Global eHealth capacity: secondary analysis of WHO data on eHealth and implications for kidney care delivery in low-resource settings

Abstract

ObjectiveTo describe the use of electronic health (eHealth) in support of health coverage for kidney care across International Society of Nephrology (ISN) regions.DesignSecondary analysis of WHO survey on eHealth as well as use of data from the World Bank, and Internet World Stats on global eHealth services.SettingA web-based survey on the use of eHealth in support of universal health coverage.Participants125 WHO member states provided response.Primary outcome measuresAvailability of eHealth services (eg, electronic health records, telehealth, etc) and governance frameworks (policies) for kidney care across ISN regions.ResultsThe survey conducted by the WHO received responses from 125 (64.4%) member states, representing 4.4 billion people globally. The number of mobile cellular subscriptions was <100% of the population in Africa, South Asia, North America and North East Asia; the percentage of internet users increased from 2015 to 2020 in all regions. Western Europe had the highest percentage of internet users in all the periods: 2015 (82.0%), 2019 (90.7%) and 2020 (93.9%); Africa had the least: 9.8%, 21.8% and 31.4%, respectively. The North East Asia region had the highest availability of national electronic health record system (75%) and electronic learning access in medical schools (100%), with the lowest in Africa (27% and 39%, respectively). Policies concerning governance aspects of eHealth (eg, privacy, liability, data sharing) were more widely available in high-income countries (55%–93%) than in low-income countries (0%–47%), while access to mobile health for treatment adherence was more available in low-income countries (21%) than in high-income countries (7%).ConclusionThe penetration of eHealth services across ISN regions is suboptimal, particularly in low-income countries. Increasing utilisation of internet communication technologies provides an opportunity to improve access to kidney education and care globally, especially in low-income countries.

Digital health experiences reported in chronic disease management: An umbrella review of qualitative studies

“…It is possible there has not been as many digital health interventions for chronic disease implemented in low-income countries. 57 However, we would hypothesise that the unique experiences synthesised in this review would differ from those exclusively represented in low-income countries. 58 Fourth, despite a wide variety of digital health interventions represented in our review, our results (as well as the reviews we analysed) were aggregated thematic syntheses of these, reporting perspectives on digital health tools in general.…”

Telemonitoring in hypertension management for patients with chronic kidney disease: a narrative review

“…Structural barriers [106,107] to the use of telemonitoring include lack of adequate infrastructures (cellular network, WiFi connectivity), the need for simple and user-friendly devices, possibly integrated into mobile phones, tablets, or home appliances, and the need to ensure data integrity, security, and privacy. Despite the structural barriers, the use of telehealth services has significantly increased, especially during and following the COVID-19 pandemic [110,111] . Moreover, a recent study has shown increasing use of eHealth services worldwide, albeit still reduced in low-and lower-middle-income countries [112] .…”