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Shimu SJ, Patil SM, Dadzie E, Tesfaye T, Alag P, Więckiewicz G. Exploring Health Informatics in the Battle against Drug Addiction: Digital Solutions for the Rising Concern. J Pers Med 2024; 14:556. [PMID: 38929777 PMCID: PMC11204661 DOI: 10.3390/jpm14060556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/14/2024] [Accepted: 05/19/2024] [Indexed: 06/28/2024] Open
Abstract
Drug addiction is a rising concern globally that has deeply attracted the attention of the healthcare sector. The United States is not an exception, and the drug addiction crisis there is even more serious, with 10% of adults having faced substance use disorder, while around 75% of this number has been reported as not having received any treatment. Surprisingly, there are annually over 70,000 deaths reported as being due to drug overdose. Researchers are continually searching for solutions, as the current strategies have been ineffective. Health informatics platforms like electronic health records, telemedicine, and the clinical decision support system have great potential in tracking the healthcare data of patients on an individual basis and provide precise medical support in a private space. Such technologies have been found to be useful in identifying the risk factors of drug addiction among people and mitigating them. Moreover, the platforms can be used to check prescriptions of addictive drugs such as opioids and caution healthcare providers. Programs such as the Prescription Drug Monitoring Program (PDMP) and the Drug and Alcohol Services Information Systems (DASIS) are already in action in the US, but the situation demands more in-depth studies in order to mitigate substance use disorders. Artificial intelligence (AI), when combined with health informatics, can aid in the analysis of large amounts of patient data and aid in classifying nature of addiction to assist in the provision of personalized care.
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Affiliation(s)
- Shakila Jahan Shimu
- Department of Health Informatics, Harrisburg University of Science and Technology, Harrisburg, PA 17101, USA;
| | | | - Ebenezer Dadzie
- School of Clinical Medicine, Inner Mongolia University for the Nationalities, Tongliao 028000, China;
| | - Tadele Tesfaye
- CareHealth Medical Practice, Addis Ababa 9023, Ethiopia;
| | - Poorvanshi Alag
- Psychiatry Department, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA;
| | - Gniewko Więckiewicz
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
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Mantri M, Sunder G, Kadam S, Abhyankar A. A perspective on digital health platform design and its implementation at national level. Front Digit Health 2024; 6:1260855. [PMID: 38665619 PMCID: PMC11043488 DOI: 10.3389/fdgth.2024.1260855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
Accessible and affordable health services and products including medicines, vaccines, and public health are an important health agenda of all countries. It is well understood that without digital health technologies, countries will face difficulties in tackling the needs and demands of their population. Global agencies including the World Health Organization (WHO), United Nations (UN), International Telecommunication Union (ITU), etc. have been instrumental in providing various tools, and guidance through digital health strategies in improving health and digital health maturity of the countries. The Digital Health Platform Handbook (DHPH) is a toolkit published by WHO and ITU to help countries create and implement a digital health platform (DHP) to serve as the underlying infrastructure for an interoperable and integrated national digital health system. We apply the foundational principles of DHPH and provide a perspective of DHP components in a layered, enterprise architecture of a digital health infrastructure. India has rolled out the blueprint of its National Digital Health Mission (NDHM) to address the emerging needs for digitization of healthcare in the country. In this paper, we also illustrate the design and implementation of WHO-ITU DHP components at the national level by exploring India's digital health mission implementation utilizing various digital public goods to build a digital health ecosystem in the country.
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Affiliation(s)
- Manisha Mantri
- HPC-Medical & Bioinformatics Application Group, Centre for Development of Advanced Computing (C-DAC), Pune, India
- National Supercomputing Mission, Centre for Development of Advanced Computing (C-DAC), Pune, India
| | - Gaur Sunder
- HPC-Medical & Bioinformatics Application Group, Centre for Development of Advanced Computing (C-DAC), Pune, India
| | - Sanjay Kadam
- National Supercomputing Mission, Centre for Development of Advanced Computing (C-DAC), Pune, India
| | - Aditya Abhyankar
- Department of Technology, Savitribai Phule Pune University (SPPU), Pune, India
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Lee KH, Kim MG, Lee JH, Lee J, Cho I, Choi M, Han HW, Park M. Empowering Healthcare through Comprehensive Informatics Education: The Status and Future of Biomedical and Health Informatics Education. Healthc Inform Res 2024; 30:113-126. [PMID: 38755102 PMCID: PMC11098769 DOI: 10.4258/hir.2024.30.2.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVES Education in biomedical and health informatics is essential for managing complex healthcare systems, bridging the gap between healthcare and information technology, and adapting to the digital requirements of the healthcare industry. This review presents the current status of biomedical and health informatics education domestically and internationally and proposes recommendations for future development. METHODS We analyzed evidence from reports and papers to explore global trends and international and domestic examples of education. The challenges and future strategies in Korea were also discussed based on the experts' opinions. RESULTS This review presents international recommendations for establishing education in biomedical and health informatics, as well as global examples at the undergraduate and graduate levels in medical and nursing education. It provides a thorough examination of the best practices, strategies, and competencies in informatics education. The review also assesses the current state of medical informatics and nursing informatics education in Korea. We highlight the challenges faced by academic institutions and conclude with a call to action for educators to enhance the preparation of professionals to effectively utilize technology in any healthcare setting. CONCLUSIONS To adapt to the digitalization of healthcare, systematic and continuous workforce development is essential. Future education should prioritize curriculum innovations and the establishment of integrated education programs, focusing not only on students but also on educators and all healthcare personnel in the field. Addressing these challenges requires collaboration among educational institutions, academic societies, government agencies, and international bodies dedicated to systematic and continuous workforce development.
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Affiliation(s)
- Kye Hwa Lee
- Department of Biomedical Informatics, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Myung-Gwan Kim
- Department of Biomedical Informatics, Graduate School of Medicine, CHA University, Seongnam,
Korea
- Institute for Biomedical Informatics, Graduate School of Medicine, CHA University, Seongnam,
Korea
| | - Jae-Ho Lee
- Department of Biomedical Informatics, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
- Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Jisan Lee
- Department of Nursing, College of Health and Welfare, Gangneung-Wonju National University, Wonju,
Korea
| | - Insook Cho
- Department of Nursing, College of Medicine, Inha University, Incheon,
Korea
| | - Mona Choi
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul,
Korea
| | - Hyun Wook Han
- Department of Biomedical Informatics, Graduate School of Medicine, CHA University, Seongnam,
Korea
- Institute for Biomedical Informatics, Graduate School of Medicine, CHA University, Seongnam,
Korea
| | - Myonghwa Park
- College of Nursing, Chungnam National University, Daejeon,
Korea
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Rahman MW, Hasan MM, Palash MS, Asaduzzaman M. Medical education in Bangladesh from Student and Teacher's Perspective: Impact and challenges of the COVID-19 pandemic. MEDEDPUBLISH 2024; 13:209. [PMID: 38689938 PMCID: PMC11058450 DOI: 10.12688/mep.19761.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2024] [Indexed: 05/02/2024] Open
Abstract
Background In low- and middle-income countries like Bangladesh, where medical education faces a range of challenges-such as lack of infrastructure, well-trained educators, and advanced technologies, abrupt changes in methodologies without adequate preparation are more challenging than in higher-income countries. This was worsened during the COVID-19 pandemic and these challenges have resulted in a change in medical education methodology. This study assesses the medical education procedure, impacts and adaptation strategies and challenges of the COVID-19 pandemic in the medical education system of Bangladesh from learners' as well as educators' perspectives. Methods The study collected data from 22 Medical Colleges/Universities across 18 districts of eight divisions using quantitative and qualitative methods. A total of 408 samples were collected consisting of 316 from students and 92 from medical teachers. Descriptive analysis and probit model were performed for obtaining results. Results The efficacy of online learning was questionable, but results showed that it was more effective for theory classes (92.4%) followed by clinical classes (75.63%) and the efficacy rate was low for practical classes (54.11%). All types of classes (theory, practical and clinical) are currently using mixed methods to some extent in medical education in Bangladesh. Regarding impacts and adaptation strategy, approximately 75.3% of the students surveyed expressed their acceptance of online education. Over 80% of the participants acknowledged the advantages of online learning, highlighting the freedom to learn from home, cost and time savings, and avoiding physical closeness with other students as major benefits. Conclusions To address future challenges like the COVID-19 pandemic in medical education in Bangladesh, a comprehensive policy approach such as strengthening technological infrastructure, promoting blended learning approaches, enhancing faculty training and support, integrating telemedicine into the curriculum, and continuously evaluating and improving policies and interventions can enhance the resilience of its medical education system, and prepare for future challenges.
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Affiliation(s)
- M. Wakilur Rahman
- Professor, Department of Rural Sociology, Bangladesh Agricultural University, Mymensingh, Dhaka Division, 2202, Bangladesh
| | - Md Mahfuzul Hasan
- Department of Agribusiness and Marketing, Bangladesh Agricultural University, Mymensingh, Dhaka Division, 2202, Bangladesh
| | - Md. Salauddin Palash
- Professor, Department of Agribusiness and Marketing, Bangladesh Agricultural University, Mymensingh, Dhaka Division, 2202, Bangladesh
| | - Md Asaduzzaman
- Assistant Professor, Department of Rural Sociology, Bangladesh Agricultural University, Mymensingh, Dhaka Division, Bangladesh
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Salluh JIF, Quintairos A, Dongelmans DA, Aryal D, Bagshaw S, Beane A, Burghi G, López MDPA, Finazzi S, Guidet B, Hashimoto S, Ichihara N, Litton E, Lone NI, Pari V, Sendagire C, Vijayaraghavan BKT, Haniffa R, Pisani L, Pilcher D. National ICU Registries as Enablers of Clinical Research and Quality Improvement. Crit Care Med 2024; 52:125-135. [PMID: 37698452 DOI: 10.1097/ccm.0000000000006050] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
OBJECTIVES Clinical quality registries (CQRs) have been implemented worldwide by several medical specialties aiming to generate a better characterization of epidemiology, treatments, and outcomes of patients. National ICU registries were created almost 3 decades ago to improve the understanding of case-mix, resource use, and outcomes of critically ill patients. This narrative review describes the challenges, proposed solutions, and evidence generated by National ICU registries as facilitators for research and quality improvement. DATA SOURCES English language articles were identified in PubMed using phrases related to ICU registries, CQRs, outcomes, and case-mix. STUDY SELECTION Original research, review articles, letters, and commentaries, were considered. DATA EXTRACTION Data from relevant literature were identified, reviewed, and integrated into a concise narrative review. DATA SYNTHESIS CQRs have been implemented worldwide by several medical specialties aiming to generate a better characterization of epidemiology, treatments, and outcomes of patients. National ICU registries were created almost 3 decades ago to improve the understanding of case-mix, resource use, and outcomes of critically ill patients. The initial experience in European countries and in Oceania ensured that through locally generated data, ICUs could assess their performances by using risk-adjusted measures and compare their results through fair and validated benchmarking metrics with other ICUs contributing to the CQR. The accomplishment of these initiatives, coupled with the increasing adoption of information technology, resulted in a broad geographic expansion of CQRs as well as their use in quality improvement studies, clinical trials as well as international comparisons, and benchmarking for ICUs. CONCLUSIONS ICU registries have provided increased knowledge of case-mix and outcomes of ICU patients based on real-world data and contributed to improve care delivery through quality improvement initiatives and trials. Recent increases in adoption of new technologies (i.e., cloud-based structures, artificial intelligence, machine learning) will ensure a broader and better use of data for epidemiology, healthcare policies, quality improvement, and clinical trials.
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Affiliation(s)
- Jorge I F Salluh
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Post-Graduation Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Amanda Quintairos
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Department of Critical and Intensive Care Medicine, Academic Hospital Fundación Santa Fe de Bogota, Bogota, Colombia
| | - Dave A Dongelmans
- Amsterdam UMC location University of Amsterdam, Department of Intensive Care Medicine, Amsterdam, The Netherlands
- National Intensive Care Evaluation (NICE) Foundation, Amsterdam, The Netherlands
| | - Diptesh Aryal
- National Coordinator, Nepal Intensive Care Research Foundation, Kathmandu, Nepal
| | - Sean Bagshaw
- Department of Medicine, Faculty of Medicine and Dentistry (Ling, Bagshaw), University of Alberta and Alberta Health Services, Edmonton, AB, Canada
- Division of Internal Medicine (Villeneuve), Department of Critical Care Medicine, Faculty of Medicine and Dentistry and School of Public Health, University of Alberta and Grey Nuns Hospitals, Edmonton, AB, Canada
| | - Abigail Beane
- Critical Care, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Maria Del Pilar Arias López
- Argentine Society of Intensive Care (SATI). SATI-Q Program, Buenos Aires, Argentina
- Intermediate Care Unit, Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina
| | - Stefano Finazzi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Italy
- Associazione GiViTI, c/o Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Bertrand Guidet
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Saint-Antoine, service de réanimation, Paris, France
| | - Satoru Hashimoto
- Division of Intensive Care, Department of Anesthesiology and Intensive Care Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Nao Ichihara
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Edward Litton
- Fiona Stanley Hospital, Perth, WA
- The University of Western Australia, Perth, WA
| | - Nazir I Lone
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
- Scottish Intensive Care Society Audit Group, United Kingdom
| | - Vrindha Pari
- Chennai Critical Care Consultants, Pvt Ltd, Chennai, India
| | - Cornelius Sendagire
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Anesthesia and Critical Care, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Rashan Haniffa
- Critical Care, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Crit Care Asia, Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Luigi Pisani
- Critical Care, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - David Pilcher
- University College Hospital, London, United Kingdom
- Department of Intensive Care, Alfred Health, Prahran, VIC, Australia
- The Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation, Camberwell, Australia
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Asah FN, Kaasbøll JJ. Challenges and Strategies for Enhancing eHealth Capacity Building Programs in African Nations. J Pers Med 2023; 13:1463. [PMID: 37888074 PMCID: PMC10608493 DOI: 10.3390/jpm13101463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/28/2023] [Accepted: 09/28/2023] [Indexed: 10/28/2023] Open
Abstract
eHealth applications play a crucial role in achieving Universal Health Coverage. (1) Background: To ensure successful integration and use, particularly in developing and low/middle-income countries (LMIC), it is vital to have skilled healthcare personnel. The purpose of this study was to describe challenges that hinder capacity-building initiatives among healthcare personnel in developing and LMIC and suggest interventions to mitigate them. (2) Methods: Adopted a descriptive research design and gathered empirical data through an online survey from 37 organizations. (3) Results: The study found that in developing and LMIC, policymakers and eHealth specialists face numerous obstacles integrating and using eHealth including limited training opportunities. These obstacles include insufficient funds, inadequate infrastructure, poor leadership, and governance, which are specific to each context. The study suggests implementing continuous in-service training, computer-based systems, and academic modules to address these challenges. Additionally, the importance of having solid and appropriate eHealth policies and committed leaders were emphasized. (4) Conclusions: These findings are consistent with previous research and highlight the need for practical interventions to enhance eHealth capacity-building in LMICs. However, it should be noted that the data was collected only from BETTEReHEALTH partners. Therefore, the results only represent their respective organizations and cannot be generalized to the larger population.
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Affiliation(s)
- Flora Nah Asah
- HISP Centre, Department of Informatics, University of Oslo, Gaustadallen 30, 0373 Oslo, Norway;
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Mensah NK, Boadu RO, Adzakpah G, Lasim OU, Amuakwa RD, Taylor-Abdulai HB, Chatio ST. Electronic health records post-implementation challenges in selected hospitals: A qualitative study in the Central Region of southern Ghana. HEALTH INF MANAG J 2023; 52:204-211. [PMID: 35570576 DOI: 10.1177/18333583221096899] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Electronic health records (EHRs) are useful tools in healthcare settings but implementation in low and middle-income countries (LMIC) face challenges. OBJECTIVE To explore post-implementation challenges affecting the deployment of EHRs and their use in selected health facilities in Ghana. METHOD Using a qualitative research approach, 21 in-depth interviews were conducted with health workers in two hospitals in the study area in Ghana, in February and June 2020. Purposive sampling was used to select participants. All interviews were audio recorded, transcribed, and coded into themes using QSR Nvivo12 software to aid thematic analyses. RESULTS Post-implementation challenges were grouped into lack of technological, logistical and managerial support, and inadequate training. Inadequate equipment was the most reported post-implementation challenge that affected EHR use. Unreliable Internet and network connectivity was a source of frustration, which caused staff to develop negative attitudes towards use of the system. Lack of funding stalled implementation of the system and limited its use to critical care units only. It was also the reason replacement of equipment delayed. CONCLUSION While EHR post-implementation challenges facing health facilities are surmountable, managerial support, backed with the requisite logistical and technical support is needed. It is not enough to rely on funding; health institutions should prioritise emerging EHR post-implementation challenges in their operating budgets. IMPLICATIONS A national framework is needed to guide effective and sustainable EHR implementation across the country.
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Affiliation(s)
- Nathan K Mensah
- Department of Health Information Management, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Richard O Boadu
- Department of Health Information Management, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Godwin Adzakpah
- Department of Health Information Management, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Obed U Lasim
- Department of Health Information Management, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Ruth D Amuakwa
- Department of Health Information Management, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Hannah B Taylor-Abdulai
- Department of Physician Assistant Studies, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Samuel T Chatio
- School of Public Health, University of Ghana, Legon, Accra, Ghana
- Navrongo Health Research Centre, Navrongo, Ghana
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Baradwan S, Al-Hanawi M. Perceived Knowledge, Attitudes, and Barriers Toward the Adoption of Telemedicine Services in the Kingdom of Saudi Arabia: Cross-Sectional Study. JMIR Form Res 2023; 7:e46446. [PMID: 37315177 PMCID: PMC10415944 DOI: 10.2196/46446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The adoption of telemedicine has facilitated the opportunity to offer the best health care services. Nevertheless, there is a mismatch between the presence of telemedicine programs in the Kingdom of Saudi Arabia and poor acceptance by the end-user patients. OBJECTIVE This study aimed to gain a holistic understanding of the knowledge, attitudes, and barriers of the end-user patients (ie, research participants) toward the utility of telemedicine services in the Kingdom of Saudi Arabia. METHODS A cross-sectional, survey-based study was conducted from June 1 to July 31, 2022, in the Kingdom of Saudi Arabia. The questionnaire was developed based on a literature review and was examined for validity and reliability. Knowledge questions used a yes-or-no format, whereas attitude and barrier questions used a 5-point Likert-scale format. Data were reported descriptively and analyzed using SPSS (IBM Corp) software. To evaluate the differences in mean scores and identify sociodemographic factors associated with knowledge and attitudes toward the adoption of telemedicine, the data were analyzed using univariate and multivariable regression analyses, respectively. RESULTS Overall, 1024 participants participated in the survey. The percentages of participants who attended a telemedicine service before, during, and after COVID-19 were 49.61% (508/1024), 61.91% (634/1024), and 50.1% (513/1024), respectively. The mean score for knowledge was 3.52 (SD 1.486; range 0-5), reflecting a high level of knowledge. The mean score for attitudes was 37.08 (SD 8.526; range 11-55), reflecting optimistic (positive) attitudes. Regarding barriers, the participants voiced some concerns regarding patient and physician resistance and attributed some cultural and technology-related limitations as potential hindrances to the full adoption of telemedicine services. The place of residence (rural vs nonrural) had a significant impact on the scores of knowledge, attitudes, and barriers, whereas gender had no significant impact. The multivariable regression analysis showed that several sociodemographic factors significantly correlated with knowledge and attitudes toward the adoption of telemedicine services. CONCLUSIONS The participants showed good knowledge and positive attitudes toward telemedicine services. The perceived barriers were in line with the published literature. This research calls for the need to strengthen the positive attitudes and rectify the barriers, so that the utility of telemedicine services can be maximized in the community.
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Affiliation(s)
- Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Mohammed Al-Hanawi
- Department of Health Services and Hospital Administration, King Abdulaziz University, Jeddah, Saudi Arabia
- Health Economics Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
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Nabukenya J, Drumright L, Alunyu AE, Semwanga AR. Critical risk and success factors for sustainability of an electronic health data capture, processing and dissemination platform for Uganda. Health Informatics J 2023; 29:14604582231180576. [PMID: 37256870 DOI: 10.1177/14604582231180576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Several studies have investigated challenges that have marred success or even caused the failure of eHealth implementations in Uganda; however, none has focused on the risks and success factors of their sustainability. This study explored critical risk and success factors for the sustainability of an electronic health data capture, processing and dissemination platform for Uganda. A mixed-method research design was followed involving collecting empirical data from all four regions of Uganda. A purposive sampling strategy was used to select the study districts per region, health facilities per district, and respondents/participants per facility or district. Findings revealed several risks and success factors for sustainability, including; bad leadership, corruption, lack of sustainable maintenance programs, lack of suitable sustainability plans, lack of ICT infrastructure investment, poor management systems, funds, stakeholder buy-ins, data sharing and access rights. The success factors included reinvestments as a partial sustainability plan for ICT infrastructure. These factors can be leveraged to ensure the continued operation of eHealth implementations in Uganda. Every electronic health project aiming at success should always make due consideration/sustainability plan at the onset of project conceptualisation; as lack of such a plan has often resulted in failed projects after the initial funds have been withdrawn.
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Affiliation(s)
- Josephine Nabukenya
- Department of Information Systems, School of Computing and Informatics Technology, Makerere University, Kampala, Uganda
| | - Lydia Drumright
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Andrew Egwar Alunyu
- Department of Information Systems, School of Computing and Informatics Technology, Makerere University, Kampala, Uganda
| | - Agnes Rwashana Semwanga
- Department of Information Systems, School of Computing and Informatics Technology, Makerere University, Kampala, Uganda
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10
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[Position Paper and Recommendations for Action for Ecologically Sustainable Ophthalmology - Statement of the German Society of Ophthalmology (DOG) and the German Professional Association of Ophthalmologists (BVA)]. Klin Monbl Augenheilkd 2023; 240:198-217. [PMID: 36812927 DOI: 10.1055/a-2015-1562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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11
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[Position paper and recommendations for action for ecologically sustainable ophthalmology : Statement of the German Society of Ophthalmology (DOG) and the German Professional Association of Ophthalmologists (BVA)]. DIE OPHTHALMOLOGIE 2023; 120:52-68. [PMID: 36625883 PMCID: PMC9838365 DOI: 10.1007/s00347-022-01792-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
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12
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Epizitone A, Moyane SP, Agbehadji IE. Health Information System and Health Care Applications Performance in the Healthcare Arena: A Bibliometric Analysis. Healthcare (Basel) 2022; 10:2273. [PMID: 36421597 PMCID: PMC9690197 DOI: 10.3390/healthcare10112273] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 10/26/2023] Open
Abstract
There have been several studies centred on health information systems with many insights provided to enhance health care applications globally. These studies have provided theoretical schemes for fortifying the enactment and utilisation of the Health Information System (HIS). In addition, these research studies contribute greatly to the development of HIS in alignment with major stakeholders such as health practitioners and recipients of health care. Conversely, there has been trepidation about HIS' sustainability and resilience for healthcare applications in the era of digitalization and globalization. Hence, this paper investigates research on HIS with a primary focus on health care applications to ascertain its sustainability and resilience amidst the transformation of the global healthcare space. Therefore, using a bibliometric approach, this paper measures the performance of health information systems and healthcare for health care applications using bibliometric data from the web of science database. The findings reveal solid evidence of the constructive transformation of health information systems and health care applications in the healthcare arena, providing ample evidence of the adaptation of HIS and health care applications within the healthcare arena to the fourth industrial revolution and, additionally, revealing the resilient alignment of health care applications and health information systems.
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Affiliation(s)
- Ayogeboh Epizitone
- ICT and Society Research Group, Durban University of Technology, Durban 4001, South Africa
| | - Smangele Pretty Moyane
- Department of Information and Corporate Management, Durban University of Technology, Durban 4001, South Africa
| | - Israel Edem Agbehadji
- Honorary Research Associate, Faculty of Accounting and Informatics, Durban University of Technology, Durban 4001, South Africa
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Ross HM, Hosman L, Baikie B, Blau E, Simpson CJ. SolarSPELL health and education: global solutions with local impacts. JOURNAL OF GLOBAL HEALTH REPORTS 2022. [DOI: 10.29392/001c.38734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background People in remote regions of developing nations have poor health outcomes with lower life expectancy and quality of life compared to higher-resourced areas. Remote communities typically lack stable access to high-quality health services. International humanitarian and development organizations including the United States Peace Corps have a longstanding history of delivering critical services. However, limited infrastructure including access to reliable electricity or internet restricts development workers’ ability to provide effective health services to rural communities. Technology that enhances health education and service delivery in remote communities may improve health outcomes by impacting health knowledge and behavior. Methods We partnered with U.S. Peace Corps to provide portable, solar-powered educational learning libraries (SolarSPELL; www.solarspell.org) to remote communities in Pacific Island nations beginning in 2015 with Peace Corps Vanuatu educational volunteers and expanded in 2017 to include health volunteers (SolarSPELL Health). We conducted ethnographic observation and interviews with Vanuatu Peace Corps volunteers, Ministry of Health officials, and local residents of rural communities. We then conducted a comprehensive evidence review to identify current best practices for assessing and treating the most common conditions. We designed simple 2-page documents with assessment and treatment guidelines, reflecting evidence-based best practices, local culture, and resource availability. Each document was accompanied by a whiteboard video featuring simple drawings and narration designed for Peace Corps volunteers and local community members. Results We report on findings from a pilot study focused on education for treating low back pain. Preliminary findings indicate significantly increased knowledge for Peace Corps volunteers (p<.01), along with non-significantly increased self-efficacy scores (p=.169). Interview data indicate high levels of satisfaction with the SolarSPELL technology, and widespread community utilization among Peace Corps volunteers and community residents. Conclusions Tailored health content on the SolarSPELL platform increases knowledge about critical health topics among Peace Corps volunteers in under-resourced rural communities. The platform and education may have a positive impact on self-efficacy. However, high baseline levels of self-efficacy noted among Peace Corps volunteers may explain the failure to reach statistically significant increases in self-efficacy scores. This finding merits further study. Future work includes measuring individual and community health outcomes, quality of life, and cost benefit resulting from reductions in lost work and transfers for advanced health services. We plan continued implementation and content expansion of SolarSPELL Health in Vanuatu and additional global sites.
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Affiliation(s)
- Heather M. Ross
- School for the Future of Innovation in Society; Edson College of Nursing and Health Innovation, Arizona State University, Tempe, USA
| | - Laura Hosman
- School for the Future of Innovation in Society, Arizona State University, Tempe, USA
| | - Bruce Baikie
- School for the Future of Innovation in Society, Arizona State University, Tempe, USA
| | - Emily Blau
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, USA
| | - Carol J. Simpson
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, USA
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Lee YJ, Lee S, Kim S, Choi W, Jeong Y, Rhim NJJ, Seo I, Kim SY. An mHealth-Based Health Management Information System Among Health Workers in Volta and Eastern Regions of Ghana: Pre-Post Comparison Analysis. JMIR Med Inform 2022; 10:e29431. [PMID: 36044256 PMCID: PMC9475412 DOI: 10.2196/29431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 11/27/2021] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite the increasing attention to electronic health management information systems (HMISs) in global health, most African countries still depend on inefficient paper-based systems. Good Neighbors International and Evaluate 4 Health have recently supported the Ghana Health Service on the rollout of a mobile health-based HMIS called the e-Tracker system in 2 regions in Ghana. The e-Tracker is an Android-based tracker capture app that electronically manages maternal and child health (MCH) data. The Ghana Health Service has implemented this new system in Community Health Planning and Services in the 2 regions (Volta and Eastern). OBJECTIVE This study aims to evaluate changes in health workers' capacity and behavior after using the e-Tracker to deliver MCH services. Specifically, the study assesses the changes in knowledge, attitude, and practice (KAP) of the health workers toward the e-Tracker system by comparing the pre- and postsurvey results. METHODS The KAP of frontline health workers was measured through self-administered surveys before and after using the e-Tracker system to assess their capacity and behavioral change toward the system. A total of 1124 health workers from the Volta and Eastern regions responded to the pre-post surveys. This study conducted the McNemar chi-square test and Wilcoxon signed-rank test for a pre-post comparison analysis. In addition, random-effects ordered logistic regression analysis and random-effects panel analysis were conducted to identify factors associated with KAP level. RESULTS The pre-post comparison analysis showed significant improvement in health workers' capacity, with higher knowledge and practice levels after using the e-Tracker system. As for knowledge, there was a 9.9%-point increase (from 559/1109, 50.41% to 669/1109, 60.32%) in the proportion of the respondents who were able to generate basic statistics on the number of children born in a random month within 30 minutes. In the practice section, the percentage of respondents who had scheduled clientencounters increased from 91.41% (968/1059) to 97.83% (1036/1059). By contrast, responses to the attitude (acceptability) became less favorable after experiencing the actual system. For instance, 48.53% (544/1121) initially expressed their preferences for an electronic system; however, the proportion decreased to 33.45% (375/1121) after the intervention. Random-effects ordered logistic regression showed that days of overwork were significantly associated with health workers' attitudes toward the e-Tracker system. CONCLUSIONS This study provides empirical evidence that the e-Tracker system is conducive to enhancing capacity in MCH data management for providing necessary MCH services. However, the change in attitude implies that the users appear to feel less comfortable using the new system. As Ghana plans to scale up the electronic HMIS system using the e-Tracker to the national level, strategies to enhance health workers' attitudes are necessary to sustain this new system.
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Affiliation(s)
- Young-Ji Lee
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Gwanak Campus, Seoul, Republic of Korea
| | - Seohyun Lee
- Department of Global Public Administration, Yonsei University Mirae Campus, Wonju, Republic of Korea
| | - SeYeon Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Gwanak Campus, Seoul, Republic of Korea
| | - Wonil Choi
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Gwanak Campus, Seoul, Republic of Korea
| | - Yoojin Jeong
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Gwanak Campus, Seoul, Republic of Korea
| | | | | | - Sun-Young Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Gwanak Campus, Seoul, Republic of Korea.,Institute of Health and Environment, Seoul National University, Gwanak Campus, Seoul, Republic of Korea
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Guillaume D, Troncoso E, Duroseau B, Bluestone J, Fullerton J. Mobile-Social Learning for Continuing Professional Development in Low- and Middle-Income Countries: Integrative Review. JMIR MEDICAL EDUCATION 2022; 8:e32614. [PMID: 35671080 PMCID: PMC9214614 DOI: 10.2196/32614] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 01/26/2022] [Accepted: 04/26/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Access to continuing professional development (CPD) for health care workers in low- and middle-income countries (LMICs) is severely limited. Digital technology serves as a promising platform for supporting CPD for health care workers by providing educational content virtually and enabling virtual peer-to-peer and mentor interaction for enhanced learning. Digital strategies for CPD that foster virtual interaction can increase workforce retention and bolster the health workforce in LMICs. OBJECTIVE The objective of this integrative review was to evaluate the evidence on which digital platforms were used to provide CPD to health care workers and clinical students in LMICs, which was complemented with virtual peer-to-peer or mentor interaction. We phrased this intersection of virtual learning and virtual interaction as mobile-social learning. METHODS A comprehensive database and gray literature search was conducted to identify qualitative, quantitative, and mixed methods studies, along with empirical evidence, that used digital technology to provide CPD and virtual interaction with peers or mentors. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Eligible articles were written in English, conducted in an LMIC, and used a mobile device to provide CPD and facilitate virtual peer-to-peer or mentor interaction. Titles, abstracts, and full texts were screened, followed by an assessment of the quality of evidence and an appraisal of the articles. A content analysis was then used to deductively code the data into emerging themes. RESULTS A total of 750 articles were identified, and 31 (4.1%) were included in the review. SMS text messaging and mobile instant messaging were the most common methods used to provide continuing education and virtual interaction between peers and mentors (25/31, 81%). Across the included articles, participants had high acceptability for using digital platforms for learning and interaction. Virtual peer interaction and mentorship were found to contribute to positive learning outcomes in most studies (27/31, 87%) through increased knowledge sharing, knowledge gains, improved clinical skills, and improved service delivery. Peer-to-peer and mentor interaction were found to improve social support and reduce feelings of isolation (9/31, 29%). There were several challenges in the implementation and use of digital technology for mobile-social learning, including limited access to resources (eg, internet coverage and stable electricity), flexibility in scheduling to participate in CPD, and sociobehavioral challenges among students. CONCLUSIONS The summary suggests that mobile-social learning is a useful modality for curriculum dissemination and skill training and that the interface of mobile and social learning serves as a catalyst for improved learning outcomes coupled with increased social capital.
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Affiliation(s)
- Dominique Guillaume
- Jhpiego, Baltimore, MD, United States
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | | | - Brenice Duroseau
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
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Ilozumba O, Kabukye J, de Keizer N, Cornet R, Broerse JEW. Cancer as a death sentence: developing an initial program theory for an IVR intervention. Health Promot Int 2022; 37:6652934. [PMID: 35913900 PMCID: PMC9342624 DOI: 10.1093/heapro/daac070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
To address current trends in poor health-seeking behaviour and late cancer diagnosis in many low- and middle-income countries, like Uganda, it is important to explore innovative awareness building interventions. One possible intervention is a common digital format, an interactive voice response (IVR) system, which is suitable for individuals with low technological and reading literacy. It is increasingly acknowledged that developing digital interventions requires co-creation with relevant stakeholders and explication of program developers’ assumptions, to make them effective, sustainable, and scalable. To this end, we sought to develop an initial program theory for a co-created IVR system for cancer awareness in Uganda. Utilising principles of the realist approach, a qualitative exploratory study was conducted through seven focus group discussions (FGDs) with people living with cancer (PLWC), health workers, and policy makers. Thematic analysis of the transcripts resulted in the emergence of four major themes. Through all themes the most consistent finding was that myths, misconceptions, and misinformation about cancer were related to every aspect of the cancer journey and influenced the experiences and lives of PLWC and their caregivers. Participants were positive about the potential of an IVR system but also had reservations about the design and reach of the system. The resulting initial program theory proposes that a context-specific IVR system has the potential to improve awareness on cancer, provided attention is given to aspects such as language, message framing, and accuracy.
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Affiliation(s)
- Onaedo Ilozumba
- Applied Health Sciences, University of Birmingham, Birmingham, UK
| | - Johnblack Kabukye
- Uganda Cancer Institute, Kampala, Uganda.,Department of Medical Informatics, Amsterdam Public Health research institute, Amsterdam UMC-Location AMC, Amsterdam, The Netherlands
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Putteeraj M, Bhungee N, Somanah J, Moty N. Assessing E-Health adoption readiness using diffusion of innovation theory and the role mediated by each adopter's category in a Mauritian context. Int Health 2022; 14:236-249. [PMID: 34114007 PMCID: PMC9070468 DOI: 10.1093/inthealth/ihab035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/16/2021] [Accepted: 05/20/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The preparedness of healthcare institutes for the foreseen changes expected to arise through the implementation of E-Health is a significant turning point in determining its success. This should be evaluated through the awareness and readiness of healthcare workers to adopt E-Health technology to reduce health information technology failures. METHODS This study investigated the relationship between the perceived attributes of innovation and E-Health adoption decisions of healthcare workers as part of a preimplementation process. Using a cross-sectional quantitative approach, the dimensions of the diffusion of innovation (DOI) theory were used to assess the E-Health readiness of 110 healthcare workers in a Mauritian specialized hospital. RESULTS A strong inclination towards E-Health adoption was observed, where the prime stimulators were perceived as modernization of healthcare management (84.1%, ẋ=4.19), increased work efficiency through reduction of duplication (77.6%, ẋ=4.10) and faster generation of results (71.1%, ẋ=4.07). The findings of this study also validated the use of five DOI dimensions (i.e. relative advantage, compatibility, complexity, trialability and observability) in a predictability model (F(5, 101)=17.067, p<0.001) towards E-Health adoption. A significant association between 'adopter category' and 'willingness to recommend E-Health adoption' (χ2(8)=74.89, p<0.001) endorsed the fact that physicians and nursing managers have central roles within a social ecosystem to facilitate the diffusion of technology and influence the adoption of innovation. CONCLUSION This is the first study of its kind in Mauritius to successfully characterize each adopter's profile and demonstrate the applicability of the DOI framework to predict the diffusion rate of E-Health platforms, while also highlighting the importance of identifying key opinion leaders who can be primed by innovators regarding the benefits of E-Health platforms, thus ensuring non-disruptive evolutionary innovation in the Mauritian healthcare sector.
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Affiliation(s)
- Manish Putteeraj
- School of Health Sciences, University of Technology Mauritius , 11134, Port Louis, Mauritius
| | - Nandhini Bhungee
- Cardiac Center, Sir Seewoosagur Ramgoolam National (SSRN) Hospital, 21017, Pamplemousses, Mauritius
| | - Jhoti Somanah
- School of Health Sciences, University of Technology Mauritius , 11134, Port Louis, Mauritius
| | - Numrata Moty
- Faculty of Law, University of Mauritius, 80837, Reduit, Mauritius
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Harahap NC, Handayani PW, Hidayanto AN. Barriers and facilitators of personal health record adoption in Indonesia: Health facilities' perspectives. Int J Med Inform 2022; 162:104750. [PMID: 35339888 DOI: 10.1016/j.ijmedinf.2022.104750] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Personal health record (PHR) has been extensively used in developed countries; however, it has been limitedly adopted in developing countries. This study was conducted in Indonesia: a developing country with the largest population in Southeast Asia. PHR that is integrated with health providers is needed to achieve a transformation from a health provider-centered to a patient-centered healthcare system. OBJECTIVE To qualitatively analyze barriers and facilitators of PHR adoption by health facilities in Indonesia from the technological, organizational, environmental, and individual factors. METHODS In this qualitative study, we used semi-structured interviews with three health facility directors, 17 IT heads, eight physicians, and three nurses from 10 primary healthcare facilities, nine government hospitals, and six private hospitals in Indonesia. Interview data were analyzed using thematic analysis in NVivo 12. The analysis stages involved familiarizing data, generating initial codes, searching themes, evaluating themes, defining and naming themes, and writing reports. RESULTS Regarding technological factors, the barriers to PHR adoption include security and privacy, interoperability, and infrastructure. Organizational support can facilitate PHR adoption in terms of organizational factors, while a lack of human resources is a barrier to PHR adoption. Regarding environmental factors, the lack of government regulations is the barrier to PHR adoption, while competition between health facilities and vendor support could facilitate PHR adoption. Finally, regarding individual factors, perceived usefulness and ease of use can be facilitators of PHR adoption, while user attitudes and e-health literacy can be barriers to PHR adoption. CONCLUSIONS This study is expected to comprehensively understand PHR adoption in Indonesia and could be applied to other developing countries with similar technological, legal, or cultural characteristics as Indonesia. This study also provides information that can guide health regulators, health facilities, or PHR vendors in planning the implementation of integrated PHR.
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Affiliation(s)
| | - Putu Wuri Handayani
- Faculty of Computer Science, University of Indonesia, Depok 16424, Indonesia.
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19
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Recent Applications of Artificial Intelligence in Radiotherapy: Where We Are and Beyond. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073223] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In recent decades, artificial intelligence (AI) tools have been applied in many medical fields, opening the possibility of finding novel solutions for managing very complex and multifactorial problems, such as those commonly encountered in radiotherapy (RT). We conducted a PubMed and Scopus search to identify the AI application field in RT limited to the last four years. In total, 1824 original papers were identified, and 921 were analyzed by considering the phase of the RT workflow according to the applied AI approaches. AI permits the processing of large quantities of information, data, and images stored in RT oncology information systems, a process that is not manageable for individuals or groups. AI allows the iterative application of complex tasks in large datasets (e.g., delineating normal tissues or finding optimal planning solutions) and might support the entire community working in the various sectors of RT, as summarized in this overview. AI-based tools are now on the roadmap for RT and have been applied to the entire workflow, mainly for segmentation, the generation of synthetic images, and outcome prediction. Several concerns were raised, including the need for harmonization while overcoming ethical, legal, and skill barriers.
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Kabukye JK, Kakungulu E, Keizer ND, Cornet R. Digital health in oncology in Africa: A scoping review and cross-sectional survey. Int J Med Inform 2021; 158:104659. [PMID: 34929545 DOI: 10.1016/j.ijmedinf.2021.104659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/09/2021] [Accepted: 12/05/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Low- and middle-income countries, especially in Africa, face a growing cancer burden. Adoption of digital health solutions has the potential to improve cancer care delivery and research in these countries. However, the extent of implementation and the impact of digital health interventions across the cancer continuum in Africa have not been studied. AIMS To describe the current landscape of digital health interventions in oncology in Africa. METHODS We conducted a scoping literature review and supplemented this with a survey. Following the PRISMA for Scoping Reviews guidelines, we searched literature in PubMed and Embase for keywords and synonyms for cancer, digital health, and African countries, and abstracted data using a structured form. For the survey, participants were delegates of the 2019 conference of the African Organization for Research and Training in Cancer. RESULTS The literature review identified 57 articles describing 40 digital health interventions or solutions from 17 African countries, while the survey included 111 respondents from 18 African countries, and these reported 25 different digital health systems. Six articles (10.5%) reported randomized controlled trials. The other 51 articles (89.5%) were descriptive or quasi-experimental studies. The interventions mostly targeted cancer prevention (28 articles, 49.1%) or diagnosis and treatment (23 articles, 40.4%). Four articles (7.0%) targeted survivorship and end of life, and the rest were cross-cutting. Cervical cancer was the most targeted cancer (25 articles, 43.9%). Regarding WHO classification of digital interventions, most were for providers (35 articles, 61.4%) or clients (13, 22.8%), while the others were for data services or cut across these categories. The interventions were mostly isolated pilots using basic technologies such as SMS and telephone calls for notifying patients of their appointments or results, or for cancer awareness; image capture apps for cervical cancer screening, and tele-conferencing for tele-pathology and mentorship. Generally positive results were reported, but evaluation focused on structure and process measures such as ease of use, infrastructure requirements, and acceptability of intervention; or general benefits e.g. supporting training and mentorship of providers, communication among providers and clients, and improving data collection and management. No studies evaluated individualized clinical outcomes, and there were no interventions in literature for health system managers although the systems identified in the survey had such functionality, e.g. inventory management. The survey also indicated that none of the digital health systems had all the functionalities for a comprehensive EHR, and major barriers for digital health were initial and ongoing costs, resistance from clinical staff, and lack of fit between the EHR and the clinical workflows. CONCLUSION Digital health interventions in oncology in Africa are at early maturity stages but promising. Barriers such as funding, fit between digital health tools and clinical workflows, and inertia towards technology, shall need to be addressed to allow for advancement of digital health solutions to support all parts of the cancer continuum. Future research should investigate the impact of digital health solutions on long-term cancer outcomes such as cancer mortality, morbidity and quality of life.
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Affiliation(s)
- Johnblack K Kabukye
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Meibergdreef 15, Amsterdam, the Netherlands; Uganda Cancer Institute, Upper Mulago Hill Road, P.O. Box 3935, Kampala, Uganda.
| | - Edward Kakungulu
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Meibergdreef 15, Amsterdam, the Netherlands
| | - Nicolette de Keizer
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Meibergdreef 15, Amsterdam, the Netherlands
| | - Ronald Cornet
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Meibergdreef 15, Amsterdam, the Netherlands
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Alodhayani AA, Hassounah MM, Qadri FR, Abouammoh NA, Ahmed Z, Aldahmash AM. Culture-Specific Observations in a Saudi Arabian Digital Home Health Care Program: Focus Group Discussions With Patients and Their Caregivers. J Med Internet Res 2021; 23:e26002. [PMID: 34889740 PMCID: PMC8701718 DOI: 10.2196/26002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 05/09/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022] Open
Abstract
Background There is growing evidence of the need to consider cultural factors in the design and implementation of digital health interventions. However, there is still inadequate knowledge pertaining to the aspects of the Saudi Arabian culture that need to be considered in the design and implementation of digital health programs, especially in the context of home health care services for patients who are chronically and terminally ill. Objective This study aims to explore the specific cultural factors related to patients and their caregivers from the perspective of physicians, nurses, and trainers that have influenced the pilot implementation of Remotely Accessible Healthcare At Home, a connected health program in the Home Health Care department at King Saud University Medical City, Riyadh, Saudi Arabia. Methods A qualitative study design was adopted to conduct a focus group discussion in July 2019 using a semistructured interview guide with 3 female and 4 male participants working as nurses, family physicians, and information technologists. Qualitative data obtained were analyzed using a thematic framework analysis. Results A total of 2 categories emerged from the focus group discussion that influenced the experiences of digital health program intervention: first, culture-related factors including language and communication, cultural views on using cameras during consultation, nonadherence to web-based consultations, and family role and commitment and second, caregiver characteristics in telemedicine that includes their skills and education and electronic literacy. Participants of this study revealed that indirect contact with patients and their family members may work as a barrier to proper communication through the Remotely Accessible Healthcare At Home program. Conclusions We recommend exploring the use of interpreters in digital health, creating awareness among the local population regarding privacy in digital health, and actively involving direct family members with the health care providers.
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Affiliation(s)
- Abdulaziz A Alodhayani
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Marwah Mazen Hassounah
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fatima R Qadri
- Prince Naif Bin Abdulaziz Health Research Center, King Saud University, Riyadh, Saudi Arabia.,Medical Researches Company, iResearch, Riyadh, Saudi Arabia
| | - Noura A Abouammoh
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Zakiuddin Ahmed
- Prince Naif Bin Abdulaziz Health Research Center, King Saud University, Riyadh, Saudi Arabia.,Riphah Institute of Healthcare Improvement & Safety, Riphah International University, Islamabad, Pakistan
| | - Abdullah M Aldahmash
- Stem Cell Unit, Department of Anatomy, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,College of Medicine, Vision Colleges, Riyadh, Saudi Arabia
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Espinoza J, Sikder AT, Dickhoner J, Lee T. Assessing Health Data Security Risks in Global Health Partnerships: Development of a Conceptual Framework. JMIR Form Res 2021; 5:e25833. [PMID: 34889752 PMCID: PMC8701669 DOI: 10.2196/25833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/30/2021] [Accepted: 10/10/2021] [Indexed: 01/23/2023] Open
Abstract
Background Health care databases contain a wealth of information that can be used to develop programs and mature health care systems. There is concern that the sensitive nature of health data (eg, ethnicity, reproductive health, sexually transmitted infections, and lifestyle information) can have significant impact on individuals if misused, particularly among vulnerable and marginalized populations. As academic institutions, nongovernmental organizations, and international agencies begin to collaborate with low- and middle-income countries to develop and deploy health information technology (HIT), it is important to understand the technical and practical security implications of these initiatives. Objective Our aim is to develop a conceptual framework for risk stratification of global health data partnerships and HIT projects. In addition to identifying key conceptual domains, we map each domain to a variety of publicly available indices that could be used to inform a quantitative model. Methods We conducted an overview of the literature to identify relevant publications, position statements, white papers, and reports. The research team reviewed all sources and used the framework method and conceptual framework analysis to name and categorize key concepts, integrate them into domains, and synthesize them into an overarching conceptual framework. Once key domains were identified, public international data sources were searched for relevant structured indices to generate quantitative counterparts. Results We identified 5 key domains to inform our conceptual framework: State of HIT, Economics of Health Care, Demographics and Equity, Societal Freedom and Safety, and Partnership and Trust. Each of these domains was mapped to a number of structured indices. Conclusions There is a complex relationship among the legal, economic, and social domains of health care, which affects the state of HIT in low- and middle-income countries and associated data security risks. The strength of partnership and trust among collaborating organizations is an important moderating factor. Additional work is needed to formalize the assessment of partnership and trust and to develop a quantitative model of the conceptual framework that can help support organizational decision-making.
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Affiliation(s)
- Juan Espinoza
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, United States.,Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Abu Taher Sikder
- Innovation Studio, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - James Dickhoner
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.,Innovation Studio, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Thomas Lee
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.,Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA, United States
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Bisrat A, Minda D, Assamnew B, Abebe B, Abegaz T. Implementation challenges and perception of care providers on Electronic Medical Records at St. Paul's and Ayder Hospitals, Ethiopia. BMC Med Inform Decis Mak 2021; 21:306. [PMID: 34727948 PMCID: PMC8561912 DOI: 10.1186/s12911-021-01670-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 10/26/2021] [Indexed: 12/05/2022] Open
Abstract
Background In resources constrained settings, effectively implemented Electronic Medical Record systems have numerous benefits over paper-based record keeping. This system was implemented in the 2009 Gregorian Calendar in the two Ethiopian territory hospitals, Ayder and St. Paul’s. The pilot implementation and similar re-deployment efforts done in 2014 and 2017 Gregorian Calendar failed at St. Paul's. This study aimed to assess the current status, identify challenges, success factors and perception of health care providers to the system to inform on future roll-outs and scale-up plans. Methods A cross sectional study design with quantitative and qualitative methods was employed. A survey was administered October to December 2019 using a structured questionnaire. A total of 240 health care providers participated in the study based on a stratified random sampling technique. An interview was conducted with a total of 10 persons that include IT experts and higher managements of the hospital. Descriptive statistics were employed to summarize the survey data using SPSS V.21. Qualitative data were thematically presented. Results St. Paul’s hospital predominantly practiced the manual medical recording system. The majority of respondents (30.6%) declared that a lack of training and follow up, lack of management commitment, poor network infrastructure and hardware/software-related issues were challenges and contributed to EMR system failure at St. Paul’s. Results from the qualitative data attested to the above results. The system is found well-functioning at Ayder, and the majority of respondents (38%) noted that lack of training and follow-up was the most piercing challenge. As per the qualitative findings, ICT infrastructure, availability of equipment, incentive mechanisms, and management commitment are mentioned as supportive for successful implementation. At both hospitals, 70 to 95% of participants hold favorable perceptions and are willing to use the system. Conclusion Assessing the readiness of the hospital, selecting and acquiring standard and certified EMR systems, provision of adequate logistic requirements including equipment and supplies, and upgrading the hospital ICT infrastructure will allow sustainable deployment of an EMR system. Supplementary Information The online version contains supplementary material available at 10.1186/s12911-021-01670-z.
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Affiliation(s)
- Alemayehu Bisrat
- Library and Info Service Directorate, St. Paul's Hospital Millennium Medical College, PO Box 1271, Addis Ababa, Ethiopia.
| | - Dagne Minda
- ICT Directorate, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Bekalu Assamnew
- Medical Education Unit, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Biruk Abebe
- Medical Education Unit, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Teshome Abegaz
- Health Informatics and Healthcare Innovation Department, School of Public Health, College of Health Sciences, Mekele University, Mekele, Ethiopia
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The Brief Review on Telemedicine: New Dream in Developing Countries. Neuromodulation 2021. [DOI: 10.5812/ipmn.115506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
: In the new modern world, technology has a remarkable role in human life and affects all aspects of it. Indeed, the need for rapid counteractions, especially in medical requirements, can lead to interesting innovations. Telemedicine was disregarded for being an unwieldy, unreliable, and unaffordable technology. Rapidly evolving telecommunications and information technologies have provided a solid foundation for telemedicine as a feasible, dependable, and useful technology. Telemedicine has been conceived as an integrated system of healthcare delivery that employs telecommunications and computer technology as a substitute for face-to-face contact between provider and client. It has the potential for ameliorating seemingly intractable problems in healthcare such as limited access to care among segments in the population, especially the geographically disadvantaged, uneven quality of care, and cost of inflation. Its true merit has yet to be determined by systematic empirical studies. In another survey, the authors defined telemedicine as a branch of e-health, which works by communication networks and delivers healthcare and medical educations from remote locations. The main aim of telemedicine is to overcome the improper distribution of human and fundamental resources. Telemedicine could be considered from the viewpoint of two basic conditions: (1) as an alternative way for emergency services in remote locations and (2) it is a better option rather than conventional health services; for example, teleradiology for rural hospitals. It can result in appropriate availability of health services and acceptable efficiency. However, this aspect of medicine was considered in the late 1990, and then, developing countries have a long way for research about it.
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Kumar M, Silver M, Chauffour J, Boyle C, Boone D. Research gaps in transforming tuberculosis data to action for better health outcomes: A systematic literature review. J Glob Health 2021; 11:04058. [PMID: 34671462 PMCID: PMC8501450 DOI: 10.7189/jogh.11.04058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background In their work to end the tuberculosis (TB) epidemic in lower- and middle-income countries, national TB programs need a tool to measure, monitor, and strengthen relevant capabilities to create a continuous transformation of data into action (D2A) to improve TB program results. However, there is a lack of scientific evidence to determine specific measurement dimensions of a D2A continuum that enables TB programs to identify the barriers and enablers of D2A and to guide the selection of interventions appropriate for the context and decision-making capabilities of various TB program actors. Methods A systematic review of peer-reviewed and grey literature was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 48 peer-reviewed publications were selected for data extraction and analysis. Results The findings show that selected publications discussed the health system level, stakeholders involved in decision making, decision type, data system, data sources, data use enablers and barriers, decision-making framework and steps, decision outcome/impact, and how that outcome was measured. The findings highlight barriers and enablers to data use and explain the relationship among data sources, decision type, and stakeholders. Seventeen D2A measurement dimensions were identified. Conclusions Transforming data to action is a continuous process that recognizes that data use indicators vary by type of decisions, decision makers, and the health system level at which decisions are made. As a logical next step, the project team plans to develop and validate a D2A continuum toolkit that will include a measurement scale, implementation guide, and data collection and analysis Microsoft Excel workbook.
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Affiliation(s)
- Manish Kumar
- Carolina Population Center, University of North Carolina at Chapel Hill, NC, USA.,Public Health Leadership Program, University of North Carolina at Chapel Hill, NC, USA
| | - Meredith Silver
- Carolina Population Center, University of North Carolina at Chapel Hill, NC, USA
| | | | - Colleen Boyle
- Carolina Population Center, University of North Carolina at Chapel Hill, NC, USA
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Ndlovu K, Scott RE, Mars M. Interoperability opportunities and challenges in linking mhealth applications and eRecord systems: Botswana as an exemplar. BMC Med Inform Decis Mak 2021; 21:246. [PMID: 34419020 PMCID: PMC8379582 DOI: 10.1186/s12911-021-01606-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/28/2021] [Indexed: 01/28/2023] Open
Abstract
Background Significant investments have been made towards the implementation of mHealth applications and eRecord systems globally. However, fragmentation of these technologies remains a big challenge, often unresolved in developing countries. In particular, evidence shows little consideration for linking mHealth applications and eRecord systems. Botswana is a typical developing country in sub-Saharan Africa that has explored mHealth applications, but the solutions are not interoperable with existing eRecord systems. This paper describes Botswana’s eRecord systems interoperability landscape and provides guidance for linking mHealth applications to eRecord systems, both for Botswana and for developing countries using Botswana as an exemplar.
Methods A survey and interviews of health ICT workers and a review of the Botswana National eHealth Strategy were completed. Perceived interoperability benefits, opportunities and challenges were charted and analysed, and future guidance derived. Results Survey and interview responses showed the need for interoperable mHealth applications and eRecord systems within the health sector of Botswana and within the context of the National eHealth Strategy. However, the current Strategy does not address linking mHealth applications to eRecord systems. Across Botswana’s health sectors, global interoperability standards and Application Programming Interfaces are widely used, with some level of interoperability within, but not between, public and private facilities. Further, a mix of open source and commercial eRecord systems utilising relational database systems and similar data formats are supported. Challenges for linking mHealth applications and eRecord systems in Botswana were identified and categorised into themes which led to development of guidance to enhance the National eHealth Strategy. Conclusion Interoperability between mHealth applications and eRecord systems is needed and is feasible. Opportunities and challenges for linking mHealth applications to eRecord systems were identified, and future guidance stemming from this insight presented. Findings will aid Botswana, and other developing countries, in resolving the pervasive disconnect between mHealth applications and eRecord systems.
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Affiliation(s)
- Kagiso Ndlovu
- Department of TeleHealth, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. .,Department of Computer Science, University of Botswana, Gaborone, Botswana.
| | - Richard E Scott
- Department of TeleHealth, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Maurice Mars
- Department of TeleHealth, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.,College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Archer N, Lokker C, Ghasemaghaei M, DiLiberto D. eHealth Implementation Issues in Low-Resource Countries: Model, Survey, and Analysis of User Experience. J Med Internet Res 2021; 23:e23715. [PMID: 34142967 PMCID: PMC8277330 DOI: 10.2196/23715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/01/2020] [Accepted: 05/15/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The implementation of eHealth in low-resource countries (LRCs) is challenged by limited resources and infrastructure, lack of focus on eHealth agendas, ethical and legal considerations, lack of common system interoperability standards, unreliable power, and shortage of trained workers. OBJECTIVE The aim of this study is to describe and study the current situation of eHealth implementation in a small number of LRCs from the perspectives of their professional eHealth users. METHODS We developed a structural equation model that reflects the opinions of professional eHealth users who work on LRC health care front lines. We recruited country coordinators from 4 LRCs to help recruit survey participants: India, Egypt, Nigeria, and Kenya. Through a web-based survey that focused on barriers to eHealth implementation, we surveyed 114 participants. We analyzed the information using a structural equation model to determine the relationships among the constructs in the model, including the dependent variable, eHealth utilization. RESULTS Although all the model constructs were important to participants, some constructs, such as user characteristics, perceived privacy, and perceived security, did not play a significant role in eHealth utilization. However, the constructs related to technology infrastructure tended to reduce the impact of concerns and uncertainties (path coefficient=-0.32; P=.001), which had a negative impact on eHealth utilization (path coefficient=-0.24; P=.01). Constructs that were positively related to eHealth utilization were implementation effectiveness (path coefficient=0.45; P<.001), the countries where participants worked (path coefficient=0.29; P=.004), and whether they worked for privately or publicly funded institutions (path coefficient=0.18; P<.001). As exploratory research, the model had a moderately good fit for eHealth utilization (adjusted R2=0.42). CONCLUSIONS eHealth success factors can be categorized into 5 groups; our study focused on frontline eHealth workers' opinions concerning 2 of these groups: technology and its support infrastructure and user acceptance. We found significant disparities among the responses from different participant groups. Privately funded organizations tended to be further ahead with eHealth utilization than those that were publicly funded. Moreover, participant comments identified the need for more use of telemedicine in remote and rural regions in these countries. An understanding of these differences can help regions or countries that are lagging in the implementation and use of eHealth technologies. Our approach could also be applied to detailed studies of the other 3 categories of success factors: short- and long-term funding, organizational factors, and political or legislative aspects.
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Affiliation(s)
- Norman Archer
- Information Systems, DeGroote School of Business, McMaster University, Hamilton, ON, Canada
| | - Cynthia Lokker
- Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Maryam Ghasemaghaei
- Information Systems, DeGroote School of Business, McMaster University, Hamilton, ON, Canada
| | - Deborah DiLiberto
- Global Health, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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Huang FT. Caring for Computers: The Hidden Work of Clinical Nurses during the Introduction of Health Information Systems in a Teaching Hospital in Taiwan. NURSING REPORTS 2021; 11:105-119. [PMID: 34968317 PMCID: PMC8608098 DOI: 10.3390/nursrep11010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/02/2022] Open
Abstract
Implementing health information systems for enhancing patient care and management occurs worldwide. Discovering how nurses, as important system end-users, experience technology-reliant clinical practice involved focus groups (n = 25) and in-depth individual interviews with nurses (n = 4) and informatics staff (n = 3) in a major Taiwanese medical center. This qualitative study explores the unintended effects of these systems on nurses’ role and clinical practice. First, nurses’ additional role caring for computer devices supporting patient care involves highly-demanding invisible effort, especially when tackling system malfunctions affecting patients with urgent conditions. Second, nurses are resourceful in developing solutions to protect patients during unexpected technical malfunctions. Third, troubleshooting using telephone technical support as the first resort is problematic. It is argued that computerization requires nurses to care for co-clients: patients and computers. Managing technical malfunctions is an unintended consequence for nurses, reflecting the hidden work required by new technology.
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Affiliation(s)
- Feng-Tzu Huang
- Liberal Arts Center, Department of Nursing, Da-Yeh University, Changhua 51591, Taiwan
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30
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Ahmed MH, Awol SM, Kanfe SG, Hailegebreal S, Debele GR, Dube GN, Guadie HA, Ngusie HS, Klein J. Willingness to use telemedicine during COVID-19 among health professionals in a low income country. INFORMATICS IN MEDICINE UNLOCKED 2021; 27:100783. [PMID: 34778509 PMCID: PMC8571100 DOI: 10.1016/j.imu.2021.100783] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION The coronavirus disease 2019 pandemic has prompted rapid restructuring of the health-care system in an effort to stop the spread of the pandemic. Thus, telemedicine is more preferable in order to prevent the COVID-19 pandemic when face to face meeting is forbidden, allowing provision of health service over a distance. This study aimed to assess willingness to use telemedicine and factors that will determine their extent of willingness during COIVID-19 among healthcare providers working in south west of Ethiopia. METHODS Institutional based cross-sectional study design was applied to assess willingness to use telemedicine among healthcare providers working at public health hospitals in south west of Ethiopia. Self-administered questionnaires were used. We have used Epi-info for data entry and Analysis of Moment Structure (AMOS) for analysis. A structural equation modeling was performed to identify factors associated with willingness to use telemedicine at 95% confidence interval (CI). RESULT In this study, less than half of respondents had high willingness to use telemedicine. Ease of use (β = 0.79, 95% CI: [0.72, 0.86], p < 0.01), attitude (β = 0.91, 95% CI: [0.87, 0.95], p < 0.01) and patient-physician relationships (β = 0.67, 95% CI: [0.54, 0.70], p < 0.01) were variables associated with willingness to use telemedicine. Anxiety towards technology (β = 0.74, 95% CI: [0.69, 0.79], p < 0.01) and patient-physician relationships (β = 0.87, 95% CI: [0.81, 0.92], p < 0.01) were determinant factors of attitude to use telemedicine. CONCLUSIONS The overall willingness to use telemedicine during COVID-19 in this setting is 46.5%. Addressing the problem related with ease of use, attitude and patient-physician relationships will help to increase the overall willingness to use telemedicine during COVID-19. An attempt to improving patient-physician relationship, provision of technical training for ease of use and working on healthcare providers' attitude will help to improve the willingness to use telemedicine.
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Affiliation(s)
- Mohammedjud Hassen Ahmed
- Department of Health Informatics, College of Health Sciences, Mettu University, Mettu, Ethiopia,Corresponding author. Mettu University, College of health sciences, Department of health informatics, Ethiopia
| | - Shekur Mohammed Awol
- Department of Health Informatics, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Shuma Gosha Kanfe
- Department of Health Informatics, College of Health Sciences, Mettu University, Mettu, Ethiopia
| | - Samuel Hailegebreal
- Department of Health Informatics, College of Medicine and Health Sciences, Arbaminch University, Arbaminch, Ethiopia
| | - Gebiso Roba Debele
- Department of Public Health, College of Health Sciences, Mettu University, Mettu, Ethiopia
| | - Geleta Nenko Dube
- Department of Health Informatics, College of Health Sciences, Mettu University, Mettu, Ethiopia
| | - Habtamu Alganeh Guadie
- School of Public Health, College of Health Sciences, Bahir dar University, Bahir dar, Ethiopia
| | - Habtamu Setegn Ngusie
- Department of Health Informatics, College of Health Sciences, Mettu University, Mettu, Ethiopia
| | - Jorn Klein
- University of South-Eastern Norway, Porsgrunn, Norway
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Tianxia120: A Multimodal Medical Data Collection Bioinformatic System for Proactive Health Management in Internet of Medical Things. JOURNAL OF HEALTHCARE ENGINEERING 2020; 2020:8828738. [PMID: 33082925 PMCID: PMC7558773 DOI: 10.1155/2020/8828738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/08/2020] [Accepted: 09/14/2020] [Indexed: 11/28/2022]
Abstract
A digital medical health system named Tianxia120 that can provide patients and hospitals with “one-step service” is proposed in this paper. Evolving from the techniques of Internet of Medical Things (IoMT), medical dig data, and medical Artificial Intelligence, the system can systematically promote the change of service status between doctors and patients from “passive mode” to “proactive mode” and realize online service that is similar to offline medical treatment scenarios. The system consists of a patient terminal and a doctor terminal. They can perform online inquiry (through graphic, voice, telephone, video, etc.), electronic prescription, multiparameter self-diagnosis, cold chain logistics, medicine distribution, etc. The system can provide rich medical health information, medical tools browsing, and health care big data aggregation processing functions. Compared with the traditional medical system, this system has the characteristics of full function, rich data, and high security. It is expected to be applied to hospital applications and medical research to promote the construction and innovation of clinical medical disciplines.
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A Case Study of a Point-of-Care Electronic Medical Record [SABER] in Totonicapán, Guatemala: Benefits, Challenges, and Future Directions. Ann Glob Health 2020; 86:122. [PMID: 33024708 PMCID: PMC7518081 DOI: 10.5334/aogh.3041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The adoption of electronic medical records (EMRs) in lower-income nations has progressed slowly due to the lack of adequate infrastructure, funding, and training. However, EMRs have been successfully implemented previously in resource-limited health systems in South Africa, Haiti, Cameroon, Kenya, and Peru. Detailed, organized, and easily accessible medical records are particularly important in emergency departments due to the volume and acuity of the patient population. Methods: In order to further study the plausibility of an EMR in a resource-limited emergency department, a web-based, Spanish-language EMR known as SABER was developed for use in Hospital Nacional José Felipe Flores in Totonicapán, Guatemala. The software collects patient data including demographics, triage, initial evaluation, review of systems, physical exam, and evaluation and plan. It then generates a .pdf file consistent with information requirements of the Guatemalan Ministry of Health. Local physicians, medical students, and nurses were trained in the use of the software, which debuted in July 2016. To assess the effectiveness of SABER as an EMR, focus groups and Likert scale surveys were conducted with six physicians and 31 medical students working in the Hospital Nacional emergency department. Results: Thirty of 32 medical students and six of six doctors would recommend SABER to another provider. Positive aspects identified by staff include ease of use, quick data entry, and the potential for large data set research. Discussion: Remaining challenges include incorporating electronic nursing orders and lab results, troubleshooting technology problems including printer difficulties, a lack of electronic signature capability, and lack of integration with the rest of the hospital. Our study is consistent with other studies that show use of an EMR may help to reduce health disparities through improved patient records, medical data collection, and organization.
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Choi M, Kim M, Kim JA, Chang H. Building Consensus on the Priority-Setting for National Policies in Health Information Technology: A Delphi Survey. Healthc Inform Res 2020; 26:229-237. [PMID: 32819041 PMCID: PMC7438690 DOI: 10.4258/hir.2020.26.3.229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 07/20/2020] [Indexed: 11/23/2022] Open
Abstract
Objectives With growing attention on the healthcare industry as a potential market for big data and artificial intelligence in the Fourth Industrial Revolution, countries around the world are introducing and developing various policies and projects related to health information technology (HIT). To assist prioritizing HIT topics in policy making, this study adopts the Delphi technique to garner expert opinions from various fields of health informatics. Methods Data were collected from November 2019 to February 2020 using the Delphi technique through two rounds of surveys administered via email. The Delphi panel consisted of 16 experts with a high level of experience in health informatics. They were from the Health Information Policy Advisory Committee of the Ministry of Health and Welfare of Korea, and the board of directors of the Korean Society of Medical Informatics. The experts were asked to assess the importance, urgency, and difficulty of HIT topics in three domains: technology, application, and infrastructure. Results Of the 40 topic items, a 100% agreement was reached for the importance of 6 items, including 2 items in technology, 1 item in application, and 3 items in infrastructure domains. Especially, Quadrant I of a 2×2 matrix showing high importance and high urgency included 7 items in the technology domain, 2 items in the application domain, and 13 items in the infrastructure domain. Conclusions Most items with high importance and urgency belonged to the infrastructure domain. The findings indicated that fostering an infrastructural environment should be polices with top priorities of HIT.
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Affiliation(s)
- Mona Choi
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Korea
| | - Mihui Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Korea
| | - Jung A Kim
- School of Nursing, Hanyang University, Seoul, Korea
| | - Hyejung Chang
- School of Management, Kyung Hee University, Seoul, Korea
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Telemedicine in Middle Eastern countries: Progress, barriers, and policy recommendations. Int J Med Inform 2020; 141:104232. [PMID: 32707430 DOI: 10.1016/j.ijmedinf.2020.104232] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/02/2020] [Accepted: 07/07/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Despite attempts to reform the healthcare delivery system in the Middle East, expectations for its progress have been-and for some still are-somewhat slow. OBJECTIVE This study reviewed progress in the use and adoption of telemedicine in Middle Eastern countries. The key dimensions affecting the progress of telemedicine in these countries were identified. METHOD A systematic review of the literature was conducted on 43 peer reviewed articles from 2010 to 2020. The review followed the scientific process of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of identification, selection, assessment, synthesis, and interpretation of findings. RESULTS The results showed that progress made in the utilization of telemedicine was insufficient and varies across Middle Eastern countries. Certain cultural, financial, organizational, individual, technological, legal, and regulatory challenges were found to prevent telemedicine from being fully used to the point where the full range of medical services can be provided. For example, doctor and patient resistance, poor infrastructure, lack of funding, poor system quality, and lack of information technology training were associated with the low adoption of telemedicine in the region. CONCLUSION This review provides a number of recommendations that will help policymakers to move toward the integration of innovative technologies in order to facilitate access to health information, health services, and training. It also recommends that health initiatives should focus on health education and health promotion in order to increase public awareness of the benefits of telemedicine services in the region.
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Development and validation of an instrument for measuring competencies on public health informatics of primary health care worker (PHIC4PHC) in Indonesia. Prim Health Care Res Dev 2020; 21:e22. [PMID: 32624060 PMCID: PMC7372181 DOI: 10.1017/s1463423620000018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Because of the increasing adoption and use of technology in primary health care (PHC), public health informatics competencies (PHIC) are becoming essential for public health workers. Unfortunately, no studies have measured PHIC in resource-limited setting. This paper describes the process of developing and validating Public Health Informatics Competencies for Primary Health Care (PHIC4PHC), an instrument for measuring PHC workers' competencies in public health informatics. Method: This study developed a questionnaire that had three stages: the Delphi technique, a pretest, and field test. Eleven academicians from a university and 13 PHC workers joined 2 rounds of group discussion in the first stage. The second stage comprised two pilot studies with 75 PHC workers in Semarang Municipality. The third stage involved validating the questionnaire with 462 PHC workers in Kendal District. This study used Pearson's product-moment correlation for the validity check and Cronbach's alpha coefficient for determining the internal consistency. This study used the K-means algorithm for clustering the results of the PHIC4PHC questionnaire. Results and Conclusion: PHIC4PHC is the first comprehensive PHIC questionnaire administered in a resource-limited setting, consisting of 11 indicators and 42 measurement items concerning knowledge of health information systems, skills required for health data management, ethical aspects of data sharing and health information literacy. The final results of PHIC4PHC were clustered into three classes based on the K-means algorithm. Overall, 45.7% PHC workers achieved medium competency, whereas 25.6% and 27.7% achieved low and high competency, respectively. Men had higher competency than women. The higher the worker's level of education, the higher the PHIC level; the longer the worker's work experience, the lower the PHIC score; and the greater the worker's age, the lower the PHIC score. Measuring and monitoring PHIC is vital to support successful health IT adoption in PHC.
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Boström E, Ali L, Fors A, Ekman I, Andersson AE. Registered nurses' experiences of communication with patients when practising person-centred care over the phone: a qualitative interview study. BMC Nurs 2020; 19:54. [PMID: 32577097 PMCID: PMC7304080 DOI: 10.1186/s12912-020-00448-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/12/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND To explore registered nurses' (RNs') experiences of practising person-centred care (PCC) by telephone with people diagnosed with chronic obstructive pulmonary disease and/or chronic heart failure. METHODS Qualitative interview study. Four RNs were individually interviewed before, during, and after participating in an intervention practising PCC by telephone. The interviews were analysed using qualitative content analysis. RESULTS The results reflect three categories of their experience: realize the complexity of practising PCC by distance, gain insight into what PCC communication meant to RNs and their approach, and develop the professional role by practising PCC theory and ethics. CONCLUSIONS PCC over the telephone facilitate healthcare and support patients. Through careful listening, the RNs (1) created space for the individual patients to express their thoughts and feelings and (2) emphasized each patient's capabilities and resources. The RNs also gained an understanding of PCC and what it means to patients and to themselves as practitioners. Potential implications are that it is important for RNs practising PCC by telephone to remould their role, to listen carefully, and to communicate as equals in conversations that respect both parties' knowledge and expertise. Health professionals need supervision and support to fully understand the person-centred approach and provide communications that support it.
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Affiliation(s)
- Eva Boström
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Lilas Ali
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 405 30 Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Andreas Fors
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 405 30 Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Närhälsan Research and Development Primary Health Care, Region Västra, Götaland, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 405 30 Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Annette Erichsen Andersson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 405 30 Gothenburg, Sweden
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Electronic Health Information Systems to Improve Disease Diagnosis and Management at Point-of-Care in Low and Middle Income Countries: A Narrative Review. Diagnostics (Basel) 2020; 10:diagnostics10050327. [PMID: 32443856 PMCID: PMC7277945 DOI: 10.3390/diagnostics10050327] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/23/2020] [Accepted: 05/07/2020] [Indexed: 11/17/2022] Open
Abstract
The purpose of an electronic health information system (EHIS) is to support health care workers in providing health care services to an individual client and to enable data exchange among service providers. The demand to explore the use of EHIS for diagnosis and management of communicable and non-communicable diseases has increased dramatically due to the volume of patient data and the need to retain patients in care. In addition, the advent of Coronavirus disease 2019 (COVID-19) pandemic in high disease burdened low and middle income countries (LMICs) has increased the need for robust EHIS to enable efficient surveillance of the pandemic. EHIS has potential to enable efficient delivery of disease diagnostics services at point-of-care (POC) and reduce medical errors. This review provides an overview of literature on EHIS's with a focus on describing the key components of EHIS and presenting evidence on enablers and barriers to implementation of EHISs in LMICs. With guidance from the presented evidence, we proposed EHIS key stakeholders' roles and responsibilities to ensure efficient utility of EHIS for disease diagnosis and management at POC in LMICs.
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Yusif S, Hafeez-Baig A, Soar J. An Exploratory Study of the Readiness of Public Healthcare Facilities in Developing Countries to Adopt Health Information Technology (HIT)/e-Health: the Case of Ghana. JOURNAL OF HEALTHCARE INFORMATICS RESEARCH 2020; 4:189-214. [DOI: 10.1007/s41666-020-00070-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 01/19/2023]
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Nahrisah P, Somrongthong R, Viriyautsahakul N, Viwattanakulvanid P, Plianbangchang S. Effect of Integrated Pictorial Handbook Education and Counseling on Improving Anemia Status, Knowledge, Food Intake, and Iron Tablet Compliance Among Anemic Pregnant Women in Indonesia: A Quasi-Experimental Study. J Multidiscip Healthc 2020; 13:43-52. [PMID: 32021233 PMCID: PMC6970256 DOI: 10.2147/jmdh.s213550] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 12/13/2019] [Indexed: 12/19/2022] Open
Abstract
Purpose To determine the effect of individual education through a pictorial handbook on anemia in conjunction with counseling on improving hemoglobin and hematocrit level, birth weight, knowledge, iron-rich food and iron-folic acid (IFA) intake. Patients and Methods The study developed a pictorial handbook that was conceptualized based on the Health Belief Model and adjusted to some cultural and local contexts. A quasi-experimental pre-test–post-test control group design was used, purposefully conducted between two homogenous municipalities, each having a rate of anemic pregnancy that was 40% or greater. The sample consists of 140 anemic pregnant women randomly allocated via lottery into two groups; the intervention group (n=70), which received two home visits—one for education and another for a counseling session, and control group (n=70), which received routine antenatal care. A chi-square test and a Mann–Whitney U-test were conducted to compare the baseline socio-demographics. An analysis of covariance (ANCOVA), controlling some possible confounders, was performed to analyze the effect of intervention. Results The post-test means of hemoglobin F (1, 132) = 122, p-value <0.001, and hematocrit levels F (1, 132) = 373, p-value <0.001, were significantly different and higher in the intervention group compared to the control group. Similar results were found in knowledge, food frequency score, number of IFA intake (with p-value <0.001), birth weight and daily iron intake from food (with p-value <0.05). The intervention had a particularly large effect on food frequency score and number of IFA intake, and medium effect on hemoglobin and hematocrit levels. Conclusion Individual education through a pictorial handbook on anemia in conjunction with the counseling intervention program had a positive impact on hemoglobin and hematocrit levels for anemic pregnant women in their third trimester of pregnancy.
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Affiliation(s)
- Putri Nahrisah
- College of Public Health Sciences, Chulalongkorn University, Pathumwan, Bangkok 10330, Thailand.,Health Office of Kota Langsa Municipality, Kota Langsa, Province of Aceh, Indonesia
| | - Ratana Somrongthong
- College of Public Health Sciences, Chulalongkorn University, Pathumwan, Bangkok 10330, Thailand
| | | | | | - Samlee Plianbangchang
- College of Public Health Sciences, Chulalongkorn University, Pathumwan, Bangkok 10330, Thailand
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Senanayake B, Tyagi N, Zhou X, Edirippulige S. Workforce Readiness and Digital Health Integration. OPPORTUNITIES AND CHALLENGES IN DIGITAL HEALTHCARE INNOVATION 2020. [DOI: 10.4018/978-1-7998-3274-4.ch010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The benefits that digital health may offer include clinical, administrative, research, and educational. Research shows that if used in the right circumstances, digital health may increase access to healthcare services, improve clinical outcomes, safety, and quality of care. Digital health also has the potential to improve organisational efficiencies by reducing duplication and unnecessary diagnostic testing. From a healthcare consumer perspective, there is an expectation that healthcare services need to be provided in a more flexible and cost-effective way as in other spheres such as banking, commerce, and media. This is another important driver for consideration to integrate digital health in healthcare services. As digital health continues to be used in routine healthcare services, practitioners may require new knowledge, skills, and competencies to make the best use of this innovative method. Education and training relating to digital health have been recognised as a priority for developing the future healthcare workforce.
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Affiliation(s)
- Buddhika Senanayake
- Centre for Health Services Research, The University of Queensland, Australia
| | - Nirupama Tyagi
- Centre for Health Services Research, The University of Queensland, Australia
| | - Xiaoyun Zhou
- Centre for Health Services Research, The University of Queensland, Australia
| | - Sisira Edirippulige
- Centre for Health Services Research, The University of Queensland, Australia
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Kabukye JK, de Keizer N, Cornet R. Elicitation and prioritization of requirements for electronic health records for oncology in low resource settings: A concept mapping study. Int J Med Inform 2019; 135:104055. [PMID: 31877404 DOI: 10.1016/j.ijmedinf.2019.104055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 12/09/2019] [Accepted: 12/17/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Understanding functional and non-functional requirements is essential to successfully implement electronic medical record (EMR) systems. Actual requirements will be different for different contexts. OBJECTIVE To elicit and prioritize requirements for implementing EMRs in oncology in low and middle income countries (LMICs), and to relate these to requirements from high-income countries. PARTICIPANTS AND SETTING Cancer care stakeholders including oncologists, general doctors, nurses, biostatisticians, information technologists, from different LMICs, were involved. METHODS Concept mapping was used. Statements of requirements were obtained during focus group discussions (FGDs) and interviews. Using surveys, the requirements were clustered and ranked on importance and feasibility. Data were analyzed in SPSS using agglomerative hierarchical clustering and multidimensional scaling, to create cluster maps and go-zone maps reflecting the relationships between the requirements and their prioritization. RESULTS Four FGD sessions, with twenty participants, were conducted. In addition, six participants were interviewed. Twenty-two participants clustered the requirements and sixty-three participants ranked them on importance and feasibility. One hundred and sixty requirement statements were generated which were reduced to sixty-four after de-duplication and merging. Nine clusters were obtained encompassing the following domains, in order of importance: Security, Conducive organization, Management/Governance, General EMR functionalities, Computer infrastructure, Data management, Usability, Oncology decision support, and Ancillary requirements. On ranking, the requirements scored between 3.74 and 4.80 on importance, and between 3.55 and 4.46 on feasibility, on a 5-point Likert scale. We generated concept maps for use when communicating with stakeholders. CONCLUSION For oncology EMRs in LMICs, requirements overlap those from high-income countries, but generic EMR functionalities, Infrastructural and organizational requirements are still considered priority in LMICs compared to oncology-specific requirements or advanced EMR features e.g. computerized decision support or interoperability. Concept mapping is a fast and cost-effective method for eliciting and prioritizing EMR requirements in a user-centered manner.
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Affiliation(s)
- Johnblack K Kabukye
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Meibergdreef 15, Amsterdam, the Netherlands; Uganda Cancer Institute, Upper Mulago Hill Road, P.O. Box 3935 Kampala, Uganda.
| | - Nicolet de Keizer
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Meibergdreef 15, Amsterdam, the Netherlands
| | - Ronald Cornet
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Meibergdreef 15, Amsterdam, the Netherlands
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Curioso WH. Building Capacity and Training for Digital Health: Challenges and Opportunities in Latin America. J Med Internet Res 2019; 21:e16513. [PMID: 31850849 PMCID: PMC6939247 DOI: 10.2196/16513] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/22/2019] [Accepted: 12/09/2019] [Indexed: 12/23/2022] Open
Abstract
Tackling global health challenges demands the appropriate use of available technologies. Although digital health could significantly improve health care access, use, quality, and outcomes, realizing this possibility requires personnel trained in digital health. There is growing evidence of the benefits of digital health for improving the performance of health systems and outcomes in developed countries. However, significant gaps remain in resource-constrained settings. Technological and socio-cultural disparities between different regions or between provinces within the same country are prevalent. Rural areas, where the promise and need are highest, are particularly deprived. In Latin America, there is an unmet need for training and building the capacity of professionals in digital health. This viewpoint paper aims to present a selection of experiences in building digital health capacity in Latin America to illustrate a series of challenges and opportunities for strengthening digital health training programs in resource-constrained environments. These describe how a successful digital health ecosystem for Latin America requires culturally relevant and collaborative research and training programs in digital health. These programs should be responsive to the needs of all relevant regional stakeholders, including government agencies, non–governmental organizations, industry, academic or research entities, professional societies, and communities. This paper highlights the role that collaborative partnerships can play in sharing resources, experiences, and lessons learned between countries to optimize training and research opportunities in Latin America.
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Affiliation(s)
- Walter H Curioso
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, United States
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Nguyen DN, Nguyen LH, Nguyen CT, Pham HQ, Hwang J, Vu GT, Tran BX, Latkin CA, Ho CSH, Ho RCM. Health Status and Health Service Utilization among Vietnamese Farmers in a Mountainous Province. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234768. [PMID: 31795115 PMCID: PMC6926677 DOI: 10.3390/ijerph16234768] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 11/22/2019] [Accepted: 11/23/2019] [Indexed: 01/04/2023]
Abstract
Problems of poor health status and low health service use among farmers in mountainous areas have not been fully investigated. A cross-sectional study was conducted in Son La, a mountainous province in Vietnam, to assess the self-rated health and health care service utilization among farmers. Visual analogue scale (VAS) was used to measure the self-rated health. Multivariate Tobit, Poisson, and logistic regression were employed to identify related factors. Among 197 farmers, the mean VAS score was 67.8 (SD = 15.5). Approximately 40% of participants reported health problems, and the most popular morbidity was hypertension—56.4%. There were 28.9% and 50.3% of farmers using inpatient and outpatient treatments in the last 12 months, respectively. Age, educational level, family income, marital status, alcohol use, and source of information have been identified as associated factors with self-rated health status and morbidities, while age, gender, education, and morbidities were related to health service utilization. Data indicated a high proportion of health issues and a high rate of health care service use among farmers in a mountainous area of Vietnam. Adaptable health policies and prevention programs or preventive health services should be implemented regularly in mountainous regions to protect farmers from the onset of morbidities and to enhance their health.
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Affiliation(s)
- Diep Ngoc Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam; (D.N.N.); (H.Q.P.)
| | - Long Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; (L.H.N.); (R.C.M.H.)
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam; (D.N.N.); (H.Q.P.)
- Correspondence: ; Tel.: +84-888678577
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam; (D.N.N.); (H.Q.P.)
| | - Jongnam Hwang
- Division of Social Welfare and Health Administration, Wonkwang University, Iksan 54538, Korea;
| | - Giang Thu Vu
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam;
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam;
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore;
| | - Roger C. M. Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; (L.H.N.); (R.C.M.H.)
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore
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Hyder AA, Selig H, Ali J, Rutebemberwa E, Islam K, Pariyo G. Integrating capacity development during digital health research: a case study from global health. Glob Health Action 2019; 12:1559268. [PMID: 31154994 PMCID: PMC6338258 DOI: 10.1080/16549716.2018.1559268] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: The Bloomberg Data for Health Initiative Research and Development Arm at Johns Hopkins University Bloomberg School of Public Health, has thus far collected NCD risk factor data from more than 13,000 citizens of three LMICs (Bangladesh, Tanzania and Uganda), and has actively worked to improve capacity with partners worldwide. Objective: This paper focuses on how a research project, can also act as a capacity building activity through its research into collecting non-communicable disease risk factor data using different mobile phone modalities. Methods: This paper evaluates the activities undertaken by the project using the ESSENCE Planning Monitoring and Evaluation Framework for Research Capacity Strengthening. Results: The project was able to successfully integrate meaningful capacity development activities across all partners. Training, networking, sharing resources, joint data collection, and analysis across individual, organizational and project levels were some of the strategies used. The ESSENCE framework allowed a good assessment strategy for this type of work. Conclusions: This paper highlights the value of making capacity development a high priority for digital health research activities, while also considering the need to monitor and evaluate those activities in order for them to be meaningful and sustainable. It also considers how to utilize the ESSENCE Framework to evaluate capacity development activities through research, and how best to adapt the Framework to different programs.
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Affiliation(s)
- Adnan A Hyder
- a Milken Institute School of Public Health , George Washington University , Washington , DC , USA
| | - Hannah Selig
- b Department of International Health, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD , USA
| | - Joseph Ali
- b Department of International Health, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD , USA.,c Berman Institute of Bioethics , Johns Hopkins University , Baltimore , MD , USA
| | - Elizeus Rutebemberwa
- d Department of Health Policy and Management , Makerere University School of Public Health , Kampala , Uganda
| | - Khaleda Islam
- e Institute of Epidemiology , Disease Control and Research , Dhaka , Bangladesh
| | - George Pariyo
- a Milken Institute School of Public Health , George Washington University , Washington , DC , USA.,b Department of International Health, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD , USA
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Rattan R, Kataria T, Banerjee S, Goyal S, Gupta D, Pandita A, Bisht S, Narang K, Mishra SR. Artificial intelligence in oncology, its scope and future prospects with specific reference to radiation oncology. BJR Open 2019; 1:20180031. [PMID: 33178922 PMCID: PMC7592433 DOI: 10.1259/bjro.20180031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 04/01/2019] [Accepted: 04/12/2019] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Artificial intelligence (AI) seems to be bridging the gap between the acquisition of data and its meaningful interpretation. These approaches, have shown outstanding capabilities, outperforming most classification and regression methods to date and the ability to automatically learn the most suitable data representation for the task at hand and present it for better correlation. This article tries to sensitize the practising radiation oncologists to understand where the potential role of AI lies and what further can be achieved with it. METHODS AND MATERIALS Contemporary literature was searched and the available literature was sorted and an attempt at writing a comprehensive non-systematic review was made. RESULTS The article addresses various areas in oncology, especially in the field of radiation oncology, where the work based on AI has been done. Whether it's the screening modalities, or diagnosis or the prognostic assays, AI has come with more accurately defining results and survival of patients. Various steps and protocols in radiation oncology are now using AI-based methods, like in the steps of planning, segmentation and delivery of radiation. Benefit of AI across all the platforms of health sector may lead to a more refined and personalized medicine in near future. CONCLUSION AI with the use of machine learning and artificial neural networks has come up with faster and more accurate solutions for the problems faced by oncologist. The uses of AI,are likely to get increased exponentially . However, concerns regarding demographic discrepancies in relation to patients, disease and their natural history and reports of manipulation of AI, the ultimate responsibility will rest on the treating physicians.
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Affiliation(s)
- Rajit Rattan
- Division of Radiation Oncology, Medanta- The Medicity, Gurgaon, Haryana, India
| | - Tejinder Kataria
- Division of Radiation Oncology, Medanta- The Medicity, Gurgaon, Haryana, India
| | - Susovan Banerjee
- Division of Radiation Oncology, Medanta- The Medicity, Gurgaon, Haryana, India
| | - Shikha Goyal
- Division of Radiation Oncology, Medanta- The Medicity, Gurgaon, Haryana, India
| | - Deepak Gupta
- Division of Radiation Oncology, Medanta- The Medicity, Gurgaon, Haryana, India
| | - Akshi Pandita
- Department of Dermatology, P. N. Behl Skin Institute, New Delhi, India
| | - Shyam Bisht
- Division of Radiation Oncology, Medanta- The Medicity, Gurgaon, Haryana, India
- Department of Dermatology, P. N. Behl Skin Institute, New Delhi, India
| | - Kushal Narang
- Division of Radiation Oncology, Medanta- The Medicity, Gurgaon, Haryana, India
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People Welcomed This Innovation with Two Hands: A Qualitative Report of an mHealth Intervention for Community Case Management in Malawi. Ann Glob Health 2019; 85. [PMID: 31025838 PMCID: PMC6634480 DOI: 10.5334/aogh.919] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Community Case Management (CCM) aims to improve health outcomes among children under five with malaria, diarrhea, and pneumonia, but its effectiveness in Malawi is limited by inconsistent standards of delivery characteristic of paper-based interventions. This may lead to negative impacts on child health outcomes and inefficient use of health system resources. This study evaluated the acceptability and impact of the Supporting LIFE Community Case Management App (SL eCCM App) by Health Surveillance Assistants (HSAs) and caregivers in two districts of Northern Malawi. METHODS Data were collected through semi-structured interviews with HSAs and caregivers as part of a nested study within a larger trial. We used deductive and inductive approaches during data analysis. Relevant constructs were identified from the Consolidated Framework for Implementation Research and combined with emerging concepts from the data. The Framework Method was used to chart and explore data, leading to the development of themes. RESULTS Seventeen HSAs and 28 caregivers were interviewed. Participants were generally enthusiastic about the SL eCCM App. Nearly all HSAs expressed a preference for the App over routine paper-based CCM. Most HSAs claimed the App was more reliable and less error prone, facilitated more accurate diagnoses and treatment recommendations, and enhanced professional confidence and respect in the community. Some HSAs believed additional features would improve usability of the App, others identified mobile network or electricity shortages as barriers. Not all caregivers understood the purpose of the App, but most welcomed it as a health and technological advancement. CONCLUSION The SL eCCM App is acceptable to both HSAs and caregivers, and in most cases, preferred, as it was believed to foster improvements in CCM delivery. Our findings suggest that mobile health interventions for CCM, such as the SL eCCM App, may have potential to improve the effectiveness and efficiency of care to children under five.
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Zeleke AA, Worku AG, Demissie A, Otto-Sobotka F, Wilken M, Lipprandt M, Tilahun B, Röhrig R. Evaluation of Electronic and Paper-Pen Data Capturing Tools for Data Quality in a Public Health Survey in a Health and Demographic Surveillance Site, Ethiopia: Randomized Controlled Crossover Health Care Information Technology Evaluation. JMIR Mhealth Uhealth 2019; 7:e10995. [PMID: 30741642 PMCID: PMC6388101 DOI: 10.2196/10995] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/25/2018] [Accepted: 10/26/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Periodic demographic health surveillance and surveys are the main sources of health information in developing countries. Conducting a survey requires extensive use of paper-pen and manual work and lengthy processes to generate the required information. Despite the rise of popularity in using electronic data collection systems to alleviate the problems, sufficient evidence is not available to support the use of electronic data capture (EDC) tools in interviewer-administered data collection processes. OBJECTIVE This study aimed to compare data quality parameters in the data collected using mobile electronic and standard paper-based data capture tools in one of the health and demographic surveillance sites in northwest Ethiopia. METHODS A randomized controlled crossover health care information technology evaluation was conducted from May 10, 2016, to June 3, 2016, in a demographic and surveillance site. A total of 12 interviewers, as 2 individuals (one of them with a tablet computer and the other with a paper-based questionnaire) in 6 groups were assigned in the 6 towns of the surveillance premises. Data collectors switched the data collection method based on computer-generated random order. Data were cleaned using a MySQL program and transferred to SPSS (IBM SPSS Statistics for Windows, Version 24.0) and R statistical software (R version 3.4.3, the R Foundation for Statistical Computing Platform) for analysis. Descriptive and mixed ordinal logistic analyses were employed. The qualitative interview audio record from the system users was transcribed, coded, categorized, and linked to the International Organization for Standardization 9241-part 10 dialogue principles for system usability. The usability of this open data kit-based system was assessed using quantitative System Usability Scale (SUS) and matching of qualitative data with the isometric dialogue principles. RESULTS From the submitted 1246 complete records of questionnaires in each tool, 41.89% (522/1246) of the paper and pen data capture (PPDC) and 30.89% (385/1246) of the EDC tool questionnaires had one or more types of data quality errors. The overall error rates were 1.67% and 0.60% for PPDC and EDC, respectively. The chances of more errors on the PPDC tool were multiplied by 1.015 for each additional question in the interview compared with EDC. The SUS score of the data collectors was 85.6. In the qualitative data response mapping, EDC had more positive suitability of task responses with few error tolerance characteristics. CONCLUSIONS EDC possessed significantly better data quality and efficiency compared with PPDC, explained with fewer errors, instant data submission, and easy handling. The EDC proved to be a usable data collection tool in the rural study setting. Implementation organization needs to consider consistent power source, decent internet connection, standby technical support, and security assurance for the mobile device users for planning full-fledged implementation and integration of the system in the surveillance site.
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Affiliation(s)
- Atinkut Alamirrew Zeleke
- Division of Medical Informatics, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany.,Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Abebaw Gebeyehu Worku
- Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Adina Demissie
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Fabian Otto-Sobotka
- Division of Epidemiology and Biometry, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Marc Wilken
- Division of Medical Informatics, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Myriam Lipprandt
- Division of Medical Informatics, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Binyam Tilahun
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Rainer Röhrig
- Division of Medical Informatics, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
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Agarwal RK, Sedai A, Ankita K, Parmar L, Dhanya R, Dhimal S, Sriniwas R, Gowda A, Gujjal P, H P, Jain S, Ramaiah JD, Jali S, Tallur NR, Ramprakash S, Faulkner L. Information Technology-Assisted Treatment Planning and Performance Assessment for Severe Thalassemia Care in Low- and Middle-Income Countries: Observational Study. JMIR Med Inform 2019; 7:e9291. [PMID: 30672740 PMCID: PMC6364210 DOI: 10.2196/medinform.9291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 01/26/2018] [Accepted: 07/19/2018] [Indexed: 01/06/2023] Open
Abstract
Background Successful models of information and communication technology (ICT) applied to cost-effective delivery of quality care in low- and middle-income countries (LMIC) are an increasing necessity. Severe thalassemia is one of the most common life-threatening noncommunicable diseases of children globally. Objective The aim was to study the impact of ICT on quality of care for severe thalassemia patients in LMIC. Methods A total of 1110 patients with severe thalassemia from five centers in India were followed over a 1-year period. The impact of consistent use of a Web-based platform designed to assist comprehensive management of severe thalassemia (ThalCare) on key indicators of quality of care such as minimum (pretransfusion) hemoglobin, serum ferritin, liver size, and spleen size were assessed. Results Overall improvements in initial hemoglobin, ferritin, and liver and spleen size were significant (P<.001 for each). For four centers, the improvement in mean pretransfusion hemoglobin level was statistically significant (P<.001). Four of five centers achieved reduction in mean ferritin levels, with two displaying a significant drop in ferritin (P=.004 and P<.001). One of the five centers did not record liver and spleen size on palpation, but of the remaining four centers, two witnessed a large drop in liver and spleen size (P<.01), one witnessed moderate drop (P=.05 for liver; P=.03 for spleen size), while the fourth witnessed a moderate increase in liver size (P=.08) and insignificant change in spleen size (P=.12). Conclusions Implementation of computer-assisted treatment planning and performance assessment consistently and positively impacted indexes reflecting effective delivery of care to patients suffering from severe thalassemia in LMIC.
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Affiliation(s)
- Rajat Kumar Agarwal
- Jagriti InnoHealth Platforms Private Ltd, Bangalore, India.,Sankalp India Foundation, Bangalore, India
| | - Amit Sedai
- Jagriti InnoHealth Platforms Private Ltd, Bangalore, India.,Sankalp India Foundation, Bangalore, India
| | - Kumari Ankita
- Jagriti InnoHealth Platforms Private Ltd, Bangalore, India.,Sankalp India Foundation, Bangalore, India
| | - Lalith Parmar
- Jagriti InnoHealth Platforms Private Ltd, Bangalore, India.,Sankalp India Foundation, Bangalore, India
| | | | - Sunil Dhimal
- Jagriti InnoHealth Platforms Private Ltd, Bangalore, India
| | | | - Ashwini Gowda
- Project Samraksha, Rashtrotthana Parishat, Bangalore, India
| | - Pooja Gujjal
- Indira Gandhi Institute of Child Health, Bangalore, India
| | - Pushpa H
- Sankalp India Foundation, Bangalore, India.,Indira Gandhi Institute of Child Health, Bangalore, India
| | - Suman Jain
- Thalassemia and Sickle Cell Society, Hyderabad, India
| | | | - Sujata Jali
- Jawaharlal Nehru Medical College, Belgaum, India
| | | | - Stalin Ramprakash
- Sankalp-People Tree Centre for Pediatric Bone Marrow Transplant, People Tree Hospitals, Bangalore, India
| | - Lawrence Faulkner
- Sankalp India Foundation, Bangalore, India.,Cure2Children Foundation, Florence, Italy
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49
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A Systematic Review of Open Source Clinical Software on GitHub for Improving Software Reuse in Smart Healthcare. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9010150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The plethora of open source clinical software offers great reuse opportunities for developers to build clinical tools at lower cost and at a faster pace. However, the lack of research on open source clinical software poses a challenge for software reuse in clinical software development. This paper aims to help clinical developers better understand open source clinical software by conducting a thorough investigation of open source clinical software hosted on GitHub. We first developed a data pipeline that automatically collected and preprocessed GitHub data. Then, a deep analysis with several methods, such as statistical analysis, hypothesis testing, and topic modeling, was conducted to reveal the overall status and various characteristics of open source clinical software. There were 14,971 clinical-related GitHub repositories created during the last 10 years, with an average annual growth rate of 55%. Among them, 12,919 are open source clinical software. Our analysis unveiled a number of interesting findings: Popular open source clinical software in terms of the number of stars, most productive countries that contribute to the community, important factors that make an open source clinical software popular, and 10 main groups of open source clinical software. The results can assist both researchers and practitioners, especially newcomers, in understanding open source clinical software.
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50
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Salameh B, Eddy LL, Batran A, Hijaz A, Jaser S. Nurses' Attitudes Toward the Use of an Electronic Health Information System in a Developing Country. SAGE Open Nurs 2019; 5:2377960819843711. [PMID: 33415233 PMCID: PMC7774452 DOI: 10.1177/2377960819843711] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 02/20/2019] [Accepted: 03/23/2019] [Indexed: 11/17/2022] Open
Abstract
The electronic-based documentation system is considered a major transformation in health care in many hospitals worldwide. Successful implementation of the system makes nurses' jobs easier, saves time, and improves the quality of care that is delivered to patients. However, little is known about the adoption of electronic health information systems in developing countries. The purpose of this study was to understand and evaluate nurses' acceptance and attitudes about implementation of an electronic health information system in Palestinian hospitals. A descriptive, cross-sectional study was conducted with 191 nurses in three governmental hospitals in Palestine. A majority of these nurses understood the need for and accepted the computer-based documentation as demonstrated by their scores on the attitude questionnaire. Inclusion of nurses in early phases of planning and implementation is important. Other developing countries can learn from the Palestinian experience with implementation of electronic health records.
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Affiliation(s)
- Basma Salameh
- Department of Nursing,
Arab
American University, Jenin, Palestine
| | - Linda L. Eddy
- Washington State University College of
Nursing, Spokane, WA, USA
| | - Ahmad Batran
- Department of Nursing,
Arab
American University, Jenin, Palestine
| | - Asma Hijaz
- Shunnarah Medical Center, Ramallah,
Palestine
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