Braa 2007 Developing HIS DevCount Flexible standards

Title Developing health Information Systems in Developing Countries: The Flexible Standards Strategy
Format publication
Authors Braa, J., Hanseth, O., Mohammed, W., Heywood, A., Shaw, V.
Journal Name (if applicable) n/a
Date Published 2007
Open Access Y/N Yes
Hard copy PDF Available Y/N Yes
Abstract This article addresses the issue of strategies for developing information infrastructures in general and for the development of IS support for the health care sector in developing countries in particular. We identify “complexity” as the main source of the challenges that such strategies need to address and propose the concept of flexible standards as a key element in a sustainable infrastructure development strategy. We begin with an overview of complexity science, and how standards to date have not addressed the needs of a changing environment. Using an action research approach in countries involved in the HISP network, we describe different contexts to demonstrate the importance of creating “attractors” to support networks of change. A case is built around the use of flexible standards as attractors, arguing that if they are well defined and simple, they will be able to adapt to the frequent changes that are experienced in the complex health environment. Simple standards are important in the scaling of information systems. A number of seemingly paradoxes are highlighted as useful strategies – integrated independence being one that encourages experimentation and heterogeneity to develop and share innovative solutions, while still conforming to simple standards. The contribution that is made is to provide theoretical concepts to support standardization processes in complex systems, and to suggest an approach to implementation of health standards in developing country settings that is sensitive to the local context.