Health workers’ perceptions and experiences of using mHealth technologies to deliver primary healthcare services: a qualitative evidence synthesis

Odendaal, Willem; Watkins, Jocelyn Anstey; Leon, Natalie; Goudge, Jane; Griffiths, Frances; Tomlinson, Mark; Daniels, Karen

doi:10.1002/14651858.cd011942.pub2

Cited by 228 publications

(275 citation statements)

References 255 publications

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“…Similar to other studies completed in LMIC, this study also identified some cultural barriers and beliefs that might limit progression of technology use in LMIC, including stigma [17]. Additionally, the findings of this study mirror other mhealth studies in LMIC that highlight the importance of user perception as related to acceptability, providing training for users, ensuring low costs, and improving trust among users to support adoption and sustainable implementation [18,19]. As found in similar studies, the complex relationship among use and degree of technology, contextual factors, human factors, and the broader operational ecosystem are substantial matters to cohesively incorporate in order to achieve sustainability of telehealth in CBR settings in Jordan [18,20,21].…”

Section: Discussionsupporting

confidence: 80%

Sustainable support solutions for community-based rehabilitation workers in refugee camps: piloting telehealth acceptability and implementation

et al. 2020

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Background The lack of training and education of Community-Based Rehabilitation (CBR) workers poses one of the most significant barriers to receiving effective occupational, physical and speech therapy for individuals with disabilities in Low-to-Middle Income Countries (LMIC), especially in countries with significant refugee populations. The aim of this study was to successfully implement a telehealth support system for CBR workers, evaluate the feasibility and acceptability of this intervention’s implementation among CBR workers in the CBR setting, and further identify strategies to address the deficit of skilled rehabilitation workers in LMIC through technological intervention. Methods This pilot study included CBR workers and CBR managers to inform feasibility, acceptability, and sustainable implementation. The RE-AIM and Dynamic Sustainability Framework were incorporated to guide procedural design, survey development, data collection, data evaluation, and increase success of telehealth implementation. CBR workers participate in trainings, telehealth sessions, surveys and focus groups to inform feasibility and acceptability. CBR Managers participated in focus groups to inform feasibility and sustainable implementation. NVIVO 12 Software was utilized to develop themes from CBR worker and CBR manager responses. Results Findings from this study demonstrate the need for additional training support for CBR workers in CBR settings throughout the entire treatment process. The telehealth system demonstrated successful short-term implementation across several domains of feasibility. Telehealth utilization was also proven acceptable, appropriate and necessary. Cultural beliefs, CBR worker training, and CBR Center infrastructure pose the most significant barriers to implementation of telehealth technologies in CBR Centers. CBR workers and managers confirmed the demand for future telehealth-based support systems, strengthening effort towards sustainability and scale-up. Conclusions Telehealth can be utilized to support CBR workers that serve vulnerable and marginalized populations, and in turn improve the global health status among refugee populations by reducing inequitable access to quality health care. The results support the need for further research to rigorously evaluate effectiveness of telehealth interventions to support CBR workers.

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Section: Discussionsupporting

confidence: 80%

Sustainable support solutions for community-based rehabilitation workers in refugee camps: piloting telehealth acceptability and implementation

et al. 2020

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“…Our findings are consistent with a Cochrane review concluding that health workers felt that two-way text-based communication can facilitate the patient-provider relationship, but that specific situations still warrant face-to-face consultations. 13 …”

Section: Discussionmentioning

confidence: 99%

“…Such communication has been studied in the context of specific diseases 10–12 or mobile phone text messaging without an adapted platform software. 13 …”

Section: Introductionmentioning

confidence: 99%

Experiences of digital communication with automated patient interviews and asynchronous chat in Swedish primary care: a qualitative study

et al. 2020

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ObjectivesTo explore staff experiences of working with a digital communication platform implemented throughout several primary healthcare centres in Sweden.DesignA descriptive qualitative approach using focus group interviews. Qualitative content analysis was used to code, categorise and thematise data.SettingPrimary healthcare centres across Sweden, in both rural and urban settings.ParticipantsA total of three mixed focus groups, comprising 19 general practitioners and nurses with experience using a specific digital communication platform.ResultsFive categories emerged: ‘Fears and Benefits of Digital Communication’, ‘Altered Practice Workflow’, ‘Accepting the Digital Society’, ‘Safe and Secure for Patients’ and ‘Doesn't Suit Everyone and Everything’. These were abstracted into two comprehensive themes: ‘Adjusting to a novel medium of communication’ and ‘Digitally filtered primary care’, describing how staff experienced integrating the software as a useful tool for certain clinical contexts while managing the communication challenges associated with written communication.ConclusionsFamily medicine staff were ambivalent concerning the use of digital communication but, after a period of adjustment, it was seen as a useful communication tool especially when combined with continuity of care. Staff acknowledged limitations regarding use by inappropriate patient populations, information overload and misinterpretation of text by both staff and patients.

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“…The survey instruments were designed to address the experiences and challenges that other health workers reported during the implementation of past digital health interventions in LMICs. 15,18,19 Statistical analysis. Descriptive analysis was done by calculating frequencies (categorical variables) and median with its interquartile range (continues variables).…”

Section: Methodsmentioning

confidence: 99%

Implementing a socio-technical system for computer-aided tuberculosis diagnosis in Peru: A field trial among health professionals in resource-constraint settings

Ugarte-Gil

Icochea²,

Otero

et al. 2020

Health Informatics J

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A major challenge of tuberculosis diagnosis is the lack of universal accessibility to bacteriological confirmation. Computer-aided diagnostic interventions have been developed to address this gap and their successful implementation depends on many health systems factors. A socio-technical system to implement a computer-aided diagnostic tuberculosis diagnosis was preliminary tested in five primary health centers located in Lima, Peru. We recruited nurses (n = 7) and tuberculosis physicians (n = 5) from these health centers to participate in a field trial of an mHealth tool (eRx X-ray diagnostic app). From September 2018 to February 2019, the nurses uploaded images of chest X-rays using smartphones and the physicians reviewed those images on web-based platforms using tablets. Both completed weekly written feedback about their experience. Each nurse participated for a median duration of 12 weeks (interquartile range = 7.5–15.5), but image upload was only possible at a median of 58 percent (interquartile range = 35.1%–84.4%) of those weeks. Each physician participated for a median duration of 17 weeks (interquartile range = 12–17), but X-ray image review was only possible at a median of 52 percent (interquartile range = 49.7%–57.4%) of those weeks. Heavy workload was most frequently provided as the reason for missing data. Several infrastructural and technological challenges impaired the effective implementation of the mHealth tool, irrespective of its diagnostic accuracy.

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Health workers’ perceptions and experiences of using mHealth technologies to deliver primary healthcare services: a qualitative evidence synthesis

Abstract: Health workers' perceptions and experiences of using mHealth technologies to deliver primary healthcare services: a qualitative evidence synthesis.

Cited by 228 publications

References 255 publications

Sustainable support solutions for community-based rehabilitation workers in refugee camps: piloting telehealth acceptability and implementation

Sustainable support solutions for community-based rehabilitation workers in refugee camps: piloting telehealth acceptability and implementation

Experiences of digital communication with automated patient interviews and asynchronous chat in Swedish primary care: a qualitative study

Implementing a socio-technical system for computer-aided tuberculosis diagnosis in Peru: A field trial among health professionals in resource-constraint settings

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