Experience of using mHealth to link village doctors with physicians: lessons from Chakaria, Bangladesh

Abstract

BackgroundBangladesh is facing serious shortage of trained health professionals. In the pluralistic healthcare system of Bangladesh, formal health care providers constitute only 5 % of the total workforce; the rest are informal health care providers. Information Communication Technologies (ICTs) are increasingly seen as a powerful tool for linking the community with formal healthcare providers. Our study assesses an intervention that linked village doctors (a cadre of informal health care providers practising modern medicine) to formal doctors through call centres from the perspective of the village doctors who participated in the intervention.MethodsThe study was conducted in Chakaria, a remote rural area in south-eastern Bangladesh during April–May 2013. Twelve village doctors were selected purposively from a pool of 55 village doctors who participated in the mobile health (mHealth) intervention. In depth interviews were conducted to collect data. The data were manually analysed using themes that emerged.ResultThe village doctors talked about both business benefits (access to formal doctors, getting support for decision making, and being entitled to call trained doctors) and personal benefits (both financial and non-financial). Some of the major barriers mentioned were technical problems related to accessing the call centre, charging consultation fees, and unfamiliarity with the call centre physicians.ConclusionVillage doctors saw many benefits to having a business relationship with the trained doctors that the mHealth intervention provided. mHealth through call centres has the potential to ensure consultation services to populations through existing informal healthcare providers in settings with a shortage of qualified healthcare providers.

Why aren't physicians prescribing more buprenorphine?

“…A second approach is use of telemedicine or teleconsultation to link inexperienced providers with mentors to help navigate buprenorphine OMT procedures. These approaches are becoming more widely used in general medicine (Biery, Bond, Smith, LeClair, & Foster, 2015; Eaton et al, 2015; Gillis, 2015; Khan et al, 2015; Marcolino, Pereira Afonso Dos Santos, Santos Neves, & Alkmim, 2015), have been associated with reductions in medical errors or referrals to formal treatments (Campanella et al, 2015), and have particular value for remote or rural areas (Saurman, Lyle, Perkins, & Roberts, 2014) for which research has indicated there is a dearth of available opioid treatment options (Blum et al, 2016; Cunningham et al, 2007; Jones et al, 2015; Knudsen et al, 2005; Knudsen, 2015). The Physician Clinical Support System-Buprenorphine(PCSS-B) is a federally funded program that is already in place to pair newly waivered physicians with an experienced provider usually via telephone or email, but possibly with in-person meetings as well (Egan et al, 2010).…”

Mobile phone use among female entertainment workers in Cambodia: an observation study

“…mHealth, or mobile health, projects have shown to be increasingly successful in developing countries. Collecting health data (8)(9)(10), increasing access to health knowledge (11)(12)(13)(14), promoting provider quality (15)(16)(17), and increasing medication/appointment adherence (18)(19)(20) are a few ways in which mobile phones have successfully been used in developing countries to support health. In addition, rigorous evaluations have demonstrated mobile phone messages to be successful in supporting preventative healthcare (8,14,18,21,22) such as chronic disease prevention in Seychelles (23).…”

Bring-your-own-device in medical schools and healthcare facilities: A review of the literature (Preprint)

“…That is, the BYOD policy should cater for other mobile device uses such as diagnosis [45,[57][58][59][60][61], patient monitoring, follow-up [46,[62][63][64][65][66], data collection [43,46,51,67], and medication adherence [68,69]. Integration of mobile devices into hospital systems, especially patient record management [70], including patient participation in computerized patient record management [71], is also worth policy consideration.…”