ABSTRACTe-Health Readiness refers to the preparedness of healthcare institutions or communities for the anticipated change brought by programs related to Information and Communications Technology (ICT). This paper presents e-Health Readiness assessment tools developed for healthcare institutions in developing countries. The objectives of the overall study were to develop e-health readiness assessment tools for public and private healthcare institutions in developing countries, and to test these tools in Pakistan. Tools were developed using participatory action research to capture partners' opinions, reviewing existing tools, and developing a conceptual framework based on available literature on the determinants of access to ehealth. Separate tools were developed for managers and for healthcare providers to assess e-health readiness within their institutions. The tools for managers and healthcare providers contained 54 and 50 items, respectively. Each tool contained four categories of readiness. The items in each category were distributed into sections, which either represented a determinant of access to e-health, or an important aspect of planning. The conceptual framework, and the validity and reliability testing of these tools are presented in separate papers. e-Health readiness assessment tools for healthcare providers and managers have been developed for healthcare institutions in developing countries.

BackgroundThe effectiveness of mobile technology to improve medication adherence via customized Short Messaging Service (SMS) reminders for stroke has not been tested in resource poor areas. We designed a randomized controlled trial to test the effectiveness of SMS on improving medication adherence in stroke survivors in Pakistan.MethodsThis was a parallel group, assessor-blinded, randomized, controlled, superiority trial. Participants were centrally randomized in fixed block sizes. Adult participants on multiple medications with access to a cell phone and stroke at least 4 weeks from onset (Onset as defined by last seen normal) were eligible. The intervention group, in addition to usual care, received reminder SMS for 2 months that contained a) Personalized, prescription tailored daily medication reminder(s) b) Twice weekly health information SMS. The Health Belief Model and Social Cognitive theory were used to design the language and content of messages. Frontline SMS software was used for SMS delivery. Medication adherence was self-reported and measured on the validated Urdu version of Morisky Medication Adherence Questionnaire. Multiple linear regression was used to model the outcome against intervention and other covariates. Analysis was conducted by intention-to-treat principle.ResultsTwo hundred participants were enrolled. 38 participants were lost to follow-up. After 2 months, the mean medication score was 7.4 (95 % CI: 7.2–7.6) in the intervention group while 6.7 (95 % CI: 6.4–7.02) in the control group. The adjusted mean difference (Δ) was 0.54 (95 % CI: 0.22–0.85). The mean diastolic blood pressure in the intervention group was 2.6 mmHg (95 % CI; −5.5 to 0.15) lower compared to the usual care group.ConclusionA short intervention of customized SMS can improve medication adherence and effect stroke risk factors like diastolic blood pressure in stroke survivors with complex medication regimens living in resource poor areas.Trial registrationClinicaltrials.gov NCT01986023 last accessed at https://clinicaltrials.gov/ct2/show/NCT01986023Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-015-0471-5) contains supplementary material, which is available to authorized users.

No abstract

The framework helps understand various aspects of e-health programs and their impact that require evaluation at different stages of the life cycle. The study led to the development of a new and comprehensive e-health evaluation tool, named the Khoja-Durrani-Scott Framework for e-Health Evaluation.

No abstract

We conducted a systematic review of the literature on telehealth in Asia. The Medline database was searched, together with three specialist journals, for peer-reviewed articles published in the ten years to June 2007 which were related to any telehealth application involving one or more Asian country. Out of the 1504 abstracts retrieved, 109 articles were selected by two independent reviewers for the final review. The number of published articles on telehealth in Asia increased during the review period. The largest number of studies were conducted in Japan (37%). Most telehealth applications were based on the store-and-forward modality (43%), with 35% using videoconferencing and 15% using a hybrid approach. Most of the studies were descriptive (75%) and only eight included a control group against which telehealth was compared. The most common means of telecommunication was ISDN lines, which were employed in 32% of the studies. Some 40% of the studies mentioned improved quality of health care; about 20% mentioned improved access to health care. Although most studies mentioned cost, only 13 of them assessed resource utilization and cost. The overall findings gave a generally optimistic picture of telehealth in Asia. However, there is a lack of good quality studies.

Prolonged in vitro culture of human embryonic stem (hES) cells can result in chromosomal abnormalities believed to confer a selective advantage. This potential occurrence has crucial implications for the appropriate use of hES cells for research and therapeutic purposes. In view of this, time-point karyotypic evaluation to assess genetic stability is recommended as a necessary control test to be carried out during extensive ‘passaging’. Standard techniques currently used for the cytogenetic assessment of ES cells include G-banding and/or Fluorescence in situ Hybridization (FISH)-based protocols for karyotype analysis, including M-FISH and SKY. Critical for both banding and FISH techniques are the number and quality of metaphase spreads available for analysis at the microscope. Protocols for chromosome preparation from hES and human induced pluripotent stem (hiPS) cells published so far appear to differ considerably from one laboratory to another. Here we present an optimized technique, in which both the number and the quality of chromosome metaphase spreads were substantially improved when compared to current standard techniques for chromosome preparations. We believe our protocol represents a significant advancement in this line of work, and has the required attributes of simplicity and consistency to be widely accepted as a reference method for high quality, fast chromosomal analysis of human ES and iPS cells.

BackgroundeHealth is widely used as a tool for improving health care delivery and information. However, distinct policies and strategies are required for its proper implementation and integration at national and international levels.ObjectiveTo determine the scope of policy issues faced by individuals, institutions, or governments in implementing eHealth programs.MethodsWe conducted a structured review of both peer-reviewed and gray literature from 1998–2008. A Medline search for peer-reviewed articles found 40 papers focusing on different aspects of eHealth policy. In addition, a Google search found 20 national- and international-level policy papers and documents. We reviewed these articles to extract policy issues and solutions described at different levels of care.ResultsThe literature search found 99 policy issues related to eHealth. We grouped these issues under the following themes: (1) networked care, (2) interjurisdictional practice, (3) diffusion of eHealth/digital divide, (4) eHealth integration with existing systems, (5) response to new initiatives, (6) goal-setting for eHealth policy, (7) evaluation and research, (8) investment, and (9) ethics in eHealth.ConclusionsWe provide a list of policy issues that should be understood and addressed by policy makers at global, jurisdictional, and institutional levels, to facilitate smooth and reliable planning of eHealth programs.