Global Diffusion of the Internet X: The Diffusion of Telemedicine in Ethiopia: Potential Benefits, Present Challenges, and Potential Factors

Delivery of healthcare services presents many challenges for governments in most developing countries. Some of these challenges include financial and human resources issues that might affect governments\u27 ability to manage and transform scarce resources to meet healthcare needs. Telemedicine, a healthcare delivery technology where physicians examine patients from distant locations using information technologies, is reported to be increasingly helpful in meeting the needs of the healthcare sector in developing nations such as those in sub-Saharan Africa. This conceptual study reports on the sectoral adoption of telemedicine in Ethiopia, a sub-Saharan African country. We examine the potential benefits of telemedicine diffusion in Ethiopia, addressing the country\u27s healthcare needs, and discussing the obstacles and challenges. Based on previous literature, as well as experiences drawn from other developing nations, we address three potential factors that could influence the diffusion of telemedicine in Ethiopia: active participation of institutions of higher education, Ethiopian foreign alliances, and government involvement. Although the initial successes are relatively small and involve isolated projects, they have been promising and have set the stage for researchers to investigate prevailing projects so as to gain better understanding of the aforementioned factors. Our study does not claim that telemedicine can solve all of Ethiopia\u27s medical challenges; however, we contend that it is a starting point to reach Africans that live in areas with limited medical facilities and personnel. Hence, our study could have far reaching implications as the world looks to help this country, and by extension, other developing countries, to overcome their medical challenges and join the information society

Holistic Approach: paradigm shift in the research agenda for digitalisation of healthcare in Sub-Saharan Africa

Despite significant resources employed in the digitalisation agenda in the healthcare sector in Sub-Saharan Africa, the transformative impact of information and communication technologies has not been realised. This article makes two contributions towards developing an understanding of this failure. First, it provides a review of a rich body of academic literature and practitioner accounts regarding barriers to digitalisation and organises them using an established framework. Second, recognising the continuing struggle that digitalisation presents, it proposes a paradigmatic shift in thinking about barriers to digitalisation and suggests the existence of a more fundamental barrier related to inappropriate incentives within the international community. Ultimately, it argues that unpacking the complex contextual reality of healthcare delivery systems is a fundamental but still unaddressed antecedent to any successful digitalisation endeavour. Thus, both the academia and the practitioners should direct their efforts to developing new approaches, which could remove this underlying obstacle

A framework for evaluating telemedicine-based healthcare inequality reduction in Ethiopia : a grounded theory approach

Text in EnglishTelehealth makes healthcare services accessible by underserved and resource-constrained rural communities of developing countries such as Ethiopia. However, the limitation of frameworks on telemedicine-based healthcare inequality reduction is a challenge for developing countries. In Ethiopia there are four telemedicine projects; however, there is no evidence that any of these projects have been evaluated by considering contextual issues. This academic research explored telehealth practices in Ethiopia with the aim of developing a comprehensive telehealth evaluation framework for developing countries. Such a conceptual framework could be used to inform health institutes and governmental policy makers and in so doing create a vehicle for the implementation of improved health practices in Ethiopia. A grounded theory approach is used to qualitatively explore the usefulness of telemedicine practices in Ethiopia, in mitigating healthcare inequality. Grounded theory makes use of emerging insights in order to contribute to new knowledge. From the inductive analysis of the study, themes such as barrier removal, service quality, synergetic effect, localization, technical setup, resource utilization and managerial readiness emerged to formulate a framework for evaluating telemedicine-based healthcare inequality reduction in the context of developing countries like Ethiopia. This study contributes to the understanding of the question of how telemedicine practices can be evaluated, to support the healthcare service and reduce the healthcare inequalities in resource constrained communities in Ethiopia. Moreover, the framework could be used during evaluation of telemedicine-based healthcare inequality reduction in the context of developing countries like Ethiopia.School of ComputingPh.D. (Information Systems

COVID-19 and Teleneurology in Sub-Saharan Africa: Leveraging the Current Exigency

tion residing in rural areas that have poor access to medical experts. Despite having a ridiculously huge, underserved population, very few African countries currently have any form of sustained and organized telemedicine practice, and even fewer have dedicated tele-neurology services. The ongoing COVID-19 pandemic has proved to be one of the most significant disruptors of vital sectors of human endeavor in modern times. In the healthcare sector, there is an increasing advocacy to deliver non-urgent care via telemedicine. This paper examined the current state of tele-neurology practice and infrastructural preparedness in sub-Saharan Africa. Currently, there is over 70% mobile phone penetration in most of the countries and virtually all of them have mobile internet services of different technologies and generations. Although the needed infrastructure is increasingly available, it should be improved upon. We have proposed the access, costs, ethics, and support (ACES) model as a bespoke, holistic strategy for the successful implementation and advancement of tele-neurology in sub-Saharan Afric

The Neglected Continent of IS Research: A Research Agenda for Sub-Saharan Africa

Research with a focus on Sub-Saharan Africa (SSA), a major region within the world’s second largest continent, is almost non-existent in mainstream information systems research. Although infrastructures for information and communication technology (ICT) are well established in the more developed and industrialized parts of the world, the same is not true for developing countries. Research on developing countries has been rare in mainstream IS and, even where existent, has often overlooked the particular situation of SSA, home to 33 of the world’s 48 least-developed countries. Ironically, it is such parts of the world that can stand to gain the most from the promise of ICT with applications that would help the socioeconomic development of this region. In this study, we present the need for focused research on the ICT development and application for SSA. The information systems research community has a unique and valuable perspective to bring to the challenges this region faces in developing its ICT infrastructure, hence extending research and practice in ICT diffusion and policy. We present here a research agenda for studying the adoption, development, and application of ICT in SSA. In particular, teledensity, telemedicine, online education, and e-commerce present important areas for research, with implications for research, practice, and teaching

The role of information communication technology (ICT) towards universal health coverage: the first steps of a telemedicine project in Ethiopia

Background: Eighty-five per cent of the Ethiopian population lives in remote areas, without access to modern health services. The limited health care budget, chronic shortage of health care workers and lack of incentives to retain those in remote areas further jeopardize the national health care delivery system. Recently, the application of information communication technology (ICT) to health care delivery and the use of telemedicine have raised hopes.Objective: This paper analyzes the challenges, failures and successes encountered in setting-up and implementing a telemedicine program in Ethiopia and provides possible recommendations for developing telemedicine strategies in countries with limited resources.Design: Ten sites in Ethiopia were selected to participate in this pilot between 2004 and 2006 and twenty physicians, two per site, were trained in the use of a store and forward telemedicine system, using a dial-up internet connection. Teledermatology, teleradiology and telepathology were the chosen disciplines for the electronic referrals, across the selected ten sites.Results: Telemedicine implementation does not depend only on technological factors, rather on e-government readiness, enabling policies, multisectoral involvement and capacity building processes. There is no perfect ‘one size fits all’ technology and the use of combined interoperable applications, according to the local context, is highly recommended.Conclusions: Telemedicine is still in a premature phase of development in Ethiopia and other sub-Saharan African countries, and it remains difficult to talk objectively about measurable impact of its use, even though it has demonstrated practical applicability beyond reasonable doubts

How 5G wireless (and concomitant technologies) will revolutionize healthcare?

The need to have equitable access to quality healthcare is enshrined in the United Nations (UN) Sustainable Development Goals (SDGs), which defines the developmental agenda of the UN for the next 15 years. In particular, the third SDG focuses on the need to “ensure healthy lives and promote well-being for all at all ages”. In this paper, we build the case that 5G wireless technology, along with concomitant emerging technologies (such as IoT, big data, artificial intelligence and machine learning), will transform global healthcare systems in the near future. Our optimism around 5G-enabled healthcare stems from a confluence of significant technical pushes that are already at play: apart from the availability of high-throughput low-latency wireless connectivity, other significant factors include the democratization of computing through cloud computing; the democratization of Artificial Intelligence (AI) and cognitive computing (e.g., IBM Watson); and the commoditization of data through crowdsourcing and digital exhaust. These technologies together can finally crack a dysfunctional healthcare system that has largely been impervious to technological innovations. We highlight the persistent deficiencies of the current healthcare system and then demonstrate how the 5G-enabled healthcare revolution can fix these deficiencies. We also highlight open technical research challenges, and potential pitfalls, that may hinder the development of such a 5G-enabled health revolution

TELEMEDICINE AND ELECTRONIC HEALTH RECORD IMPLEMENTATION IN RURAL AREA: A LITERATURE REVIEW

The Indonesian Minister of Health 2019 issued regulations regarding the implementation of telemedicine services between health service facilities. Telemedicine is aimed primarily at rural areas. This research aims to look at the quality of telemedicine-based services, which are documented in an electronic health record (EHR) with complete information. This research uses the narrative literature review method:  Garuda journal channels, Google Scholar, IEEE Explorer, ProQuest, PubMed, Science Direct, and Scopus. With the input-output process approach, eight scientific articles were published on countries with telemedicine/telehealth policies in rural areas. The implementation of telemedicine has advantages and disadvantages depending on the things supported and the target users. It must have policies, infrastructure, financial resources, and human resources to use, maintain and develop telemedicine. Telemedicine will help the health service process by increasing the degree of public health in rural areas if it is used on a large scale. The completeness of the EHR seems to be lacking in terms of informed consent. Still, a quality EHR can make it easier for health workers to enforce the history, establish the diagnosis, and provide patient healthcare

Developing a mHealth-based portable ultrasound platform for breast cancer screening

Background Breast cancer is amongst the 10 most common cancers globally. The disease burden is increasing rapidly in Sub-Saharan African countries, where women living in rural and or remote areas are particularly prone to be diagnosed with late-stage breast cancer. This is due to the limited availability of advanced screening and diagnostic options. Ultrasound is a feasible screening tool for breast cancer, due to its portability, affordability and accuracy. The integration of mHealth with portable ultrasound enables the provision of screening services in rural and remote areas, through electronic consultation by a non-specialist with a specialist for interpretation and reporting of the ultrasound results. This project developed an application for a mHealth-based portable ultrasound platform that could be used by a non-specialist to provide breast cancer screening services with remote specialist support. Methods A systematic review of the literature was conducted for the period of 2004 to 2019 to gather evidence on the use of mHealth-based portable ultrasound platforms for improved access to ultrasound services like breast cancer screening. The evidence from the literature was used to design and develop a prototype of an application for a mHealth-based portable ultrasound platform suitable for breast cancer screening. The prototype application was integrated with a mobile-based portable ultrasound from Philips Lumify. Images generated by scanning a phantom breast using the portable ultrasound were uploaded onto the application and downloaded from the application to demonstrate the concept. Results The systematic review showed only two clinical conditions (obstetrics and cardiovascular disease) which used a mHealth-based portable ultrasound platform. The outcomes from the studies showed improved access to the respective ultrasound services in terms of patient management, early detection, improved quality of care and increased patient attendance, which resulted in access to other services. The integration of the prototype application with a mobile-based portable ultrasound resulted into a mHealthbased portable ultrasound platform prototype intended for breast cancer screening. The ability to upload images onto the platform and download images from the platform satisfied the design requirements for the platform. Conclusion A mHealth-based portable ultrasound prototype was developed, which has potential for improving access to breast cancer screening services. Further research including testing of the application with health professionals and patients is recommended to strengthen the feasibility of the concept