Telemedicine in Camp Mode While Screening for Noncommunicable Diseases: A Preliminary Report from India

Ganapathy, Krishnan; Nukala, Lovakanth; Premanand, Satgunam; Tamilmaran, Purushothaman; Aggarwal, Preeti; Saksena, Shalini; BrindhaDevi, Sulur Pechimuthu

doi:10.1089/tmj.2018.0300

Cited by 9 publications

(6 citation statements)

References 18 publications

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“…Ganapathy et al, 2019 [ 51 ] Tele-emergency services → remote hospitals VC, S&F Kaza/Keylong, Northern India 3 S 18. Ganapathy et al, 2020 (online in 2019) [ 52 ] Teleconsultations, screening services for noncommunicable diseases → regional areas VC, S&F Six regions in India 5 S 19. Hines et al, 2015 [ 53 ] Tele-speech pathology → rural schools VC Sydney, Australia 4 S 20.…”

Section: Methodsmentioning

confidence: 99%

“…Training was normally delivered during the implementation of telemedicine to ensure maximum utility [50,56,78]. Training included how to use and troubleshoot equipment [46,49] and how to perform consultations through the technology [52,80]. Ongoing training and regular site checks were required to maintain telemedicine programs, especially in facilities with high staff turnover [41,53,67].…”

Section: Phase 2 Managing Change -Operational Practicesmentioning

confidence: 99%

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A systematic scoping review of change management practices used for telemedicine service implementations

Kho

Gillespie

Martin‐Khan

2020

BMC Health Serv Res

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Background: Telemedicine improves access to health care services enabling remote care diagnosis and treatment of patients at a distance. However, the implementation of telemedicine services often pose challenges stemming from the lack of attention to change management (CM). Health care practitioners and researchers agree that successful telemedicine services require significant organizational and practice change. Despite recognizing the importance of the "people-side" of implementation, research on what constitutes best practice CM strategies for telemedicine implementations remains fragmented, offering little cohesive insight into the specific practices involved in the change process. We conducted a systematic scoping review of the literature to examine what and how CM practices have been applied to telemedicine service implementation, spanning a variety of health care areas and countries. Methods: Three bibliographic databases (CINAHL, PubMed, and ISI Web of Science) and four specialist telehealth journals were searched. To keep the review manageable and relevant to contemporary telemedicine technologies and contexts, the search was limited to articles published from 2008 to 2019. Forty-eight articles were selected for inclusion. Results: From the 48 articles, 16 CM practices were identified relating to either strategic or operational aspects of telemedicine implementations. We identify the key CM practices that are recognized in the broader CM literature as essential for successful and sustained change but are not commonly reported in telemedicine implementation studies. We draw on the CM literature to provide a comprehensive process-based, researched-informed, organizing framework to guide future telemedicine service implementations and research. Conclusions: Our findings suggest that the slow rate of adoption of telemedicine may be due to a piecemeal approach to the change process, and a lack of understanding of how to plan, manage and reinforce change when implementing telemedicine services.

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Section: Methodsmentioning

confidence: 99%

Section: Phase 2 Managing Change -Operational Practicesmentioning

confidence: 99%

A systematic scoping review of change management practices used for telemedicine service implementations

Kho

Gillespie

Martin‐Khan

2020

BMC Health Serv Res

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“…35,36,38,39 Additionally, digital technology had been shown to aid risk screening, teleconsultation, and self-diagnosis. 35,40 The impor-tance of structured EHRs and real-world databases throughout patient lifecycles had also been recognized. [41][42][43] To amplify the impact of digital health and realize our process mapping vision, the intertwining of technologies such as 5G, AI, and big data with the medical sector was essential.…”

Section: Discussionmentioning

confidence: 99%

Digital health integration for noncommunicable diseases: Comprehensive process mapping for full‐life‐cycle management

He,

Cui,

Feng

et al. 2024

J Evidence Based Medicine

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AimTo create a systematic digital health process mapping framework for full‐life‐cycle noncommunicable disease management grounded in key stakeholder engagement.MethodsA triphasic, qualitative methodology was employed to construct a process mapping framework for digital noncommunicable disease management in Shanghai, China. The first phase involved desk research to examine current guidance and practices. In the second phase, pivotal stakeholders participated in focus group discussions to identify prevalent digital touchpoints across lifetime noncommunicable disease management. In the final phase, the Delphi technique was used to refine the framework based on expert insights and obtain consensus.ResultsWe identified 60 digital touchpoints across five essential stages of full‐life‐cycle noncommunicable disease management. Most experts acknowledged the rationality and feasibility of these touchpoints.ConclusionsThis study led to the creation of a comprehensive digital health process mapping framework that encompasses the entire life cycle of noncommunicable disease management. The insights gained emphasize the importance of a systemic strategic, person‐centered approach over a fragmented, purely technocentric approach. We recommend that healthcare professionals use this framework as a linchpin for efficient disease management and seamless technology incorporation in clinical practice.

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“…Key informant interviews highlight structural barriers (high opportunity costs) among physicians, who perceive they have neither time nor capacity to educate patients. Nonetheless, key informant interviews support other evidence-based programs, such as a task-shifted, large-scale NCD screening program in Chennai, India, to increase linkage to care using onsite teleconferencing at the point of screening [ 31 ]. Addressing risk knowledge, medication adherence, and patient-provider communication [ 8 , 32 ] with intervention delivery task-shifted to a lower cadre of workers than physicians within a community-based approach is an ongoing focus of hypertension interventions in Ghana [ 33 , 34 ]; however, there has been limited focus on utilization of a social cognitive approach that prioritizes patient testimonials and a spirituality framework to deliver skills-based education focused on self-efficacy.…”

Section: Discussionmentioning

confidence: 99%

Adapting a skills-based stroke prevention intervention for communities in Ghana: a qualitative study

Ojo

Ryan

Birkemeier

et al. 2020

Implement Sci Commun

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Background Stroke is a major cause of death in Ghana. Evidence-based interventions for stroke prevention have been successful in the US; however, in low- and middle-income countries (LMICs), such interventions are scarce. The “Discharge Education Strategies for Reduction of Vascular Events” (DESERVE) intervention led to a 10-mmHg reduction in systolic blood pressure (SBP) among Hispanic survivors of mild/moderate stroke and transient ischemic attack (TIA) at 1-year follow-up. Our objectives were to capture the perceptions of a diverse set of stakeholders in an urban community in Ghana regarding (1) challenges to optimal hypertension management and (2) facilitators and barriers to implementation of an evidence-based, skills-based educational tool for hypertension management in this context. Methods This exploratory study used purposive sampling to enroll diverse stakeholders in Accra (N = 38). To identify facilitators and barriers, we conducted three focus group discussions: one each with clinical nurses (n = 5), community health nurses (n = 20), and hypertensive adults (n = 10). To further examine structural barriers, we conducted three key informant interviews with medical leadership. All interviews were audio recorded and transcribed. Thematic analysis was carried out via deductive coding based on Proctor’s implementation outcomes taxonomy, which conceptualizes constructs that shape implementation, such as acceptability, adoption, appropriateness, cost, and feasibility. Results Findings highlight facilitators, such as a perceived fit (appropriateness) of the core intervention components across stakeholders. The transferable components of DESERVE include: (1) a focus on risk knowledge, medication adherence, and patient–physician communication, (2) facilitation by lay workers, (3) use of patient testimonials, (4) use of a spirituality framework, and (5) application of a community-based approach. We report potential barriers that suggest adaptations to increase appropriateness and feasibility. These include addressing spiritual etiology of disease, allaying mistrust of biomedical intervention, and tailoring for gender norms. Acceptability may be a challenge among individuals with hypertension, who perceive relative advantage of alternative therapies like herbalism. Key informant interviews highlight structural barriers (high opportunity costs) among physicians, who perceive they have neither time nor capacity to educate patients. Conclusions Findings further support the need for theory-driven, evidence-based interventions among hypertensive adults in urban, multiethnic Ghana. Findings will inform implementation strategies and future research.

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Telemedicine in Camp Mode While Screening for Noncommunicable Diseases: A Preliminary Report from India

Cited by 9 publications

References 18 publications

A systematic scoping review of change management practices used for telemedicine service implementations

A systematic scoping review of change management practices used for telemedicine service implementations

Digital health integration for noncommunicable diseases: Comprehensive process mapping for full‐life‐cycle management

Adapting a skills-based stroke prevention intervention for communities in Ghana: a qualitative study

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