Information Management for the Assistive Technology Provision in Community: Perspectives of Local Policymakers and Health Service Providers

Abstract

Background Assistive technology (AT) is a way to enhance the performance of daily activities in people with disabilities and help them live more independently. However, an important problem in providing AT lies in the effectiveness of information management. Local policymakers and health service providers have become aware of this problem and their perspectives are the key to solving it. Methods This study explored the types of AT provided for people with disabilities in the community and the perspectives on information management of local policymakers and health service providers. A survey checklist and semistructured in-depth interview were the instruments of this study. The key informants in this study included administrators, nurses, and physical therapists from four community areas in Chiang Mai, Thailand. Results The medical records showed that the types of AT provided were mostly second-hand (57.24%) and borrowed devices (57.73%). All of them were low-tech devices (crutch, cane, walker, wheelchair, and adaptive tricycle). In addition, the results indicated three perspective aspects related to information management: (1) problems in the database recording system, (2) different policies and processes of information management, and (3) improvement of the AT provision system. Conclusion The perspectives of local policymakers and health service providers indicated related problems, impacts of policies, and ways to improve the AT provision system by applying information technology.

The Policies of Provision of Assistive and Welfare Technology—A Literature Review

“…The policy domain covers the existence and aspects of a national policy on AT/WT [14]. Seven of the reviewed articles [12,[17][18][19][20][21][22] have policy content. The overarching and common finding regarding AT/WT policies is that they constitute a complex area without guidance.…”

“…Organisational aspects are complex due to different organisations and local systems. Lersilp et al [20] classify three main related organisations providing AT/WT: local community hospitals, district hospitals and sub-district municipalities. These organisations have different local policies under different provincial health offices, and even if persons with disabilities have legal rights, there are still limitations due to government budgets.…”

“…These organisations have different local policies under different provincial health offices, and even if persons with disabilities have legal rights, there are still limitations due to government budgets. Although there is a related regulation and an AT/WT provision system, many types of AT/WT products are not used by the patients/clients, and some are not even received in the patients' homes [20]. The connection among policy, strategy and action plans should be flexible at two levels-operationally (functions are performed), as well as locally and regionally-ensuring effective mechanisms for national policies to successfully work in often quite different subnational contexts.…”

“…The connection among policy, strategy and action plans should be flexible at two levels-operationally (functions are performed), as well as locally and regionally-ensuring effective mechanisms for national policies to successfully work in often quite different subnational contexts. This means that the same services are delivered in somewhat different ways and perhaps by different organisations, groups or individuals in different places [20,21].…”

“…The findings in the literature also reveal specialised AT/WT centres for quality assurance, improved provision, security, lending/recycling, efficiency and equality processes. Such centres can provide services to municipalities, flexible teleservices and similar technological support [17][18][19][20]22]. A long-term process increases the quality of assessment, the provision of products, evaluation and support at both individual and broader levels [19,22].…”