afford to implement complex information technology in its health sector due to the high costs of computerization and the generally low capacity which was found in many/most CDEs. Both of these factors are rapidly changing. Information technology, with few exceptions, continues to enjoy an ever-decreasing price point and a deflationary cycle. Increases in some software costs are offset by huge decreases in hardware costs. This makes HMIS projects more affordable with each passing day. Likewise the educational institutions in many CDEs continue to stress computer science and related disciplines, graduating some of the world’s best experts in the field. India, for example, has become a powerhouse, and many other countries are rapidly following its example Finally, those organizations which provide funding for infrastructure projects, such as the World Bank, the Asian Development Bank, USAid and others, are increasingly funding such projects throughout, at the request of their clients. This year is the second year that HICSS has hosted this mini-track. Three papers are presented this year. The firsts looks at adoption of IT in healthcare settings in China. The authors apply Structuration Theory to conceptualize the concept of information culture, which is then used to analyze relationships between information culture and the development of e-health in China. The second paper presents analysis of and recommendations from information systems used for drug prevention, control, and treatment in Chile. Evaluations of the systems are discusses, as well as recommendations for IT support of cooperative, international efforts to combat the drug problem. The final paper presents an evaluation of a virtual microscopy system and discusses potential applications of the technology in countries with developing economies. Regardless of your host environment, whether you are from Hawai‘i, the USA mainland, the developed Asian countries or elsewhere, we can all learn from their experiences.

The health systems in many developing countries lag seriously behind the developed world in the use of health management information systems (HMIS). The World Bank, like other international donor organizations, is increasingly called upon to provide technical and financial assistance in this area, but success stories remain rare. Because HMIS are critical to developing and improving health systems delivery and finance, the bank must find ways to increase effectiveness of the interventions it supports. This paper attempts to contribute to this process by proposing a new conceptual framework for the assessment of HMIS interventions, and then demonstrating the framework by applying it to an existing project to support national health insurance in Latvia. The paper documents the key characteristics of the HMIS project, discusses successes and failures to date, and presents lessons learned that may be applicable to other HMIS projects in developing countries. The case study focuses on a functional classification of the HMIS implementation, and critical success factors that have emerged with regard to systems implementation in developed countries.

Evaluating computer systems is difficult. Computer software, one of the most abstract of man’s creations, is not so much an object as an idea, making it difficult to measure and to compare. We can’t kick its tires. We can, however, observe its performance. And judgments about software quality can sometimes be made by breaking the software design into its constituent parts and studying each of them.