Responsibility Governance Framework for e-Health solution designing in Sri Lanka

Healthcare (HC) policies are complex and revised on situational basis, which requires flexibility in healthcare processes. However, most Healthcare Information System (HIS) deployments fail to align with governance directives. This misalignment creates challenges in delegating responsibilities among stakeholders and automating healthcare workflows. To address these challenges, it is essential to develop a structured approach that first classifies responsibilities and then designs e-Health solutions that comply with constantly evolving governance directives. The research is based on a comprehensive literature review and a case study conducted at a medical service centre. It follows the well-established design science research methodology and a case-based approach. The proposed solution consists of a three-dimensional framework with three sub-frameworks; (i) Healthcare Process (HCP) (ii) Healthcare Responsibility (HCR) (iii) Healthcare Rule Enforcement (HCRE). This Healthcare Governance Framework is designed to handle the complexity and dynamics of HC service processes. It helps identify and manage governance requirements through the HCR sub-framework, providing a complete solution. Additionally, the framework facilitates the design of HC solutions by using rule-based process patterns. This approach enables domain experts and software designers to better understand policy requirements and implement e-Health solutions that fully meet the needs of HC stakeholders. The derived rules and patterns were tested against existing governance procedures. The framework was further tested by comparing the performance of automated and manual systems at the Medical Centre of the University of Sri Jayewardenepura. Finally, the framework was evaluated with input from healthcare domain experts and strengthened based on their feedback.