In eHealth in India today, the nature of work, the challenges and the finances: an interview-based study

Abstract

BackgroundIndia is a country with vast unmet medical needs. eHealth has the potential to improve the quality of health care and reach the unreached. We have sought to understand the kinds of eHealth programmes being offered in India today, the challenges they face and the nature of their financing.MethodsWe have adopted an interview-based methodology. The 30 interviews represent 28 organizations, and include designers, implementers, evaluators and technology providers for eHealth programmes.ResultsA range of programmes is being run, including point-of-care in rural and urban areas, treatment compliance, data collection and disease surveillance, and distant medical education. Most programmes provide point-of-care to patients or other beneficiaries in rural areas. Technology is not a limiting factor but the unavailability of suitable health personnel is a major challenge, especially in rural areas. We have identified a few factors that help this situation. Financial sustainability is also a concern for most programmes, which have rarely been scaled up. There are recent for-profit efforts in urban areas, but no reliable business model has been identified yet. Government facilities have not been very effective in eHealth on their own, but collaborations between the government and non-profit (in particular) and for-profit organisations have led to impactful programmes.ConclusionsIt is unlikely that eHealth will have widespread and sustainable impact without government involvement, especially in rural areas. Nevertheless, programmes run solely by the government are unlikely to be the most effective.

Factors affecting sustainable adoption of e-health technology in developing countries: an exploratory survey of Nigerian hospitals from the perspective of healthcare professionals

“…This findings corresponds to those published in other studies. For example, Qureshi et al (2013), Hoque, Mazmum & Bao (2014) and Jaroslawski & Saberwal (2014) identified some challenges affecting the adoption and utilization of ICT tools in hospitals, which include poor user acceptance, lack of infrastructure, financial constraints, lack of computer literacy, and organizational policies.…”

Use of information and communication technology and retention of health workers in rural post-war conflict Northern Uganda: findings from a qualitative study

“…The results of our study appear to indicate that investing in health centres’ ICT might prove to be one very important avenue for boosting retention of health workers in rural areas. In order for ICT to influence retention positively, there is need to train health workers [32]. Further, increasing the presence of ICT in rural health centres will likely improve retention and availability of health workers in rural areas including those in rural post-war conflict situations.…”

“…These current barriers need to be addressed directly by making ICT intervention one of the priority strategies in the plan for the reconstruction of post-war conflict situations. Massive training and investment in ICT facilities by government and other development partners based on the needs of health workers should be considered as a priority [32]. If ICT is to improve health workers’ retention as aforementioned, then the elimination of the identified barriers should be one of the immediate steps to take in encouraging or fostering retention of health workers in rural areas.…”

A systematic review of reviews to identify key research opportunities within the field of eHealth implementation

“…the government [33] indirectly affect the quality of service that healthcare providers can provide to their patients. A further problem, agreeing on reimbursement [24], can be a challenge for new technologies especially as they are of unproven value [7] as well as when some technologies are initially viewed as too expensive to integrate into everyday clinical practice [31]. The literature, therefore highlights the need to improve cost-effectiveness and avoid initiatives, which are considered as wasteful [32].…”