scholarly journals Acceptability of Information Technology Systems Developed for Distant Philippine Communities among Local Health Providers

2021 ◽  
Author(s):  
Alvin B. Caballes
Keyword(s):  
Information Technology ◽  
Health Workers ◽  
Tracking System ◽  
Relevant Information ◽  
Local Health ◽  
Health Providers ◽  
Diagnostic Device ◽  
Health Records ◽  
It Systems ◽  
Device Component

Introduction. The National Telehealth Service Program (NTSP) has developed Information Technology (IT) systems aimed at improving health services primarily in isolated Philippine communities. These included two electronic health records modalities (Community Health Information Tracking System, or CHITS, and Real-time Regular Routine Reporting for Health, or R4Health), a referral system (Telemedicine), and a remote diagnostic device (RxBox).Objectives. This study was undertaken to describe the utilization and cost patterns as well as the perceptions of the local health personnel regarding the use of the various NTSP systems. The implications of the end-user perceptions on the acceptability and expanded use of the IT interventions were inferred, from which corresponding policy recommendations were made.Methods. Twelve NTSP sites, including far-flung and economically depressed communities, where the systems were concurrently available over a defined six month period, were selected. The frequency of respective system transactions for these sites was collected from NTSP files. Interviews and focus group discussions were conducted at the communities, involving physicians, nurses, midwives, and other health workers. Associated costs, and perceptions related to the adoption, operation, and sustained use of the IT systems were elucidated.Results. Telemedicine, though the least costly modality, was the least utilized of the systems. While both R4Health and CHITS facilitated health data management, CHITS provided more locally-relevant information. The RxBox system, due to its clinical diagnostic device component, was widely accepted and also increased health center consultations, especially among pregnant patients. Technical malfunctions, as well as system failures following natural calamities, were recurrent problems.Conclusions. The RxBox system, with its bundled health records and specialist consultation functions, is highly accepted by health providers and other community stakeholders. The technology can be expected to be similarly well-regarded in other settings. The stand-alone IT modalities that do not directly or significantly benefit the actual implementers are not as sustainable.

scholarly journals Diabetic retinopathy service delivery and integration into the health system in Pakistan—Findings from a multicentre qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260936
Author(s):  
Stevens Bechange ◽  
Anne Roca ◽  
Elena Schmidt ◽  
Munazza Gillani ◽  
Leena Ahmed ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Health Workers ◽  
Tracking System ◽  
Integrated Approach ◽  
Community Services ◽  
Great Promise ◽  
Diabetic Patients ◽  
Local Health ◽  
Integration Of Services ◽  
The Impact

This paper is based on qualitative research carried out in a diabetic retinopathy (DR) programme in three districts of Pakistan. It analyses the organisation and delivery of DR services and the extent to which the interventions resulted in a fully functioning integrated approach to DR care and treatment. Between January and April 2019, we conducted 14 focus group discussions and 37 in-depth interviews with 144 purposively selected participants: patients, lady health workers (LHWs) and health professionals. Findings suggest that integration of services was helpful in the prevention and management of DR. Through the efforts of LHWs and general practitioners, diabetic patients in the community became aware of the eye health issues related to uncontrolled diabetes. However, a number of systemic pressure points in the continuum of care seem to have limited the impact of the integration. Some components of the intervention, such as a patient tracking system and reinforced interdepartmental links, show great promise and need to be sustained. The results of this study point to the need for action to ensure inclusion of DR on the list of local health departments’ priority conditions, greater provision of closer-to-community services, such as mobile clinics. Future interventions will need to consider the complexity of adding diabetic retinopathy to an already heavy workload for the LHWs.

The Impact of Social Mobilization on Health Service Delivery and Health Outcomes

2018 ◽  
Author(s):  
Xavier Giné ◽  
Salma Khalid ◽  
Mansuri Ghazala
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Health Outcomes ◽  
Health Workers ◽  
Health Service Delivery ◽  
Health Providers ◽  
Child Health Outcomes ◽  
Rural Pakistan ◽  
Post Natal Care ◽  
The Impact

This chapter uses a randomized community development programme in rural Pakistan to assess the impact of citizen engagement on public service delivery and maternal and child health outcomes. The programme had a strong emphasis on organizing women, who also identified health services as a development priority at baseline. At midline, we find that the mobilization effort alone had a significant impact on the performance of village-based health providers. We detect economically large improvements in pregnancy and well-baby visits by female health workers, as well as increased utilization of pre- and post-natal care by pregnant women. In contrast, the quality of supra-village health services did not improve, underscoring the importance of community enforcement and monitoring capacity for improving service delivery.

Safe Use of Electronic Health Records and Health Information Technology Systems

2013 ◽  
Vol 9 (4) ◽  
pp. 177-189 ◽  
Author(s):  
Charles R. Denham ◽  
David C. Classen ◽  
Stephen J. Swenson ◽  
Michael J. Henderson ◽  
Thomas Zeltner ◽  
...  
Keyword(s):  
Information Technology ◽  
Electronic Health Records ◽  
Health Information Technology ◽  
Health Information ◽  
Health Records ◽  
Electronic Health ◽  
Technology Systems

scholarly journals Examining local perspectives on the influence of climate change on the health of Hamer pastoralists and their livestock in Ethiopia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Samuel Lumborg ◽  
Samuel Tefera ◽  
Barry Munslow ◽  
Siobhan M. Mor
Keyword(s):  
Climate Change ◽  
Water Scarcity ◽  
Health Workers ◽  
Animal Health ◽  
Disease Outbreaks ◽  
Vulnerable Groups ◽  
Local Health ◽  
Framework Analysis ◽  
Healthcare Facilities ◽  
Grazing Lands

AbstractThis study explores the perceived influence of climate change on the health of Hamer pastoralists and their livestock in south-western Ethiopia. A combination of focus group discussions and key informant interviews were conducted with Hamer communities as well as local health workers, animal health workers and non-governmental organisation (NGO) staff. Thematic framework analysis was used to analyse the data. Reductions in rangeland, erratic rainfall, recurrent droughts and loss of seasonality were perceived to be the biggest climate challenges influencing the health and livelihoods of the Hamer. Communities were travelling greater distances to access sufficient grazing lands, and this was leading to livestock deaths and increases in ethnic violence. Reductions in suitable rangeland were also precipitating disease outbreaks in animals due to increased mixing of different herds. Negative health impacts in the community stemmed indirectly from decreases in livestock production, uncertain crop harvests and increased water scarcity. The remoteness of grazing lands has resulted in decreased availability of animal milk, contributing to malnutrition in vulnerable groups, including children. Water scarcity in the region has led to utilisation of unsafe water sources resulting in diarrhoeal illnesses. Further, seasonal shifts in climate-sensitive diseases such as malaria were also acknowledged. Poorly resourced healthcare facilities with limited accessibility combined with an absence of health education has amplified the community’s vulnerability to health challenges. The resilience and ambition for livelihood diversification amongst the Hamer was evident. The introduction of camels, increase in permanent settlements and new commercial ideas were transforming their livelihood strategies. However, the Hamer lack a voice to express their perspectives, challenges and ambitions. There needs to be collaborative dynamic dialogue between pastoral communities and the policy-makers to drive sustainable development in the area without compromising the values, traditions and knowledge of the pastoralists.

scholarly journals Which Strategies Improve Physicians' Experience with Health Information Technology?

ACI Open ◽  
2021 ◽  
Vol 05 (01) ◽  
pp. e47-e53
Author(s):  
Jacqueline Haskell ◽  
Brittany Mandeville ◽  
Emily Cooper ◽  
Rebekah Gardner
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Rhode Island ◽  
Response Rate ◽  
Physician Burnout ◽  
Health Records ◽  
Effective Strategies ◽  
Department Of Health ◽  
Part Time

Abstract Objectives While electronic health records (EHRs) have improved billing efficiency and note legibility, they may also disrupt clinical workflows, affect patient interactions, and contribute to physician burnout. This study aimed to identify effective strategies, as reported by physicians, to mitigate these EHR shortcomings. Methods The Rhode Island Department of Health administers a health information technology (HIT) survey biennially to all physicians in active practice statewide. The 2019 survey asked physicians about strategies implemented personally or by their practice to improve their experience working with HIT. Physicians who identified at least one strategy were then asked if each implemented strategy was “actually useful.” Results The 2019 survey was administered to 4,266 physicians, with a response rate of 43%. Both office- and hospital-based physicians most commonly reported that their practices had implemented voice-recognition dictation software (48 and 68%, respectively). Office- and hospital-based physicians identified self-care as the most commonly implemented personal change (48 and 47%, respectively). However, 26% of office-based and 15% of hospital-based physicians reported reducing clinical hours or working part-time to improve their experience working with HIT. The strategies identified as “actually useful” varied by practice setting and were not always the most widely implemented approaches. Conclusion Most physicians reported that both they personally and their practices had implemented strategies to improve their experience with HIT. Physicians found some of these strategies more helpful than others, and the strategies identified as most useful differed between office- and hospital-based physicians. From a workforce and access perspective, prioritizing strategies that physicians find “actually useful” is critical, as many physicians in both settings reported reducing clinical hours to improve their experience.

scholarly journals Addressing lead exposure in children in Georgia: challenges and successes of a multi-agency response

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Ruadze ◽  
I Khonelidze ◽  
L Sturua ◽  
P Lauriola ◽  
H Crabbe ◽  
...  
Keyword(s):  
Public Health ◽  
Blood Concentration ◽  
Tracking System ◽  
Action Plan ◽  
Blood Lead ◽  
Relevant Information ◽  
State Intervention ◽  
Intervention Programme ◽  
Public Health Action ◽  
Pb Exposure

Abstract The national response for reducing lead (Pb) exposure in Georgia is coordinated by the National Centre for Disease Control and Public Health (NCDC&PH) and implemented as a multi-agency (CDC, UNICEF, WHO, University of Emory) response. Given concerns about the extent of Pb exposure, in 2018 Multiple Indicator Cluster Surveys (MICS) of representative samples of children have been conducted to study several demographic and health aspects, including a study of the prevalence of blood Pb levels among 2 to 7 years old children (n = 1578). This survey was conducted in collaboration with the Italian Instituto Superiore di Sanita' (ISS), UNICEF and NCDC. The laboratory analyses were conducted at ISS in Italy. Initial results showed that in 41% of all children, blood Pb concentration was ≥ 5 µg/dl, a challenge which motivated public agencies to establish an initial public health action plan to assess environmental samples (paint, dust, water, soil, selected food items such as spices and imported sweets) in families where Pb concentrations were ≥ 10 µg/dL. A State intervention programme, monitoring Pb blood concentration among MICS children and their family members, provided relevant information on exposed households and led to a reduction of Pb blood concentration across the most exposed households. In collaboration with Public Health England, NCDC has conducted a small Pb isotope ratio study aimed at identifying the most relevant sources of Pb exposure contributing to elevated blood Pb in MICS children. It is expected that these data will support the design of more detailed public health interventions to reduce exposure to key sources of Pb, thus leading to further reduction of Pb-induced health effects in Georgia. In addition, this experience will clarify elements of an ongoing monitoring of environmental factors such as an Environmental Public Health Tracking system, to support national capacity to manage the risks to public health. Key messages Environmental health response requires extensive research and multi-agency approach. If State implements adequate intervention it is possible to reduce blood lead (Pb) level.

scholarly journals Medical Record Keeping in the Summer Camp Setting

2016 ◽  
Vol 07 (04) ◽  
pp. 1154-1167
Author(s):  
Jaycelyn Holland ◽  
Stuart Weinberg ◽  
S. Rosenbloom ◽  
Laura Kaufman
Keyword(s):  
Medical Record ◽  
Summer Camp ◽  
The United States ◽  
Summer Camps ◽  
Pediatric Care ◽  
Health Staff ◽  
Health Providers ◽  
Health Records ◽  
Record Keeping ◽  
Survey Responses

Summary Background Approximately one fifth of school-aged children spend a significant portion of their year at residential summer camp, and a growing number have chronic medical conditions. Camp health records are essential for safe, efficient care and for transitions between camp and home providers, yet little research exists regarding these systems. Objective To survey residential summer camps for children to determine how camps create, store, and use camper health records. To raise awareness in the informatics community of the issues experienced by health providers working in a special pediatric care setting. Methods We designed a web-based electronic survey concerning medical recordkeeping and healthcare practices at summer camps. 953 camps accredited by the American Camp Association received the survey. Responses were consolidated and evaluated for trends and conclusions. Results Of 953 camps contacted, 298 (31%) responded to the survey. Among respondents, 49.3% stated that there was no computer available at the health center, and 14.8% of camps stated that there was not any computer available to health staff at all. 41.1% of camps stated that internet access was not available. The most common complaints concerning recordkeeping practices were time burden, adequate completion, and consistency. Conclusions Summer camps in the United States make efforts to appropriately document healthcare given to campers, but inconsistency and inefficiency may be barriers to staff productivity, staff satisfaction, and quality of care. Survey responses suggest that the current methods used by camps to document healthcare cause limitations in consistency, efficiency, and communications between providers, camp staff, and parents. As of 2012, survey respondents articulated need for a standard software to document summer camp healthcare practices that accounts for camp-specific needs. Improvement may be achieved if documentation software offers the networking capability, simplicity, pediatrics-specific features, and avoidance of technical jargon. Citation: Kaufman L, Holland J, Weinberg S, Rosenbloom ST. Medical record keeping in the summer camp setting.

scholarly journals Section 1: Health and Clinical Management: Leveraging Information Technology to Improve Quality and Safety

2007 ◽  
Vol 16 (01) ◽  
pp. 22-29
Author(s):  
D. W. Bates ◽  
J. S. Einbinder
Keyword(s):  
Information Technology ◽  
Patient Safety ◽  
Clinical Data ◽  
Data Exchange ◽  
Personal Health Records ◽  
Personal Health ◽  
Health Records ◽  
Provider Behavior ◽  
Published Research ◽  
Improve Patient

SummaryTo examine five areas that we will be central to informatics research in the years to come: changing provider behavior and improving outcomes, secondary uses of clinical data, using health information technology to improve patient safety, personal health records, and clinical data exchange.Potential articles were identified through Medline and Internet searches and were selected for inclusion in this review by the authors.We review highlights from the literature in these areas over the past year, drawing attention to key points and opportunities for future work.Informatics may be a key tool for helping to improve patient care quality, safety, and efficiency. However, questions remain about how best to use existing technologies, deploy new ones, and to evaluate the effects. A great deal of research has been done on changing provider behavior, but most work to date has shown that process benefits are easier to achieve than outcomes benefits, especially for chronic diseases. Use of secondary data (data warehouses and disease registries) has enormous potential, though published research is scarce. It is now clear in most nations that one of the key tools for improving patient safety will be information technology— many more studies of different approaches are needed in this area. Finally, both personal health records and clinical data exchange appear to be potentially transformative developments, but much of the published research to date on these topics appears to be taking place in the U.S.— more research from other nations is needed.

scholarly journals Conflict affected, parallel health systems: challenges to collaboration between ethnic and government health systems in Kayin State, Myanmar

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Colette Pang Biesty ◽  
Aung Ja Brang ◽  
Barry Munslow
Keyword(s):  
Health System ◽  
Health Systems ◽  
Health Workers ◽  
Health Providers ◽  
Peace Accord ◽  
Government Health ◽  
Peace Processes ◽  
Post Conflict ◽  
Observation Methods ◽  
Minority Ethnic Groups

Abstract Background Myanmar has had a long history of civil wars with its minority ethnic groups and is yet to see a sustainable peace accord. The conflicts have had a significant impact on health in Myanmar, with ethnic populations experiencing inequitable health outcomes. Consequently, to meet the health needs of ethnic people, Ethnic Health Organisations and Community-Based Health Organisations (EHO/CBHOs) created their own health system. The EHO/CBHO and Government health systems, provided by the Myanmar Ministry of Health and Sports (MoHS), remain parallel, despite both stakeholders discussing unification of the health systems within the context of ongoing but unresolved peace processes. EHO/CBHOs discuss the ‘convergence’ of health systems, whilst the MoHS discuss the integration of health providers under their National Health Plan. Methods A qualitative study design was used to explore the challenges to collaboration between EHO/CBHOs and the MoHS in Kayin state, Myanmar. Twelve health workers from different levels of the Karen EHO/CBHO health system were interviewed. Semi-structured, in-depth interviews were digitally recorded, transcribed, and coded. Data was analysed thematically using the Framework method. Topic guides evolved in an iterative process, as themes emerged inductively from the transcripts. A literature review and observation methods were also utilised to increase validity of the data. Results The challenges to collaboration were identified in the following five themes: (1) the current situation is not ‘post conflict’ (2) a lack of trust (3) centralised nature of the MoHS (4) lack of EHO/CBHO health worker accreditation (5) the NHP is not implemented in some ethnic areas. Conclusions Ultimately, all five challenges to collaboration stem from the lack of peace in Myanmar. The health systems cannot be ‘converged or ‘integrated’ until there is a peace accord which is acceptable to all actors. EHO/CBHOs want a federal political system, where the health system is devolved, equitable and accessible to all ethnic people. External donors should understand this context and remain neutral by supporting all health actors in a conflict sensitive manner.

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