Challenges in predicting health needs and disease patterns: a case study on the implementation of an electronic hospital separation record in Sri Lanka

This paper presents analysis and insights arising from the pilot implementation of a national electronic hospital separation record system in Sri Lanka. The paper reveals that while a successful technical implementation has been achieved, numerous socio-technical challenges remain. The paper provides a tangible example of the difficulties faced by developing countries when being encouraged to rush to introduce national e-health systems. Critically, over-confidence in the accuracy, validity and inviolability of electronic data poses real challenges for local and national decision-making around prediction of disease patterns and health needs.