eHealth policy framework in Low and Lower Middle-Income Countries; a PRISMA systematic review and analysis

Abstract

Background Low and lower middle-income countries suffer lack of healthcare providers and proper workforce education programs, a greater spread of illnesses, poor surveillance, efficient management, etc., which are addressable by a central policy framework implementation. Accordingly, an eHealth policy framework is required specifically for these countries to successfully implement eHealth solutions. This study explores existing frameworks and fills the gap by proposing an eHealth policy framework in the context of developing countries. Methods This PRISMA-based (PRISMA Preferred Reporting Items For Systematic Reviews and Meta-Analyses) systematic review used Google Scholar, IEEE, Web of Science, and PubMed latest on 23rd May 2022, explored 83 publications regarding eHealth policy frameworks, and extracted 11 publications scrutinizing eHealth policy frameworks in their title, abstract, or keywords. These publications were analyzed by using both expert opinion and Rstudio programming tools. They were explored based on their developing/developed countries’ context, research approach, main contribution, constructs/dimensions of the framework, and related categories. In addition, by using cloudword and latent semantic space techniques, the most discussed concepts and targeted keywords were explored and a correlation test was conducted to depict the important concepts mentioned in the related literature and extract their relation with the targeted keywords in the interest of this study. Results Most of these publications do not develop or synthesize new frameworks for eHealth policy implementation, but rather introduce eHealth implementation frameworks, explain policy dimensions, identify and extract relevant components of existing frameworks or point out legal or other relevant eHealth implementation issues. Conclusion After a thorough exploration of related literature, this study identified the main factors affecting an effective eHealth policy framework, found a gap in the context of developing countries, and proposed a four-step eHealth policy implementation guideline for successful implementation of eHealth in the context of developing. The limitation of this study is the lack of a proper amount of practically implemented eHealth policy framework cases in developing countries published in the literature for the review. Ultimately, this study is part of the BETTEReHEALTH (More information about the BETTEReHEALTH project at https://betterehealth.eu) project funded by the European Union Horizon’s 2020 under agreement number 101017450.

The impact of county-level factors on meaningful use of electronic health records (EHRs) among primary care providers

“…Meaningful use of EHRs requires EHR capabilities that include, among other things, patient portals, patient-monitoring system, and computerized provider order entry (CPOE) as discussed earlier. Leveraging advanced use, EHRs hold great promise to improve poor health outcomes and health equity [ 9 , 10 , 71 ]. The Medicaid Promoting Interoperability Program has greatly contributed to the uptake of technology in clinical care practices in the U.S., as nearly 9 out of 10 offices have adopted a basic EHR system [ 10 ].…”

“…In Florida specifically the majority of Medicaid providers do not use the EHR system to their full capabilities [ 30 ]. Our study provides critical insights into the structural barriers (regional, local, economic, and resource-related issues) that hinder the optimal diffusion of health IT for low-resourced providers [ 71 ].…”

Energy Efficient Real-Time E-Healthcare System Based on Fog Computing

“…It also tried to avoid the drawbacks of cloud computing, particularly the lack of security and privacy, by introducing an innovative security framework based on chain ontology. Also, in Mengiste et al [40], researchers have pointed out the reasons for the inefficiency of e-health models published in several works. Their study identified the key elements influencing an efficient e-health policy framework and discovered a gap in the context of developing nations, and proposed a fourstep e-health policy implementation guideline for effective e-health implementation in the context of developing countries.…”

Digital Health Interventions for Promoting Healthy Aging: A Systematic Review of Adoption Patterns, Efficacy, and User Experience

“…This review reveals that while the adoption of digital health technologies has gradually increased among older adults, uptake remains varied across demographic groups and intervention types. Facilitators like perceived usefulness, social influences, and ease of use can promote adoption [50,71,72]. However, barriers spanning technological challenges, limited accessibility, lack of awareness, and concerns over privacy and trust persist, especially among disadvantaged groups [73][74][75].…”

“…Managerial support, training, and workflows integrating technologies into routine care are key facilitators [71]. Global policy frameworks also emphasize the need for coordinated deployment and capacity building for eHealth [72].…”