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E-Readiness: A Crucial Factor for Successful Implementation of
E-Health Projects in Developin Countries !i"e Pa"istan

+amar A,a- +ureshi
!
.r. Allah Nawa/
!
Ir,anullah 0han
!


1uhammad 2aseem
2

.r. 3ida 1uhammad

!.Assistant Pro,essor) .e#artment o, Public Administration) 4omal 5ni6ersity) Pa7istan
2.Assistant Pro,essor) .e#artment o, 1anagement Studies) 8a/ara 5ni6ersity) 1ansehra
.Pro,essor) 4andahara 1edical 9ollege) Peshawar

A#stract
I9:s are currently being used in de6elo#ed and de6elo#ing countries and ha6e been used to im#ro6e access to
sources o, 7nowledge ,or both #atients and health care #ro6iders. 8owe6er) the undersi/ed health and I9: sector
in a country such as Pa7istan limits its #otential and wider bene,its. Ado#tion o, e-health is a change #rocess
demanding a lot o, beha6ioral modi,ications in the wor7-en6ironment ,or health wor7ers #articularly doctors.
Success,ul im#lementation and use o, I:-a##lications in healthcare organi/ations is neither automatic nor #urely
technical #rocess. It is rather a social #rocess re-uiring less science and more art o, de6elo#ing) im#lementing
and success,ully using the new systems. :he success and ,ailure o, any digital initiati6e in the healthcare
organi/ations is s-uarely de#endent more on the -uestions o, use than on the issues o, de6elo#ment. :he
technologies ha6e gradually become less e;#ensi6e and uni6ersally a6ailable. :he only technical issue in the
way o, com#uteri/ing health ser6ices in the de6elo#ing states li7e Pa7istan is the readiness o, healthcare
#ro,essionals to ado#t and use digital technologies. <-8ealth im#lementation on a6erage is lower in #ublic sector
hos#itals o, Pa7istan than #ri6ate sector counter#arts. '#tions ,or ca#acity de6elo#ment in health in,ormatics are
6ery limited in Pa7istani institutions and ha6e been re6iewed on limited scale by the researchers= hence) it needs
to be e;#lored through a6ailable literature. :his study aims to determine the readiness o, doctors ,or success,ul
e-#ro>ects? im#lementation #rograms in the current situation and the way ,orward ,or #olicy ma7ers in managing
this critical issue in ,uture.
$e%&ords: e-readiness) e-#ro>ect im#lementation) .e6elo#ing countries

'( Introduction
:he #rimary ,ocus o, e-health systems is to im#ro6e the -uality o, health care with a 7ey ,ocus on e6idence-
based #ractice. It-a##lications in healthcare organi/ations deal with the collection) mani#ulation) storage)
retrie6al and classi,ication o, in,ormation to deli6er healthcare and #romote health. It has been de,ined as @the
systematic a##lication o, in,ormation and com#uter science and technology healthcare #ractice) research) and
learning o, the health care #ro,essionals "0ho>a et al.) 2%%*$. I9:s in healthcare are used ,or more rational
decision-ma7ing) e6idence-based #ractice) and e,,icient resource management. As in,ormatics is #re6ailing with
a great #ace across the health sector globally )trained #ro,essionals are needed to utili/e and im#lement health
in,ormatics tools to get ma;imum bene,its. 9om#uters and mobile de6ices li7e #hysicians? digital assistant) and
com#uteri/ed #hysician order entry system are commonly in use nowadays and are there,ore an essential #art o,
the e-health "1ali7 et al.) 2%%*$.

8ealthcare #ro,essionals o, Pa7istan will be bene,itted with the use o, in,ormation technology and a##lications
,or the ad6ancement o, 7nowledge in the health care sector. 2ithout the su##ort o, a com#etent wor7,orce) I:
a##lications de#loyment in #ublic sector hos#itals o, Pa7istan is not #ossible until a com#etent wor7,orce is
hired and trained ,or success,ul im#lementation and use o, in,ormation technology. :he success o, e-8ealth
#rograms and systems need multi,aceted balancing o, the ri6al 6iews and concerns o, the 6arious sta7eholders.
Some doctors and #hysicians loo7 at the new technology with doubts= they ha6e ,ears that these new e-8ealth
systems are threats to their #ro,essional inde#endence and status. Patients o,ten get hold o, the #otential bene,its
but they are also conscious about the sa,ety and #ri6acy issues o, electronically held #atient?s data. 8ealthcare
#ro,essionals may re-uire using I:-a##lications to bring real im#ro6ements in #atient care. Policyma7ers may
need to be #ersuaded that initial e;#enditures in the new technology will bring the bene,its assured. All these
contradictory belie,s and #oints need to be addressed while starting any e-8ealth #ro>ect "Arian et al.) 2%!2$.

Public sector organi/ations must show e,,ecti6e in6ol6ement to consider the needs o, a large number o,
sta7eholders? in healthcare organi/ations. Also the go6ernments must de6elo# #olicy structure ,or a #ro#er
guidance about the ado#tion and use o, I9:s. Bac7 o, a #ro#er national #olicy structure ,or ado#tion and use o,
ISCI9:s in healthcare sector is a ,urther an obstacle to achie6e success,ul introduction o, I:-a##lications into
health #rograms "28') 2%%4$. Still where #olicies and methods e;ist) technology de6elo#ers) dealers) users) and
decision-ma7ers must be conscious o, them and the im#act they may ha6e on their decision regarding the
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ac-uirement) e;#ansion) use) and o#eration o, health I9:s.

Policies must) essentially) be in consonance with any o6erall in,ormatics #olicies in a country as well as with its
o6erall healthcare sector #olicies. :he national health I9: #olicies) in turn) im#ose restrictions to any #olicies
that may be established lower in the hierarchy) at regional or local le6els. 'nce de6ised) they must be e;ecuted
in a coordinated manner "Sha-rah D Amin) 2%!%$. :he goal o, establishing national strategies ,or I9:s is to
#ro6ide a rational and logical national agreement directed to ,acilitate im#lementation o, e-8ealth #ro>ects)
de6elo#ing a #ro#er in,rastructural setu#) ta7e ,ull ad6antage o, the bene,its ,or in6ested ,inancial resources in
I:-a##lications ,or healthcare organi/ations and enabling healthcare #ro,essionals to wor7 more e,,ecti6ely.

)( e-Health Readiness
<-health Readiness means the #re#aredness o, healthcare organi/ations or societies ,or the e;#ected change
caused by #lans associated with I:-a##lication "0ho>a et al.) 2%%*$. <-readiness is de,ined as the ,acility and
ca#ability to ,ollow 6alue creation chances assisted by the utili/ing the Internet. 'r it is a country?s ca#ability to
su##ort and sustain the de6elo#ment o, I9:s. Bi7ewise) organi/ational readiness com#rises in,rastructure)
related systems) and technical s7ill,ulness. <-Readiness is not only a #roblem with the subordinate le6el
em#loyees) but e;#anded to to# management also ".urrani et al.) 2%!2$. <ndea6ors to de6elo# willingness
assessment tools ,or e-health #ro>ects ha6e ta7en #lace in the 9anadian #ro6inces o, Alberta and 'ntario where
tools to e6aluate e-health readiness in hos#itals and medical institutions and the #ublic were de6elo#ed "0ho>a et
al.) 2%%*$. In s#ite o, being really com#lete) these tools gi6e attention to de6elo#ed countries) and do not deal
with the ,actors o, slow ado#tion and use e-8ealth systems in de6elo#ing countries. It is) there,ore) signi,icant to
de6elo# tools and de6ices that are more #articular to the challenges ,aced by de6elo#ing states "Nyella D
1ndeme) 2%!%$. :he readiness o, general #ublic de#ends on their attitude as according to se6eral researchers
ma7e a distinction between client ty#esE Internet belie6ers and non-Internet belie6ers.

a. :he Internet belie6ers ha6e 7nowledge and ha6e the e;#ertise in using internet and belie, and they
ha6e a totally engrained e-habit. Such users consider use o, internet as a normal e6ery day?s
acti6ity= somewhat that is not yet worth tal7ing about with their ,riends.
b. Non-belie6ers are those who start to utili/e the Internet. Such users re-uire considerable #ersuasion
to de6elo# trust and e;#ertise so that they start de6elo#ing their e-8abit. 'nce they are online these
users tend to be sur#rised and #leased o, their achie6ements and want to #ass on this news to their
,riends and colleagues. A,ter turning them into belie6ers they ta7e the ne;t ste# and become rectors
F a 6iral e,,ect where users ac-uire more users "3erraro) 2%%*$.

:he arri6al o, web technology com#rises a new medium o, business which #uts the #eo#le in a situation to
directly and -uic7ly interact with the web ser6ices. :hough) de6elo#ing nations 7ee# on deli6ering most o, their
ser6ices and #roducts using traditional deli6ery channels) #articularly #a#er-based organi/ational networ7s. :his
is mainly due to the resistance o, organi/ational members to new technologies "0undi) 2%!%$.

:here are many crucial decisions in the im#lementation o, e-8ealth systems ,or instance hos#itals? #ri6acy
#olicy and #rocedures a##ro#riately e;amined by the interrelated go6ernmental regulatory bodies. Secondly the
main concern should be ,ocused on e-8ealth disclosure #olicies to com#letely identi,y the hos#itals? duties and
res#onsibilities and also those o, its clients "#atients$ regarding the <-Systems "Al6are/) 2%%4$. :he issues
relating to I9:s are also concerned with the management?s wea7 understanding o, I9:?s cost-related concerns.
:he healthcare-organi/ations? concentration is mainly on ad6antages ,rom e-8ealth #lans and #ro>ects and
ignores cost im#lications. A 8os#itals? authorities calculate a##ro;imately huge bene,its and ma;imum cost
sa6ings ,rom their in6estment in I:-#ro>ects. :his ma7es the organi/ations to wait e;tra number o, years >ust to
get the estimated ,inancial returns ,rom IS e;#loitation and use. 3inally) the organi/ation ,aces lower e,,iciency
and com#etiti6eness due to lengthened use o, outdated technology "1engiste) 2%!%$.

*( Readiness in pu#lic-sector healthcare orani+ations of Pa"istan
:hough) introduction o, I:-a##lications to change e;isting #a#er-based data collection tools and de6ices in
#ublic healthcare organi/ations o, de6elo#ing nations li7e Pa7istan is a tough #rocedure o, change o,ten loaded
with a number o, conte;t-sensiti6e issues ,or e;am#leE shortage o, su,,icient resources "such as #oor ,inancial
resources and mismatched in,rastructural arrangements$ "AbouGahr D 9ommar 2%%*= 1osse and Sahay 2%%$=
insu,,icient e;#ertise and 7nowledge at a local le6el to control new e-systems une6en and uncoordinated
organi/ational structure and 6ariety o, sta7eholders along with #olitical and bureaucratic limitations "0imaro D
Nham#ossa 2%%5$.

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In order to generally e6aluate e-health readiness o, doctors and #hysicians in healthcare organi/ations o,
de6elo#ing states) the e-gadgets must tac7le the 7ey determinants o, accessibility to e-health systems #ertinent to
their en6ironment) along with other ma>or #lanning issues such as needs assessment) e;ecution) and e6aluation
"1ali7 et al.) 2%%*$. Im#ortance o, these issues should #ermit greater access to e-health ,or healthcare #ro6iders
o, di,,erent genders and le6els o, organi/ation) and #atients o, di,,erent genders and socioeconomic grou#s.
8andling these issues o, un,airness in access to e-health could) in turn) hel# in resol6ing the issue o, the digital
di6ide) which is so common in the de6elo#ing countries "Ansari et al.) 2%!2$.

:he e-8ealth de6ices ha6e also been con6erted into the country?s local language "5rdu$ to enhance their
usability in more insigni,icant and remote areas o, the country) where language can otherwise be a ma>or
obstacle to #artici#ation and growth. :he e;istence o, e-health readiness assessment tools should hel# in
im#ro6ing the -uality o, #lanning o, e-health #rograms in healthcare organi/ations o, Pa7istan) as well as
de6elo#ing the awareness) su##ort) and belie, among doctors) #hysicians) other sta,, and #lanners lin7ed with I:-
a##lications #re6iously in use"Arian et al.) 2%!2$. :he tools should also hel# sol6e technology-related and
learning issues amongst sta,,) e-de6ices must also su##ort im#ro6ed communication between the healthcare
organi/ations) the #eo#le) and the healthcare #ro6iders) and also remo6e the barriers regarding the use o, I9:
associated with gender and socioeconomic circumstances "Robert et al.) 2%!2$.

According to :hielst "2%%7$) ,ollowing an assessment o, di,,erent studies in the healthcare area established that
#ercei6ed use,ulness is a ,orecaster o, technology acce#tance in healthcare organi/ations. <ase o, use was not
,ound to be im#ortant. In terms o, technology di,,usion) "8oran et al.) 2%%H$ ,ound that in order to di,,use
technology in an organi/ation) it is im#ortant to determine #hysicians? beha6ior) their wor7,low #ractices and
their o#inions regarding the 6alue o, s#eci,ic in,ormation systems.

,( Implementation of e-health projects in developin countries
Im#lementation o, I:-a##lications in de6elo#ing states re-uires not only a trans,er o, technology but also the
#resentation o, the culture that go with these systems. 2hat is trans,erred are not only machines) hardware)
so,tware) s7ill,ulness and 7nowledge but also the beha6iors) the 6alue systems together with the social) #olitical)
and cultural ma7eu#. As it may be com#arati6ely 6ery easy to transmit the technical wor7 o, art) it is ,ar more
di,,icult to trans,er the socio-cultural en6ironment to other settings. Bi7e all other technologies) I: is also conte;t
sensiti6e and ensuring technological learning is essential ,or its success,ul trans,er to de6elo#ing countries. :hus)
we need to understand that com#uteri/ed 8IS in de6elo#ing states is a 7ind o, I: trans,er which matters "Ansari
et al.) 2%!2$.

1ost o, the so,tware being #urchased in de6elo#ing countries is #ro#rietary so,tware where de6elo#ers #ut curb
on the rights to their so,tware and charge ,ees ,or each co#y "limited number o, com#uters$. Pro#rietary so,tware
means so,tware that has an owner who has the control o6er the so,tware by im#osing restrictions on its use and
co#ying the same. :he obstacle to use) co#ying) or modi,y can be achie6ed by law,ul or technical means.
:echnical means include releasing machine-readable binaries only) and withholding the human-readable source
code. Begal means include so,tware licensing) co#yright and #atent law. 'ther authors em#hasi/e that the owner
is o, ma>or im#ortance) in contrast to I,ree so,tware?) where the liberty o, com#uter users is most im#ortant
"Arian et al.) 2%!2$.

:he im#act o, the organi/ational as#ect on success,ul ado#tion and use o, I9:s? has been e;#lained and
in6estigated in multi#le #ers#ecti6es. Some o, the researches ha6e used di,,erent terminologies including
conte;ts) en6ironment 6ariables) and ,actors when tal7ing about the organi/ational dimension. 1anagement style
is a measure o, organi/ational conte;t which is characteri/ed as mission) si/e) goals) to# management su##ort)
health in,ormation system "8IS$ e;ecuti6e hierarchical #lacement) maturity o, 8IS ,unction) si/e o, this ,unction)
management #hiloso#hyCstyle) e6aluator #ers#ecti6e) culture) and IS budget si/e. In addition) organi/ational
,actors that in,luence I9: usage as organi/ational structure) si/e) managerial I9: 7nowledge and awareness) to#
management su##ort ),inances) goal con,iguration and budgeting method "8ussain et al.) 2%%7$.

Some researchers recogni/ed new technologies that consist o, 7nowledge-sharing between 6arious sta7eholders)
in,ormation systems de6elo#ment ,or organi/ing and controlling #atients? record) training and education)
de6elo#ing awareness among #eo#le about ma>or causes o, a s#eci,ic disease and #re6ention ,rom di,,erent
illness. 8owe6er) these issues are e;#osed ,or debate surrounding the I9: ,ield with a 6ariety o, terminology
di,,erences. :hese wide ,ocus areas o, I9: a##lications in achie6ing health 1.4s are mostly suggested ,rom
the 6iew#oint o, de6elo#ed countries where both demand-side and su##ly-side o, in,ormation are o, main 6alue.
8owe6er) Iin,ormation and 7nowledge society? being a 7ey matter in de6elo#ment settings im#lies that access to
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in,ormation should be the base and best re#resented by demand-dri6en I9: use. 0nowledge) as the core o,
de6elo#ment agenda that ,undamentally contributes to interconnect all in,ormation-related digital di6ides) can be
another Istrategic resource? to be e;#loited in a resource-#oor setting "1ali7 et al.) 2%%*$.

Success,ul engagement with doctors and #hysicians is critical ,or success,ul im#lementation o, I9:s in
healthcare. I9: can be 6ery challenging to the inde#endence and #ro,essional status o, healthcare #ro6iders. :he
dis#ute arises ,rom the #otential o, I9: that changes the wor7 #attern o, deli6ering healthcare ser6ices) allows
di,,erent s7ill-mi;es in clinical teams) em#owers di,,erent doctors to ma7e decisions about #atient care) and
em#owers and enables the #atients to sel,-care. Illustrating the se#arate roles ,or di,,erent sta7eholders is
im#ortant in ensuring that their e,,orts are harmoni/ing "Panos) 2%%5$. 3or instance) the international donor
community #lays a role in managing ,unds ,or I9:s and health #rograms. State go6ernments should concentrate
on de6elo#ing a clear rigid structure ,or #romoting e-ual in6ol6ement o, sta7eholders) and manage
im#lementation. 9i6il society organi/ations) the #ri6ate sector) educational institutions) and healthcare
organi/ations are e;#ected to go ahead on im#lementation and in monitoring) assessing) and learning ,rom
e;#erience. 4rassroots organi/ations and local go6ernments ha6e roles to #lay in identi,ying needs "0ho>a et al.)
2%!2$.

2hen in6esting in I9:s) a number o, signi,icant criteria ,or assessing and a##ro6ing the #ro>ect must be ta7en
into account. In6estments in I9:s are not so dissimilar ,rom other im#ortant in6estments in terms o, the
measures and actions that must be ,ollowed and the need ,or thoroughly-built business #lans "PA8') !&&*$.:he
cost-bene,it analysis o, an e-8ealth system includes the -uestions o, sustainability "starting) maintaining and
nourishing the e-Pro>ects$. Inter6entions need to be designed that will ha6e an im#act not only in the immediate
,uture but ,or many years to come. Sustainability issues can include continuous im#ro6ement and u#grading)
training) and maintenance o, the system. I9: 6entures) mainly those dealing with in,ormation systems) are
in,amous ,or running o6er time and o6er budget) still they ,ail to carry-out all the #articular tas7s in an
acce#table and suitable way. :his can be mainly a6oided by e,,icient #ro>ect management) together with
#lanning) -uality assurance) and resource management com#onents. 'btaining a success,ul system is not sim#ly
a #rocess o, com#etiti6e tendering) local de6elo#ment) or acce#tance o, an e;ternally ,unded donated system.
:he #rocurement #rocess should be designed and #lanned) in order to go with the e;#lanations o, the need and
circumstances. :his in turn needs a systematic a##roach to de,ining the re-uirements and the a6ailable resources)
including running costs and sta,, a6ailability "Sha-rah D Amin) 2%!%$.

4.! :heoretical 3ramewor7


-( Research .ethodolo%
In this study literature sur6ey ,rom the e;isting sources was done. A,ter e;hausting the rele6ant sources o,
in,ormation) in ne;t ste# a 9om#uter based so,tware A:BAS.ti was used ,or -ualitati6e data analysis. :he main
conce#ts and 6ariables were ,ed into A:BAS.ti ,or coding) e;traction o, -uotes and memos creation.
3urthermore) li7e e;#erts o, -ualitati6e research) we also e;amined) categori/ed) tabulated and recombined the
data ,or analysis. 2e used hermeneutics "James) !&&2$) discourse "1a;) !&&%$ and heuristic "1ousta7as) !&&%$
analyses to ,ind the ,act. :he below ,igure demonstrates the relationshi# between the inde#endent "e-readiness$
and the de#endent 6ariable "e-#ro>ect im#lementation$. :his model is the conce#tual ,ramewor7 o, the
-uestions addressed in the current #a#er.
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/( Discussions
8ealthcare organi/ations ado#ting and utili/ing e-8ealth systems admit and recei6e a number o, ad6antages) ,or
instance) decrease in medical errors) reduction in cost o, deli6ering healthcare ser6ices and enhancement o,
#hysicians? com#etence. In s#ite o, 7nowing about all these #otential bene,its o, I:-a##lications in health)
doctors and #hysicians still resist to include and integrate com#uter technology while attending #atients. :hese
healthcare #ro6iders #re,er to write #rescri#tions by hand rather than using the technology ,or the same. :he
resistance by the healthcare #ro,essionals is due to a number o, reasons "Sha-rah D Amin) 2%!%$. 8ealthcare
#ro,essionals argue the #rocess o, obtaining #atients records ,rom a range o, com#uter a##lications is not a
clinical s7ill o, doctors and is >ust wastage o, time. Ket another reason o, resistance by the doctors ,or I:-
a##lication in health sector es#ecially in de6elo#ing states is Bac7 o, their training and education in I9:s. 3or a
success,ul ado#tion and e;ecution o, I:-a##lications in hos#itals all o6er the world) com#uter s7ills o,
#hysicians and sta,, in6ol6ed is a must "Saleem) 2%%&$.

<-Readiness re,ers to the #re#aredness o, a community or an institution to im#lement success,ully any #rogram
that in6ol6es in,ormation and communications technology "I9:$. Assessment o, e-readiness can ,acilitate the
#rocess o, change ,or indi6iduals and organi/ations to ado#t I9:) and a6oid chances o, rela#se and ,ailure. 1any
research studies which used some o, the current ,orecasting models o, user awareness and readiness o,
healthcare #ro,essionals ,or the new technology are ,ound to be #oor in a healthcare #ers#ecti6e. 9hetley) A.
"2%%H$ recogni/ed that only #ercei6ed use,ulness is im#ortant and ease o, use was insigni,icant while #redicting
Internet use by a##lying the <;tended :echnology Acce#tance 1odel ":A1$ to the 8ealthcare <n6ironment.
"Ba#ointe) Bamothe D 3ortin)2%%H$ recogni/ed that :A1 as designed by ".a6ies et al.) !&*&$ is not right ,or e-
8ealth systems while e;amining the dynamics o, I: ado#tion in a most im#ortant change #rocess in healthcare
deli6ery ser6ices. :hey e;#lained that ado#tionCresistance as#ects may be grou# related as o##osed to the
essential basis o, :A1 which is indi6idualistic) e,,ect o, intra and inter organi/ational ,actors) lin7ages to
cultures) en6ironmental ,actors as well as the com#lication o, the organi/ational en6ironment.

Problems regarding im#lementation o, health in,ormation system "8IS$ in de6elo#ing countries are many in
number. Issues in connection with the im#lementation o, 8IS in de6elo#ing countries mainly relate to cost) #oor
in,rastructure) lac7 o, I9: s7ills #oor strategies and donor #olicies) as well as more sensiti6e issues such as
#ower dynamics and identity ,orming "0imaro D Nham#ossa) 2%%5$. In #articular) the most well-7nown
research on 8IS ado#tion and use in de6elo#ing countries e;#lain that the issues are hardly e6er related to "or at
least not limited to$ the technology itsel,. Power dynamics) #olitics) identity ,ormation) e6eryday-routine-
integration and other societal as#ects are o,ten what ma7e the di,,erence between im#lementation and non-
im#lementation 8IS "Nyella D 1ndeme) 2%!%$. <arlier studies also highlighted that healthcare #ro6iders)
#articularly #hysicians) ha6e a trend to be unwilling ,or the new technology "3it/gerald) 2%%*$.

0( Conclusions and suestions
4enerally) there is small in6estment in I9:s ,or healthcare settings in ma>ority o, the de6elo#ing states. :his
condition is because o, 6arious ty#es o, ISCI9:s are being obtained ,rom di,,erent donors. A small number o,
#ublic healthcare organi/ations ha6e #ro#er IS or I9:s a6ailable with them) and there is no de#endable
in,rastructure to enable inter-organi/ational transmission o, in,ormation. 9onsistently) there is no nationwide
health in,ormation and I: in,rastructure to strengthen and im#ro6e the deli6ery o, healthcare ser6ices. 28'
"2%%4$ em#hasi/es that the technologies and de6ices ado#ted and used must be according to the s#eci,ic
re-uirements o, healthcare organi/ations) i, they are to be well thought-out as essential in6estments. Biterature
also re6eals that there are a relati6ely low number o, healthcare institutions o,,ering the ca#acity building in
8ealth In,ormatics in Pa7istan which re,lects the lac7 o, a6ailability o, trained healthcare #ro,essionals and thus
their willingness to ado#t e-health systems. 9onsidering the ,actors res#onsible ,or this state o, a,,airs) urgent
and concrete strategies must be de6elo#ed to address the concerns o, academic institutions as they re#resent a
highly sensiti6e domain o, health systems o, Pa7istan.

Im#ro6ing the o6erall health in,ormatics) re6iew o, institutional ca#acity and #romotion o, health in,ormatics
education might bring about a #ositi6e numbers in health wor7ers. :he e-health education in Pa7istan is in its
in,ancy stage. :he central strategy) strong leadershi# and a##ro#riate ,unds ,ocusing on health in,ormatics
education and training are lac7ing in Pa7istan. 1oreo6er) a great number o, #ersonnel are needed to be trained in
the health in,ormatics disci#line at 6arious le6els o, healthcare organi/ations. 9urrently there is a great need o,
I:-#ro,essionals in Pa7istani #ublic sector hos#itals. :hese #ro,essionals must #ossess 7nowledge and
understanding o, both I: and health care. :here are many di,,erent ways ,or #romoting uni6ersal e-health
systems 6iew and one o, them is to de6elo# #ersistent #artnershi# between established uni6ersal health centers
and institutes which are located in de6elo#ing countries. :raining needs should be assessed ,rom multi#le
Public Policy and Administration Research www.iiste.org
ISSN 2224-57!"Pa#er$ ISSN 2225-%&72"'nline$
(ol.4) No.*) 2%!4

!%2
#ers#ecti6es o, hos#ital) #ublic) educational and cor#orate sectors. A suitable a##roach to e-health ca#acity
building is needed) which can blend in with the medical and educational culture o, Pa7istan. 9urrent and ,uture
issues and challenges in e-health should be addressed in the ca#acity building #rogram.

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