Standard health data exchange model enables the use and reuse of data to improve maternal health programs and services: A case study from India

Abstract

Background The evidence on development of a health data exchange (HDX) in India is lacking, both in terms of the use of data for patient care (use) and aggregate data use (reuse) to improve maternal health services and programs. This study describes the requirements and proposes an HDX model development, focused on the adoption and use of design standardization. Methods A landscape analysis was conducted through a literature review to understand the existing HDX models. A qualitative case study focusing on a tertiary care state government hospital in India was performed. Twenty key informants were selected through purposive sampling and virtual interviews were undertaken. A mix of deductive and primarily inductive data analysis was conducted using the NVIVO 12.0 software. Findings Following an iterative design process and based on the essential requirements suggested by the key informants, an inter-organizational HDX scheme was developed. The HDX model leverages the electronic health records to enable the use of data for patient care, and use of aggregate patient data to support management and administrative decisions at the institutional, state-wide and national levels. The model describes how to balance the inter-organizational and intra-organizational data exchange needs. Integrating systems at the local level with those at the state and the national level was identified as one of the key components of this process. Conclusions The patient-level data is critical for the delivery of best attainable health care. At the same time, the aggregate data is critical, especially in the domain of decision-making and global health. The development of a versatile HDX model is a pre-requisite for a successful use and reuse of data, by ensuring that no functionality is lost and that the data is used in the best way possible.