Stakeholders’ Perceptions of the Implementation of a Patient-Centric Digital Health Application for Primary Healthcare in India (original) (raw)
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A Study on Digital Healthcare in India
2022
Digital health refers to the amalgamation of data, technology and electronic communication in healthcare. It covers a wide range of applications, including telemedicine, electronic health records, health tracking, wearable devices and health apps, aimed at improving healthcare delivery, overall wellness, patient monitoring through digital means. Digital health holds an immense significance in India due to its potential to address challenges faced in healthcare like limited access to healthcare services in remote areas, the need for cost-effective solutions, and overburdened healthcare infrastructure. It can bridge the gaps in healthcare delivery, facilitate health data management and enable remote consultations for a large population. This paper focuses on the awareness of digital health apps among people of India and highlighting the dominance of digital healthcare in the Indian market. Survey and interview method has been selected to study the objectives of this research project.
BMJ Open, 2022
ObjectivesTo understand factors underpinning the accuracy and timeliness of mobile phone numbers and other health information captured in India’s government registry for pregnant and postpartum women. Accurate and timely registration of mobile phone numbers is necessary for beneficiaries to receive mobile health services.SettingMadhya Pradesh and Rajasthan states in India at the community, clinical, and administrative levels of the health system.ParticipantsInterviews (n=59) with frontline health workers (FLHWs), data entry operators, and higher level officials. Focus group discussions (n=12) with pregnant women to discuss experiences with sharing data in the health system. Observations (n=9) of the process of digitization and of interactions between stakeholders for data collection.Primary and secondary outcome measuresThematic analysis identified how key actors experienced the data collection and digitisation process, reasons for late or inaccurate data, and mechanisms that can bo...
ICT Framework to Support a Patient-Centric approach in Public Healthcare
J. Community Informatics, 2020
Although Information and Communication Technologies (ICTs) in the healthcare sector are extensively being deployed globally, they are not used effectively in developing countries. Many resource-poor countries face numerous challenges in implementing ICT interventions. For instance, most health applications deployed in Malawi are not user-centric. As a result, such ICT interventions do not benefit many health consumers. Furthermore, the dearth of a patient-centric ICT framework in Malawi renders eHealth and mHealth interventions less sustainable and less cost effective. The aim of this study is therefore to develop an ICT Framework that will support patient-centric healthcare services in the public health sector in Malawi. The comprehensive literature review and semi-structured interviews highlighted many challenges underlying ICT development in Malawi. This ICT framework was validated by five experts selected from different areas of expertise including mHealth application developers, ICT policy makers, and public health practitioners in Malawi. Results show that the framework is relevant, useful, and applicable within the context of Malawi's public health sector. The framework can also be implemented in various countries with similar settings. This paper builds on the proposal made earlier on the formulation of an ICT framework for patient-centric care in Malawi.
Operability, Usefulness, and Task-Technology Fit of an mHealth App for Delivering Primary Health Care Services by Community Health Workers in Underserved Areas of Pakistan and Afghanistan: Qualitative Study, 2020
Background: The recent proliferation of digital health technology in low-and middle-income countries has made it possible for community health workers (CHWs) to use mobile health (mHealth) to perform tasks such as data collection and training. Although most studies focus on the prospect of digital apps to motivate and connect CHW, only a few have captured end-user experiences with mobile-based apps. We examined the experience of frontline health workers with a move towards digitalized real-time data to record maternal and childcare services in remote areas of Afghanistan and Pakistan. Objective: Our study aimed to explore CHW perceptions on the operability of the mHealth app in a community setting, usefulness of the app in the delivery of assigned maternal and childcare functions, and the task-technology fit with monitoring information systems. Methods: The Hayat app, designed to digitalize and facilitate electronic record keeping, was evaluated to be embedded into mainstream health systems. The app had 2 components: smartphone app for data entry and web dashboard for visualization of the maternal, newborn, and child health reports. Using a qualitative exploratory study design, we conducted a total of 8 focus group discussions with purposively selected lady health workers (LHWs) and CHWs in 3 districts of Pakistan and 3 hamlets of Afghanistan, respectively. Focus group discussions were conducted in the local language, audio recorded, and converted into expanded notes for thematic analysis. Results: Although a majority of LHWs used the app with ease, some initially faced difficulties in operating it and requested a longer duration of training. Contrary to LHWs, the CHWs were able to use the app without difficulty, as they were using it only to register clients. Overall, use of the mHealth app in both countries resulted in a positive impact on health education sessions, easier communication with parents or clients, tracking of routine immunization defaulters and follow-ups, improved data validity, easily accessible vaccination schedules, and faster registration. In addition to building up their image in the community and personal development, the improved reporting and monitoring mechanisms also set the stage for the LHWs to get recognized for their hard work. CHWs in Afghanistan also reported the app provided immediate access to information when requested by their supervisor. Although the Hayat app eliminates the need to carry multiple registers and helps in recalling client information at the touch of a button, technical issues around connectivity and data inputting tabs were highlighted by the participants. Conclusions: The digitization of records not only provided CHWs support in their daily routine but also strengthened monitoring mechanisms and improved motivation. We recommend conducting end user experience studies before embedding apps into mainstream health systems as high acceptability does not always result in high uptake of digital technology.
National Digital Infrastructure and India’s Healthcare Sector: Physician’s Perspectives
The qualitative report, 2023
Patient-centric digital infrastructure can potentially enhance the efficiency of healthcare systems. However, even in developed nations, evidence suggests low adoption rates for such infrastructure and lack of support from clinicians is considered as one of the most critical hindering factors. In this study, we examine physicians' perceptions of the proposed large-scale information technology initiative in India that aims to transform the health sector and provide universal health coverage to all residents of India. We employed the information ecology lens to understand the broader changes in the healthcare system that could result from the initiative. We use focus group discussion and in-depth interviews to comprehend the perceptions of doctors about the initiative. Drawing upon Foucault's conceptualization of power, we find that physicians, the key stakeholders in this initiative, are skeptical about the changes in the locus of power in the new ecosystem. Specifically, they perceive that knowledge power has shifted from a historical "expert knowledge power" to power related to "data management." The physicians believe that changes are expected to manifest through monitoring, controlling, and managing the data rather than providing knowledge-based services. We present recommendations to engage physicians' perspectives in implementing large-scale patient-centric digital infrastructure.
Digitalization of routine health information systems: Bangladesh, Indonesia, Pakistan
Bulletin of the World Health Organization
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A Glimpse Into the Deployment of Digital Health in India
Telehealth and Medicine Today, 2024
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Digital health initiatives can take better cognizance of marginalized communities in India
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