Mapping national information and communication technology (ICT) infrastructure to the requirements of potential digital health interventions in low- and middle-income countries

Hui, Chi Yan; Abdulla, Adina; Ahmed, Z.; Goel, Himanshi; Habib, G M Monsur; Hock, Toh Teck; Khandakr, Parisa; Mahmood, Hana; Nautiyal, Animesh; Nurmansyah, Mulya; Panwar4, Rutuja Patil Shweta; Rinawan, Fedri Ruluwedrata; Salim, Hani; Satav, Ashish; Shah, Jitendra; Shukla, Akshita; Tanim, Chowdhury Zabir Hossain; Balharry, Dominique; Pinnock, Hilary; Group, the RESPIRE

doi:10.7189/jogh.12.04094

Cited by 12 publications

(5 citation statements)

References 68 publications

(71 reference statements)

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“…There are several challenges in delivering primary healthcare in India, from patients’ and providers’ sides alike [ 28 , 29 ]. Digital health interventions show potential for the management of primary healthcare, particularly in rural and health access-limited areas of LMICs, including India [ 30 ]. Digital health interventions in the form of text messages have been designed and delivered in rural India to reduce smoking [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Self-Management of Hypertension and Diabetes Using Patient-Generated Health Data Through M-health in Central India

Bali,

Pakhare

et al. 2024

Cureus

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Introduction: Digital health innovations are modern solutions for the management and treatment of diseases, particularly non-communicable diseases. This study was conducted to assess the feasibility of the management of diabetes and hypertension through patient-generated health data (PGHD). Methods: A mobile application (One Health) was used for the entry of data on blood pressure, blood glucose, physical activity, and dietary intake for six months by the patients. Frequency of application download, monthly data entry, and change in control of blood pressure and glycemic markers during six months of application use were used to assess the feasibility and impact of the application for the management of hypertension and type 2 diabetes mellitus (T2DM). Results: A higher proportion of patients entered data generated non-invasively (blood pressure) as compared to data generated via invasive techniques (glycemic control measures). The frequency of monthly data entry remained unchanged during One Health use. At the end of six months, control of hypertension and glycemic control was achieved in 53.3% and 33.9% of patients, respectively. Furthermore, there was a significant reduction of mean diastolic blood pressure (0.60 (±2.31); p=0.03) and glycosylated hemoglobin (0.657 (±1.808); p=0.04). Discussion: The acceptability of One Health appears to be associated with the frequency of data entry. The entry of health data by patients was sufficient to effect positive change in health indicators. Although mobile applications enable the monitoring and management of chronic health conditions, additional research shall help in optimizing interventions to be adopted as acceptable tools of patient management.

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Section: Discussionmentioning

confidence: 99%

Feasibility of Self-Management of Hypertension and Diabetes Using Patient-Generated Health Data Through M-health in Central India

Bali,

Pakhare

et al. 2024

Cureus

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“…Social technical factors such as the digital health policy in the local country, sufficient training/support for users to use the system, health information/information communication technology literacy, gender, age disparities, and digital divide also need to be considered for successful implementation. 67 , 68 …”

Section: Discussionmentioning

confidence: 99%

Assessing the technical feasibility of a flexible, integrated Internet-of-things connected for asthma (C4A) system to support self-management: a mixed method study exploring patients and healthcare professionals perspectives

et al. 2022

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Background A connected system with smart devices could transform patient care and empower patients control of their asthma. Objective To explore how a connected-for-asthma system (C4A) with smart devices from multiple companies (smart-inhaler; smart-watch; smart-peak-flow meter, manual digital thermometer during the Coronavirus disease (COVID)-pandemic) could support asthma self-management. Methods In a proof-of-concept mixed-methods study (Winter 2021/2022), we collected data from devices linked via the C4A app enabling patients to self-monitor and share a monitoring summary (in PDF format) with their clinician. Ten patients (range of age/gender, asthma experience, Apple/Android user) via social media, used C4A for a month. We conducted pre/post-interviews with patients, and a single post-interview with an asthma nurse and 3 general practitioners. Thematic analysis, informed by the Unified Theory of Acceptance and Use of Technology was triangulated with descriptive analysis of usage data. Results The system was perceived as “easy” to use. During the study, 7517 data points were collected from 10 patients; monitoring reduced over the month. Patients used devices if they trusted their “accuracy,” and adopted the system to monitor new medication or assess troublesome symptoms. One patient lost contact (because of COVID), 8 wanted to keep using C4A to manage their asthma, though were selective about the most useful devices. Clinicians wanted the report to provide an asthma score/status and reliever usage. Conclusion A connected system could enable flexible digital care by linking data from several devices to support self-management. To promote adoption/adherence, setup has to be simple, and patients need to trust that the devices accurately reflect their condition.

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“…To avoid this, patients are advised to conduct measurements in an area where they have a strong home wi-fi or mobile data signal. This can be a barrier in areas with low-resource availability, poor internet infrastructures or congestion because of high local demand [ 63 ▪ ]. Where signals are adequate, mobile data plans may be a backup solution for transferring patient data.…”

Section: Developing Digital Home Monitoring Technology and Infrastruc...mentioning

confidence: 99%

“…At a policy level, this not only means ensuring the technology infrastructure for reliable internet and mobile coverage but also resolving the current lack of clarity over funding streams and reimbursement for digital healthcare. In low-income and middle-income countries, unstable electricity supplies further compromise access [ 63 ▪ ], and gender imbalance in mobile ownership may disadvantage women [ 92 ]. Other barriers are lack of familiarity with technology, especially in the elderly and language barriers in ethnic minority groups [ 93 ].…”

Section: Societal Implications and Over-arching Principlesmentioning

confidence: 99%

Implementation of digital home monitoring and management of respiratory disease

Pinnock

Hui

Boven

2023

Current Opinion in Pulmonary Medicine

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Purpose of reviewDigital respiratory monitoring interventions (e.g. smart inhalers and digital spirometers) can improve clinical outcomes and/or organizational efficiency, and the focus is shifting to sustainable implementation as an approach to delivering respiratory care. This review considers key aspects of the technology infrastructure, discusses the regulatory, financial and policy context that influence implementation, and highlights the overarching societal themes of equity, trust and communication. Recent findingsTechnological requirements include developing interoperable and connected systems; establishing stable, wide internet coverage; addressing data accuracy and monitoring adherence; realising the potential of artificial intelligence; and avoiding clinician data overload. Policy challenges include concerns about quality assurance and increasingly complex regulatory systems. Financial barriers include lack of clarity over cost-effectiveness, budget impact and reimbursement. Societal concerns focus on the potential to increase inequities because of poor e-health literacy, deprivation or lack of available infrastructure, the need to understand the implications for patient/professional interactions of shifting care to remote delivery and ensuring confidentiality of personal data.

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Mapping national information and communication technology (ICT) infrastructure to the requirements of potential digital health interventions in low- and middle-income countries

Abstract: Mapping national information and communication technology (ICT) infrastructure to the requirements of potential digital health interventions in low-and middle-income countries. J Glob Health 2022;2:04094.

Cited by 12 publications

References 68 publications

Feasibility of Self-Management of Hypertension and Diabetes Using Patient-Generated Health Data Through M-health in Central India

Feasibility of Self-Management of Hypertension and Diabetes Using Patient-Generated Health Data Through M-health in Central India

Assessing the technical feasibility of a flexible, integrated Internet-of-things connected for asthma (C4A) system to support self-management: a mixed method study exploring patients and healthcare professionals perspectives

Implementation of digital home monitoring and management of respiratory disease

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