Architectural Design of the National Health Information System for Rwanda

The use of information technology in healthcare services can improve the quality of care. The large amount of research has demonstrated the role of the use of Information and communication technology (ICT) solutions to overcome the challenges in patient information management. One of the challenges is the healthcare information sharing between providers. In high income countries, the challenge of exchanging information is almost solved. Nearly all high income countries have implemented a national healthcare network which connects healthcare providers in the whole country. Furthermore, European Union (EU) aims at the point of cross-border healthcare information exchange which supports the mobility of EU citizens. However, in developing countries, they are not yet ready to take the full advantage of ICT in their healthcare systems. The main objective of the thesis was to design the architecture of a national health information system for Rwanda, which is a developing country with limited resources. The research was based on three main issues: One was to determine existing health IT solutions in the healthcare system of Rwanda. The second one was to explore how other countries have developed their national health information systems (NHISs). The third was to find out how open source solutions can build a national network for a country. From the research, the components of the architecture have been defined and finally the architecture was designed. The research started by examining the current situation of ICT solutions in the healthcare system of Rwanda. This showed the progress in implementing certain electronic medical record systems in certain health facilities. However, there is no single hospital with a fully functional system. This step was followed by exploring how other countries implemented their NHIS and it showed that the process varies country by country. It was clear that in developing countries, open source solutions got a large market share contrary to developed countries where proprietary systems are the most used. Finally, open source solutions proved the capability to build a NHIS with different examples of robust open source solutions available in health IT nowadays. Although it would have been interesting, the thesis does not estimate the financial resources needed for the implementation of the architecture. It is possible to implement the NHIS for Rwanda by using both proprietary and open source solutions. However, the interoperability issue can be mitigated by minimizing different types of electronic medical records in healthcare facilities.