scholarly journals Addressing Care Continuity and Quality Challenges in the Management of Hypertension: a Case Study of the Private Healthcare Sector in Kenya (Preprint)

Author(s):  
Aisha Walcott-Bryant ◽  
William Ogallo ◽  
Sekou Remy ◽  
Katherine Tryon ◽  
Winnie Shena ◽  
...  
2020 ◽  
Author(s):  
Aisha Walcott-Bryant ◽  
Sekou Remy ◽  
William Ogallo ◽  
Katherine Tryon ◽  
Winnie Shena ◽  
...  

BACKGROUND The rise of noncommunicable diseases in sub-Saharan Africa places strain on already stretched healthcare systems, that have traditionally focused on infectious diseases. Healthcare provision is fragmented, and there is a dearth of literature on the experiences, challenges, and solutions for improving the management of noncommunicable diseases in sub-Saharan private healthcare sectors. OBJECTIVE We investigated the management of hypertension in the Kenyan private healthcare sector to understand how a health information system could be used to address care continuity and quality challenges in the management of hypertension and other noncommunicable diseases. METHODS We conducted in-depth interviews and direct observations at 18 healthcare institutions in Kenya. We analyzed the data to identify the key challenges and proposed solutions to the challenges. We subsequently used the generated insights to propose the design of a digital health solution for enabling care quality and continuity at the study setting and similar ecosystems. RESULTS The private healthcare sector in Kenya is fragmented and faces challenges such as high cost of care, limited healthcare literacy, lack of self-management support, ineffective referral systems, inadequate care provider training, and inadequate regulation. Care coordination is hindered by suboptimal encounter data collection, limited view of patient histories, and little trust between care providers. Patient health records are siloed in multiple paper and electronic systems that lack integration. The proposed digital health platform system supports care coordination and continuity within fragmented healthcare systems by enabling patient-consented data sharing while ensuring that care providers in separate facilities have holistic views of the patient’s clinical and non-clinical history. CONCLUSIONS Health information systems can play a pivotal role in addressing the care continuity and quality challenges in the management of noncommunicable diseases in sub-Saharan Africa private healthcare sectors. Leveraging technology and processes to support patients managing chronic noncommunicable diseases in disparate clinical and nonclinical settings (e.g. at home and in support groups) is critical.


Author(s):  
Stephen Cantarutti ◽  
Emmanuel M. Pothos

Abstract Background According to recent polling, public trust in the healthcare sector remains low relative to other industries globally. The implications of low healthcare trust permeate throughout the industry in a number of ways, most visibly by discouraging therapy compliance. Methods This study investigated four putative determinants of trust in healthcare-related scenarios: individuals vs. collective groups as communicators of healthcare advice; expert vs. laypeople as providers of healthcare communication; public vs. private healthcare sector; and positive vs. negative information. Two hundred seventy-four participants were recruited via Prolific Academic and were presented with four statements in random order, related to a positive reflection of the public healthcare sector, a negative reflection of the public healthcare sector, a positive reflection of the private healthcare sector and a negative reflection of the private healthcare sector. According to these reflection, participants were repeatedly asked to rate the system on its trustworthiness. Trust outcomes were constructed using a four-dimension framework, consisting of benevolence, reliability, competence and predictability. Results Claims relating to the public sector had a significantly stronger impact on benevolence and reliability than claims relating to the private sector; claims from individuals had a significantly stronger impact on all trust variables than claims from collectives; and claims from laypeople had a significantly greater impact on reliability and competence ratings than claims from experts. Conclusions The findings in this study offer insight into the patterns with which trust decisions are made in healthcare contexts. More importantly, this research offers a novel perspective of how different factors interact to affect the various facets of trust. These results provide a foundation for future study in this evolving area, and offer insights into designing effective communication strategies that cultivate greater levels of individual trust in the healthcare sector.


Electronics ◽  
2021 ◽  
Vol 10 (14) ◽  
pp. 1615
Author(s):  
Zeeshan Ali Khan ◽  
Ubaid Abbasi ◽  
Sung Won Kim

Low power wide area networks (LPWAN) are comprised of small devices having restricted processing resources and limited energy budget. These devices are connected with each other using communication protocols. Considering their available resources, these devices can be used in a number of different Internet of Things (IoT) applications. Another interesting paradigm is machine learning, which can also be integrated with LPWAN technology to embed intelligence into these IoT applications. These machine learning-based applications combine intelligence with LPWAN and prove to be a useful tool. One such IoT application is in the medical field, where they can be used to provide multiple services. In the scenario of the COVID-19 pandemic, the importance of LPWAN-based medical services has gained particular attention. This article describes various COVID-19-related healthcare services, using the the applications of machine learning and LPWAN in improving the medical domain during the current COVID-19 pandemic. We validate our idea with the help of a case study that describes a way to reduce the spread of any pandemic using LPWAN technology and machine learning. The case study compares k-Nearest Neighbors (KNN) and trust-based algorithms for mitigating the flow of virus spread. The simulation results show the effectiveness of KNN for curtailing the COVID-19 spread.


2016 ◽  
Vol 19 (1) ◽  
pp. 53-63 ◽  
Author(s):  
Marine Erasmus ◽  
Nicola Theron

The Competition Commission (CC) commenced with an enquiry into South Africa’s private healthcare sector at the beginning of 2014, the outcome of which could have far-reaching consequences for the medical industry in South Africa. The panel appointed to consider competition in the private healthcare sector has indicated that they are interested in understanding increased consolidation in the private hospital market and the effect this may have on competitive dynamics. This article considers historical concentration trends in the private hospital market from 2000 to 2012. In addition it also deals with changes in market structure in the medical scheme and administrator markets. These trends provide a complete picture of market structure changes and the implications for relative bargaining power of the various parties. It finds that whereas the market concentration of private hospitals has remained relatively stable since 2004, the market concentration of medical schemes and administrators has increased over this period.


2020 ◽  
Vol 58 (9) ◽  
pp. 1841-1862 ◽  
Author(s):  
Francesca Dal Mas ◽  
Helena Biancuzzi ◽  
Maurizio Massaro ◽  
Luca Miceli

PurposeThe paper aims to contribute to the debate concerning the use of knowledge translation for implementing co-production processes in the healthcare sector. The study investigates a case study, in which design was used to trigger knowledge translation and foster co-production.Design/methodology/approachThe paper employs a case study methodology by analysing the experience of “Oncology in Motion”, a co-production program devoted to the recovery of breast cancer patients carried on by the IRCCS C.R.O. of Aviano, Italy.FindingsResults show how design could help to translate knowledge from various stakeholders with different skills (e.g. scientists, physicians, nurses) and emotional engagement (e.g. patients and patients' associations) during all the phases of a co-production project to support breast cancer patients in a recovery path. Stewardship theory is used to show that oncology represents a specific research context.Practical implicationsThe paper highlights the vast practical contribution that design can have in empowering knowledge translation at different levels and in a variety of co-production phases, among different stakeholders, facilitating their engagement and the achievement of the desired outcomes.Originality/valueThe paper contributes to the literature on knowledge translation in co-production projects in the healthcare sector showing how design can be effectively implemented.


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