Asynchronous Remote Medical Consultation for Ghana

Computer-mediated communication systems can be used to bridge the gap between doctors in underserved regions with local shortages of medical expertise and medical specialists worldwide. To this end, we describe the design of a prototype remote consultation system intended to provide the social, institutional and infrastructural context for sustained, self-organizing growth of a globally-distributed Ghanaian medical community. The design is grounded in an iterative design process that included two rounds of extended design fieldwork throughout Ghana and draws on three key design principles (social networks as a framework on which to build incentives within a self-organizing network; optional and incremental integration with existing referral mechanisms; and a weakly-connected, distributed architecture that allows for a highly interactive, responsive system despite failures in connectivity). We discuss initial experiences from an ongoing trial deployment in southern Ghana.Comment: 10 page

Human computer interaction for international development: past present and future

Recent years have seen a burgeoning interest in research into the use of information and communication technologies (ICTs) in the context of developing regions, particularly into how such ICTs might be appropriately designed to meet the unique user and infrastructural requirements that we encounter in these cross-cultural environments. This emerging field, known to some as HCI4D, is the product of a diverse set of origins. As such, it can often be difficult to navigate prior work, and/or to piece together a broad picture of what the field looks like as a whole. In this paper, we aim to contextualize HCI4D—to give it some historical background, to review its existing literature spanning a number of research traditions, to discuss some of its key issues arising from the work done so far, and to suggest some major research objectives for the future

Real-Time Tele-Auscultation Consultation Services over the Internet: Effects of the Internet Quality of Service

A real-time tele-auscultation over the Internet is effective medical services that increase the accessibility of healthcare services to remote areas. However, the quality of auscultation’s sounds transmitted over the Internet is the most critical issue, especially in real-time service. Packet loss and packet delay variations are the main factors. There is little knowledge of these factors affecting auscultation’s sounds transmitted over the Internet. In this work, we investigate the effects of packet loss and packet delay variations, in particular, heart and lung sounds with auscultation’s sound over the Internet in real-time services. We have found that both sounds are more sensitive to packet delay variations than packet loss. Lung sounds are more sensitive than heart sounds due to their timing interpretation. Some different levels of packet loss can be tolerated, e.g., 10% for heart sounds and 2% for lung sounds. Packet delay variation boundary of 50 msec is recommended. In addition, we have developed the real-time tele-auscultation prototype that tries to minimize the packet delay variation. We have found that real-time waveform of auscultation’s visualization can help physician’s confident level for sound interpreting. Some techniques for quality of service improvement are suggested, e.g., noise reduction and user interface (UI)

Implementation of Telemedicine Services in Lower-Middle Income Countries: Lessons for the Philippines

Regardless of the promising potential of telemedicine to address healthcare problems, especially in lower-middle income countries, its success rate has been unsatisfactory and many telemedicine services fail to sustain their implementation shortly after initial funding or after a pilot phase. Therefore, it is important to document existing models of telemedicine implementation in these countries, to identify commonalities and extract experiences that would be useful for implementers, policy makers and future researchers. This review seeks to review and describe the experience of Low and Middle Income Countries (LMICs) in implementing telemedicine services. Evidence extracted from the included studies were analysed through a narrative synthesis which suggests a multi-sectoral approach for implementing telemedicine. It highlights the importance of education, financing options, policy, technology, governance, and partnership, in the wider picture of a sustainable telemedicine implementation among developing countries such as the Philippines. Moreover, the literature reveals both top-down and bottom-up approach for successful telemedicine implementation. These approaches include strengthening the local health workers and integrating telemedicine into the health system. Studies included in this review have been helpful, but there is an obvious lack of studies with high level of evidence that can yield generalisable, thus findings must be inferred with prudence. Even so, this review described and summarised the data which allowed description of factors and lessons in the implementation of telemedicine in LMICs

Using ODL and ICT to develop the skills of the unreached: a contribution to the ADEA triennial of the Working Group on Distance Education and Open Learning

Innovation in technology is occurring at rapid pace thus shrinking the distances and making information and knowledge more than ever accessible to everyone irrespective of where the person resides. This paper consists of four main articles. The first one deals with technological trends. The second one focuses on the deployment and use of open and distance education mode in rural areas by documenting initiatives that embrace information and communication technologies (ICTs). Due to challenges faced in rural areas only a few success stories/cases currently exist and some of these are cited in this article. The challenges faced in the deployment of ICT enhanced ODL have been highlighted as well as the potential of developing and delivering effective and relevant ODL programmes in rural areas in order to ensure that issues of educational equity and social exclusion rural communities are adequately addressed. ICTs in ODL are perhaps the greatest tool to date for self-education and value addition to any community’s development efforts, yet poor rural communities particularly in Africa do not have the necessary awareness, skills or facilities to enable themselves to develop using ICTs. Inadequate ICT infrastructures in rural areas remain a major source for the digital divide in Africa and for under-performance of distance learners. The third one analyses the support provided to ODL learners who often encounter difficulties in completing their studies through the distance education mode due to loneliness, uncertainties and de-motivation. ICT has not been able to sufficiently support distance learners in overcoming those obstacles efficiently. An investigation regarding those learning supports has been conducted in ten distance learning institutions, along with an intensive literature review with the aim of understanding the high percentage of dropout rates of distant learners. The learners’ interactions have been scrutinized through content analysis of their synchronous exchanges, during a completely online course. After taking into account the limited technical and human resources in Africa, a technological virtual environment along with a pedagogical framework has been proposed with the aim of giving adequate educational support to them. The fourth article has explored The Open University (UK) and its efforts to use new technologies to deliver online courses to difficult-to- reach learners in prison environments. The case study analysed here is an international course (called, B201- Business Organisations and their environments) which also touches an African cohort of learners. The implications for designing and delivering online ODL to the complex unreachable environments of prisons anywhere, and particularly in Africa, have been discussed

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

Lancet Psychiatry

Few individuals living with mental disorders around the globe have access to mental health care, yet most have access to a mobile phone. Digital technology holds promise for improving access to, and quality of, mental health care. We reviewed evidence on the use of mobile, online, and other remote technologies for treatment and prevention of mental disorders in low-income and middle-income countries. Of the 49 studies identified, most were preliminary evaluations of feasibility and acceptability. The findings were promising, showing the potential effectiveness of online, text-messaging, and telephone support interventions. We summarised the evaluations as: technology for supporting clinical care and educating health workers, mobile tools for facilitating diagnosis and detection of mental disorders, technologies for promoting treatment adherence and supporting recovery, online self-help programmes for individuals with mental disorders, and programmes for substance misuse prevention and treatment. Continued research is needed to rigorously evaluate effectiveness, assess costs, and carefully consider potential risks of digital technology interventions for mental disorders, while determining how emerging technologies might support the scale-up of mental health treatment and prevention efforts across low-resource settings.P30 DA029926/DA/NIDA NIH HHS/United StatesR01 MH104555/MH/NIMH NIH HHS/United StatesU19 MH109988/MH/NIMH NIH HHS/United StatesU48 DP005018/DP/NCCDPHP CDC HHS/United States2017-07-24T00:00:00Z28433615PMC552365

e-ESAS: Evolution of a Participatory Design-based Solution for Breast Cancer (BC) Patients in Rural Bangladesh

Healthcare facility is scarce for rural women in the developing world. The situation is worse for patients who are suffering from diseases that require long-term feedback-oriented monitoring such as breast cancer. Lack of motivation to go to the health centers on patients’ side due to sociocultural barriers, financial restrictions and transportation hazards results in inadequate data for proper assessment. Fortunately, mobile phones have penetrated the masses even in rural communities of the developing countries. In this scenario, a mobile phone-based remote symptom monitoring system (RSMS) with inspirational videos can serve the purpose of both patients and doctors. Here, we present the findings of our field study conducted on 39 breast cancer patients in rural Bangladesh. Based on the results of extensive field studies, we have categorized the challenges faced by patients in different phases of the treatment process. As a solution, we have designed, developed and deployed e-ESAS—the first mobile-based RSMS in rural context. Along with the detail need assessment of such a system, we describe the evolution of e-ESAS and the deployment results. We have included the unique and useful design lessons that we learned as e-ESAS evolved through participatory design process. The findings show how e-ESAS addresses several challenges faced by patients and doctors and positively impact their lives