Context: e-Health programs are implemented assuming that e-health/digital health can prove beneficial but pieces of evidence for assessing the actual benefits of e-health programs are lacking. Aims: To utilize the benefit evaluation (BE) framework to assess Asha Soft, which is an online payment and performance monitoring system initiative taken by Rajasthan. Settings and Design: BE of Asha Soft in Rajasthan. Methods and Materials: BE of ASHA Soft was done using scoping review with consultation exercise. The rationale behind using this methodological framework is to contextualize knowledge of the current state of understanding within BE framework practice contexts. The themes used for data compilation and analysis were based on three broad dimensions of BE framework namely, health information technology quality, use, and net benefits. Results: The state of Rajasthan has been the first in the country to start an online system of payment and monitoring of ASHA workers, through Asha Soft. It has administrative and supportive functions. Its simple and easy to use graphical user interference helps users to make accurate data entries and obtain desired monitoring and analytical reports. It has attributed to the availability of data on various parameters which help decision-maker to decide about the performance of ASHA worker and has brought a positive impact on the work performance of ASHAs. This online payment and monitoring mechanism has argumented motivational level and intention of use. The program has optimally utilized available human resources and no apparent monetary cost was involved in developing this software. Conclusions: This scoping study using the BE framework has provided evidence on the potential benefits of Asha Soft adoption in Rajasthan. It is recommended that future in-depth assessment of other e-health initiatives could be undertaken to guide the decision making.
Context: In India, COVID-19 pandemic has limited the utilization and access to dental services owing to the risk of infections transmission. In this context, tele-dentistry could be useful but there is paucity of literature which provides guidance on the scope and challenges for using tele-dentistry in India. Aims: To identify challenges, scope and assessment approaches of tele-dentistry from an Indian perspective. Settings and Design: Scoping Review. Methods and Material: Scoping review was conducted using the Arksey and O’Malley framework. Databases were searched in July from April to August 2020. Studies concerning challenges and scope of tele-dentistry in India were included. Additionally, literature about assessment approaches used for tele-dentistry programs were also reviewed Results: A total of 64 studies were reviewed, out of which 26 articles were included in the final review. Scoping review reveled that tele-dentistry can act as a seamless tool for diagnosing, training and screening. Few studies suggested the relevance of smartphone technology for specialist consultations and proper diagnosis. Majority of studies revealed shortage of basic infrastructure as a major challenge for tele-dentistry in India. Assessment studies were mainly focused on economic perspective and cost-effectiveness of the programs. Conclusions: This review provide guidance for using tele-dentistry in India. It is also reflected that there is a need for further research about the assessment of tele-dentistry in terms of safety, clinical outcomes, and patient perception.
Background: Government of Rajasthan has undertaken a series of e-Health initiatives, especially under various programs of National Health Mission in the past few years. There is a paucity of studies which document and provide appraisal of these initiatives in Rajasthan. Aim: To document ongoing e-Health Initiatives based on technologies and approaches used, coverage by the region and population, services provided and scope. Materials and Methods: Primary data collection in form of key-informant interviews while secondary data collection in form of internet-based search of peer and non-peer reviewed literature was conducted to achieve the study objectives. Appropriate documents, records, and reports were reviewed to ensure that all necessary information was obtained. Results: A total of 13 e-Health initiatives were included in the study. The e-Health programs were classified with the use of WHO's classification of Digital Health Interventions v1.0. Most of the initiatives perceived in the study were found to be beneficial to the community, covering the entire population targeted. Supporting agencies, technologies used, and challenges faced during the implementation were identified and documented. Lack of trained manpower, technical and software glitches and deficiency of awareness activities were few obstacles that were found consistent across all user groups. Conclusions: The overview from this study augmented the knowledge about further scopes and sustainability of these initiatives. Deploying dedicated professionals may improve the functioning of these initiatives. Since e-Health interventions significantly influence healthcare systems, further scale-up of such studies with appropriate evaluation should be planned to guide policy decisions.
IntroductionTo establish a centralized inventory management system for the efficient functioning of all healthcare facilities, e-Upkaran (equipment management and maintenance system) was launched in 2015 in the state of Rajasthan. This study is conducted to assess the functioning of e-Upkaran in Rajasthan. MethodsThe assessment of the e-Upkaran system for primary and secondary healthcare centers was carried out using a systematic review of the literature and a multi-indicator stakeholder questionnaire. The benefits evaluation framework focused on the system quality, information and service quality, use and user satisfaction, and net benefits utilized for the assessment. A review of the literature was done to highlight the importance of computerized medical equipment management and maintenance systems and appraise the challenges and benefits associated with such systems as compared to the traditional pen-paper register. Information was gathered based on available documents, field observation, and data obtained from specific hospital staff, including the bioengineers and other users of e-Upkaran. ResultsThe finding of this study suggests that e-Upkaran efficiently improves documentation, reporting, maintenance, and management of medical equipment. It is more efficient than the traditional paper-pen system. It is designed to minimize downtime and maintain equipment in good operating condition and has potential benefits in terms of improving information quality, use, and net benefit. The cost of service ratio is within the benchmark value. This system has also considerably reduced out-of-pocket expenditure. Computer proficiency and the workload of other e-health programs pose a challenge in the implementation of this program. ConclusionThe e-Upkaran system is competent in terms of improving information quality, use, and net benefit. Other Indian states could also adopt this system to improve their biomedical equipment management and maintenance system.
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