CHAPTER THREE
3.5 THE USE OF leTs TO MANAGE HEALTH INFORMATION
The emergence and convergence of ICTs have increasingly played a vital role in local, national and international socio- economic transformations. ICTs are tools used in the production, storage, access, distribution, transmission and use of information (and indeed data and knowledge). They are arange of technologies: computers with the various peripherals and software, radio, television, digital cameras and so on. They also include telecommunication technologies such as telephone, both analogue and digital, cellular telephone and satellites (Kaniki 1999). Other technologies, like networks
emergence of these technologies and their integration have resulted in the "easy production, easy distribution, and easy access and usage of information as long as various preconditions such as the necessary technologies and the ability to use and maintain them are available" (Kaniki 1999).
Although ICTs provide exciting opportunities for health information management, astudy by Driscoll (2001) on the use of ICTs in health reveals that the general technological and infrastructural development in many African countries is agreat hindrance to optimal research and communication. In most parts of Africa, access to ordinary telecommunication is a challenge. Fax and other electronic facilities are generally inadequate. In an assessment of ICTs for the health sector in Benin (DriscoIl2001), the researchers mentioned that in some villages there is virtually no electronic communication occurring anywhere and most people have been completely cut off from access to the information which originates elsewhere in the world and in others, some people have telephone services and afew have simple radio systems. In a related study on the actual and potential usage of ICTs at district and provincial levels in Mozambique, the findings revealed that computers and the Internet are rapidly being used at the provincial capitals and major districts by the health sector. But the major problems identified were the lack of ICTs skills and education and poorly developed networks (Braa 2001).
3.5.1. Computers, computer networks and the Internet 3.5.1.1 Computers
The introduction of mini and personal computers have allowed individuals to network and share information resources (LaMorte, cited in Setegan 2002:33). In the health sector, the use of computers can enhance and expedite data processing and the presentation of information, which is the major frustration among health professionals and decision- makers. It reduces the time required for processing data, as well as the burden involved in the manual capturing, manual generating and manual disseminating of data and information. Wilson (2000: 199) stressed that the use of computers is one of the most promising means of improving the quality, timeliness, clarity, presentation and use of information for health care management. It greatly reduces the time required for processing data at the district, regional and national levels, as well as the number of errors inherent in the manual process; develops decision-making support tools for planning increased services, coverage and logistics; manages the data for monitoring the attainment of the targets and objectives of health programmes; and trains health personnel through computer-based interactive tutorials for self-instruction and continuing education.
3.5.1.2 Computer networks
Computer networks and telecommunication networks bring together numerous computers to communicate and share data and other resources. There are two main types of computer networks based on geographical coverage: local area networks (LANs) and wide area networks (WANs) (Rowley 1996:104). A LAN links computers, terminals, printers and backing storage devices over a limited geographical area. The aim of a LAN is to manage information and share resources such as processors, disk storage, printers and communication gateways among agroup of users. Adevice, called a node, is connected to the network by direct cable in the form of twisted wire cable, coaxial cable or fibre optic cable. In a WAN, computers are linked via telecommunication links to communicate with one another regardless of their location. Such telecommunication systems may include digital telephone, microwave, satellite dish and radio or physical data transmission media such as twisted copper wires or cables, coaxial cables and fibre optics. The LANs and WANs can be connected in an all-embracing network. This all-embracing network of computer networks and computers is known as the Internet. In this thesis, the type of network to which the author makes reference is the Internet.
3.5.1.3 The Internet or Information Superhighway
The Internet or simply the Net is the "global connectivity via a mesh of networks based on the TCP/IP [Transmission Control Protocol/Internet Protocol] and Open Systems Interconnection (OSI) protocols" (Rowley 1996:109). The TCP/IP and OSI are standard protocol suites that facilitate connectivity or communication among computers. The standardization and subsequent adoption of the protocol suites was one of the major developments of the Internet from a single network of four computers (ARPnet) to an amorphous global net (Luyn 1999 cited in Setegn 2002:34).
3.5.1.3.1 Internet facilities and services
The Internet has a wide range of facilities and services, which have developed widely over the years. These are discussed below based on, to mention but some, Chisenga (1997:18), Kaniki (1999), and Behrens (2000:2).
3.5.1.3.1.1 Electronic mail (E-mail)
E-mail technology allows users to create/compose documents (mails), attach files to the mails and send them to individuals or groups of individuals, i.e. recipients. It also permits the recipients to view and read, print or forward to others the mails and attachments that they have received.
3.5.1.3.1.2 World Wide Web (WWW, the Web or W3)
Created in 1989 by Tim Berners-Lee, the WWW has grown to be one of the most popular facilities of the Internet. It allows users to locate and view multimedia documents or pages with graphics, animations, audios and/or videos. The Web documents are created using the Hyper Text Mark-up Language (HTML), aWeb document coding language and other Web authoring tools such as Java, JavaScript and ActiveX. This feature of the Web links documents to hypertextuality (text documents with links to other documents) and hypermedia (multimedia documents with links to other documents).
Clicking on hypermedia or hypertext link connects you to other documents on the Web. Accessing adocument (site or page) on the Web is via an address or a URL (Uniform Resource Locator), using a browser. The URL is the name of the computer where the resource is stored and the location of the resource on the computer.
3.5.1.3.1.3 Intranet
Intranet is "an organisation's internal communication system using Internet technology" (Rowley 1998:194).lntranets are also known as an organisation's internal Website or "inner" Web, not connected to the global Internet. Access to the intranet is restricted to members of the organization. From the literature reviewed, two types of Intranet were identified: flat-content intranet and interactive intranet.
In flat-content intranets, files can be requested from the server, received by the client computer and viewed via the Web browser. Interactive intranets, however, are slightly more complex, offering more opportunities for two-way communication within an organization. Interactive intranets offer the following: e-mail, computer-based training and learning, video-conferencing and interactive services facilitated by "forms processing" and "mailto" HTML commands.
3.5.1.3.1.4 Portal
A Portal is an entry point to the Internet or a gateway to Web access. Portals offer services such as directories, search facilities, links to related Websites and e-mail access. There are different types of portals on the Internet: search engine portals such as Yahoo!, Internet Service Provider portals and subject portals. An example of the latter is the General Medical Council portal for doctors in the United Kingdom which is available at <www.doctors.net.uk> (AI-Shahi et aI., 2002).
3.5.1.3.1.5 SUbject guide
A subject guide is also referred to as a subject tree or directory. It is a Website that hierarchically arranges a subject index of Web resources according to subject categories or classes and subcategories (Behrens 2000:34). Subject guides work like catalogues and contain links to the files they index and serve as a starting point to browse the Web.
By clicking on the hyperlink, the user can surf on the subject of interest.
3.5.1.3.1.6 Subject or thematic portals
These are also known as subject-based information gateways (SBIGs) or quality controlled subject services. They are
"subject entrances (clearing houses) to quality assessed Internet resources" (NetLab 1999:1). SBIGs focus on the coverage of specific subjects and aim at serving a particular community with similar information-seeking behaviour.
The information or resources on SBIGs are selected by subject specialists, based on an officially published list of criteria, and they are indexed. The core activities (selecting, indexing) of SBIGs is not done automatically, as in the case of search engines (DESIRE Consortium 2000:2). One of the most popular examples of SBIGs is the Social Science Information Gateway (SOSIG). SOSIG provides relevant information and links to other resources on issues relating to social sciences (SOSIG 2000:1). Some health portals include the Scientific Electronic Library Online (www.scielo.org), Bioline International (http://bioline.bdt.org.br), and African Journals Online (www.inasp.org.uk).
3.5.1.3.1.7 ListServ (Mailing lists or Discussion groups)
ListServs are specialized mailing systems through which information, ideas and experiences can be shared or ideas exchanged with others people who share a common interest. Individuals simply subscribe to the list to join the discussion and it is controlled by a moderator. Among them are AHILA-NET (Association of Information and Libraries in Africa) and WHO-HIF NET (World Health Organisation-Health Information Forum). Inquiries and any other messages that are deemed relevant are sent to the moderator who controls the flow of information between the list members.
3.5.1.3.1.8 Telnet
Telnet (remote login) enable users to log on to aremote machine and operate it. That is, to manipulate files on another
access his/her computer at the work place from home or anywhere in the world.
3.5.1.3.1.9 File transfer protocol (FTP)
An FTP permits a user to transfer files from one computer to another. This is possible when the user has access to the system.