From Fragmented to Functional: Improving Rehabilitation Data in Georgia's Health Information Systems for Better Decision-Making

Abstract

Introduction: Integrating rehabilitation data into health information systems (HIS) is critical for effective healthcare decision-making, especially in low- and middle-income countries (LMICs) like Georgia. Despite legal obligations under the Convention on the Rights of Persons with Disabilities (CRPD) and the Georgia Rehabilitation Service Development Strategy, rehabilitation data in Georgia remains fragmented. This study aims to assess the adequacy of the HIS for rehabilitation in Georgia to support the planning, monitoring, and expansion of rehabilitation service developments in the country. Methods: The cross-sectional study design combined a documentary review with qualitative interviews. The documentary review examined legislative/regulatory documents from official bodies. Qualitative data were collected through 24 semi-structured interviews with stakeholders representing six rehabilitation facilities (four providing services under the Universal Health Care Program (UHCP) with government funding and two on a fee-for-service basis) and two policymakers. NVivo 12 was used to analyze interviews through the first deductive (Health Metrics Network framework) followed by an inductive coding approach. Results: Findings reveal that rehabilitation data in Georgia's HIS are inconsistent, lacking standardized definitions or reporting practices. Differences were identified in data collection practices across facilities. The UHCP facilities employ the functional assessment tool but reporting inconsistencies persist. Multiple recording modules lack standardization, with variations in the volume and type of data reported. Key challenges include the absence of unified coding systems, incomplete data capture, and reliance on unstructured formats, hindering data analysis and integration. Conclusion: Although Georgia has made progress by integrating rehabilitation services into the UHCP, gaps in HIS still limit effective decision-making. Addressing these gaps requires a standardized data collection framework emphasizing programmatic and functional outcomes, patient-centered measures, and the comprehensive use of existing electronic systems. Strengthening HIS via coordinated stakeholder efforts and streamlined data reporting will improve rehabilitation services and serve as a model for other LMICs.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This research was supported by Results for Development (R4D), whose grant funded the time and resources necessary for data collection and analysis.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval was obtained from the National Bioethics Committee of Georgia (Ethical approval (IRB # 2023-074)) housed at the National Center for Disease Control and Public Health (NCDC) before the commencement of the fieldwork.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in this study are available from the authors upon reasonable request.

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