Overview of e-Health initiatives in Rajasthan

Abstract

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.

Facilitators and Barriers for Telemedicine Systems in India from Multiple Stakeholder Perspectives and Settings

“…The unavailability of reliable internet connectivity and hardware infrastructure was reported as a critical barrier to telemedicine adoption in primary healthcare systems and all modes of real-time delivery 26,30,31,47,49,50,52,58,61,65 . The concerns with internet quality (e.g., slow speeds, poor connectivity, and high costs) have been highlighted in the literature as a continuing challenge for the operation of telemedicine systems.…”

“…Additionally, we also identified the lack of training and awareness regarding the usage of telemedicine and the associated equipment among patients and providers as a significant barrier to the adoption of telemedicine systems in primary and secondary healthcare 26,30,31,36,44,45,49,56,58,61,65 . This may probably be due to the limited dissemination of information regarding telemedicine through workshops, conferences, seminars, and other platforms.…”

“…According to some doctors, this poor technological literacy creates resistance to adopting change 43,58 and poses a critical barrier to the acceptance and development of telemedicine. Meanwhile, some studies identified resistance to telemedicine implementation by doctors and patients as a cultural barrier 11,19,30,31,36,44,49,58 . The end-user resistance to telemedicine could at least partially be attributed to their lack of technology-related knowledge, expertise, and experience, which can also affect their perceptions and willingness to adopt telemedicine.…”

“…Furthermore, some studies have also reported the lack of business and/or financial models to integrate telemedicine into the existing healthcare system as a critical barrier to adopting telemedicine systems at this level 49,58,64,67 . Nevertheless, this study 43 reported another interesting finding from the survey of government and public hospital doctors in North India about doctors' belief that other risks, such as privacy and security risk, social risk, and technological risk, far outweigh the financial risk.…”

“…The cost of telemedicine systems is reported as one of the significant facilitators and barriers from all perspectives. 59% of the articles reported reduction in costs as one of the significant facilitators of telemedicine adoption, especially in primary and tertiary healthcare systems, as telemedicine saves time, travel, and the related costs when an in-person consultation is not warranted 11,16,26,27,30,31,46,49,[51][52][53][54][55][56][57][58]61,62,64 .…”