Strengthening Delivery of Health Services Using Digital Devices

Orton, Maeghan; Agarwal, Smisha; Muhoza, Pierre; Vasudevan, Lavanya; Vu, Alexander

doi:10.9745/ghsp-d-18-00229

Cited by 38 publications

(42 citation statements)

References 32 publications

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“…The complex nature of CRPS and its multifactorial presentation may instigate this more readily than in other pain and nonpain health conditions. It is conceivable that the increased use of digital technology as a means to accessing CRPS expertise and interdisciplinary support could provide wider access to clinical guidance for health professionals in low resource settings (Orton, Agarwal, Muhoza, Vasudevan, & Vu, ).…”

Section: Discussionmentioning

confidence: 99%

Complex regional pain syndrome: An international survey of clinical practice

Grieve

Llewellyn

Jones

et al. 2019

European Journal of Pain

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Background Published guidelines promote best practice in complex regional pain syndrome (CRPS) treatment and management; however, these recommendations are not always applied in clinical practice. Understanding existing care internationally will help inform future patient and health professional service delivery, education initiatives and content of clinical guidelines. Methods An e‐survey was conducted in order to gain an insight into routine CRPS clinical practice. Health professionals and academics, from the field of CRPS, were recruited from an international population. Quantitative and qualitative data were elicited. Data were mapped onto a framework to identify macro‐regional factors. Results Of the 260 survey respondents, 96% (n = 241) provided clinical care for people with CRPS, with academics not involved in patient care also responding. Half of respondents expressed difficulty in recognizing the symptoms of CRPS but treatment aims corresponded with published guidelines. However, a lack of resources and fragmented care were reported as barriers to early intervention. Service constraints were most frequently reported by European respondents. Five themes emerged from the qualitative data: the benefit of interdisciplinary working; the importance of symptom management; need for early diagnosis and intervention; establishing a collaborative partnership with patients; the value of education for patients and health professionals. Conclusions Our data suggest that more work is required to raise awareness of the Budapest CRPS diagnostic criteria so as to promote early diagnosis and intervention. Future work to optimize clinical effectiveness should consider enhancing interdisciplinary service delivery that encourages a collaborative patient/clinician partnership; includes excellent patient education; and addresses modifiable patient‐related factors. Significance Health professionals expressed some level of difficulty recognizing the signs and symptoms of CRPS despite the majority of health professionals having had clinical experience exceeding 6 years in the field of CRPS. More work is required to raise awareness amongst clinicians of the Budapest CRPS diagnostic criteria so as to promote early diagnosis and intervention Health professionals' treatment aims reflected the current clinical guidelines however, a lack of resources and fragmented care were frequently cited as barriers to achieving these.

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Section: Discussionmentioning

confidence: 99%

Complex regional pain syndrome: An international survey of clinical practice

Grieve

Llewellyn

Jones

et al. 2019

European Journal of Pain

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“…The WHO’s first guidelines on digital health states the term was introduced as ‘a broad umbrella term encompassing eHealth (which includes mHealth), as well as emerging areas, such as the use of advanced computing sciences in “big data,” genomics and artificial intelligence’ 1. Digital health examples include using mobile phones to help train community healthworkers,2 digital referrals3 and mobile clinical decision support systems 4. While digital health has seen a large and growing body of implementation research in LMICs, the ethical issues it raises have also motivated research interest, although to a lesser extent 5.…”

Section: Introductionmentioning

confidence: 99%

Prioritarian principles for digital health in low resource settings

et al. 2020

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This theoretical paper argues for prioritarianism as an ethical underpinning for digital health in contexts of extreme disadvantage. In support of this claim, the paper develops three prioritarian principles for making ethical decisions for digital health programme design, grounded in the normative position that the greater the need (of the marginalised), the stronger the moral claim. The principles are positioned as an alternative view to the prevailing utilitarian approach to digital health, which the paper argues is not sufficient to address the needs of the worst off. As researchers of digital health, we must ensure that the most globally marginalised are not overlooked by overtly technocentric implementation practices. Consequently, the paper concludes by advocating for use of the three principles to support stronger critical reflection on the ethics involved in the design and implementation of digital health programmes.

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“…For example, the government invested in educating the workforce involved in telemedicine services during this time [54]. A systematic review on strengthening health services using ICT found it strategic to invest in human resources to implement and support telemedicine [83].…”

Section: Plos Onementioning

confidence: 99%

Three decades of telemedicine in Brazil: Mapping the regulatory framework from 1990 to 2018

Silva

Ribeiro

et al. 2020

PLoS ONE

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This study characterized the evolution of Brazilian public telemedicine policy in the Brazilian Unified Health System for 30 years from 1988 to 2019 by analyzing its legal framework. We identified 79 telemedicine-related legislations from the federal government (laws, decrees, and ordinances) and 31 regulations of federal councils of health professionals. Three historical phases were established according to the public policy cycle, and material was classified according to the purpose of the normative documents. The content analysis was based on the advocacy coalition framework model. Of the federal legislations, 8.9% were for the Formulation/Decision-Making phase, 43% for the Organization/Implementation phase, and 48.1% for the Expansion/Maturation phase of telemedicine policy in Brazil. The Federal Council of Medicine was the most active in standardizing telemedicine and was responsible for 21 (67.7%) regulations. The first legislations were passed in 2000; however, the coalitions discussed topics related to telemedicine and created their belief systems from the 1990’s. The time cycle which included formulation and decision making for Brazilian telemedicine policy, extended until 2007 with the creation of several technical working groups. The expansion and maturation of telemedicine services began in 2011 with the decentralization of telemedicine policy actions across the country. Telemedicine centers which performed telediagnosis influenced the computerization of primary health care units. We conclude that Brazilian telemedicine field has greatly grown and changed in recent years. However, despite the proliferation of legislations and regulations in the period studied, there is still no fully consolidated process for setting up a wholly defined regulatory framework for telemedicine in Brazil.

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Strengthening Delivery of Health Services Using Digital Devices

Cited by 38 publications

References 32 publications

Complex regional pain syndrome: An international survey of clinical practice

Complex regional pain syndrome: An international survey of clinical practice

Prioritarian principles for digital health in low resource settings

Three decades of telemedicine in Brazil: Mapping the regulatory framework from 1990 to 2018

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