eHEALTH DIGEST

An Investigation into the Adoption and Use Issues of eHealth in Public Sector Hospitals of Developing Countries

The use of eHealth technologies, including mobile health, is spreading rapidly in the developing countries. According to World Health Organization (WHO), the use of mobile phones and computers is growing in these countries.

Majority of the programs that WHO looked at in developing countries are identified as "technology enabled", meaning they used "information and communications technology" (ICT) to improve healthcare. The leading technologies in this context are phones, computers, and texting. The latter fell into third place because so many people in these countries are illiterate.

eHealth systems are extending geographic access, data management, facilitating communications between patients and providers, and improving treatment and diagnosis. Among the leading types of tele-health in developing countries are "video chat" programs and phone "hotlines" that provide remote access to physicians. This research paper highlights the different aspects of eHealth systems with regard to adoption and use in developing countries.

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A New mHealth Communication Framework for Use in Wearable WBANs and Mobile Technologies

Driven by the development of biomedical sensors and the availability of high mobile bandwidth, mobile health (mHealth) systems are now offering a wider range of new services. This revolution makes the idea of in-home health monitoring practical and provides the opportunity for assessment in "real-world" environments producing more ecologically valid data.

In the field of insomnia diagnosis, for example, it is now possible to offer patients wearable sleep monitoring systems which can be used in the comfort of their homes over long periods of time. The recorded data collected from body sensors can be sent to a remote clinical back-end system for analysis and assessment. Most of the research on sleep reported in the literature mainly looks into how to automate the analysis of the sleep data and does not address the problem of the efficient encoding and secure transmissions of the collected health data.

This article reviews the key enabling communication technologies and research challenges for the design of efficient mHealth systems. An end-to-end mHealth system architecture enabling the remote assessment and monitoring of patient's sleep disorders is then proposed and described as a case study. Finally, various mHealth data serialization formats and machine-to-machine (M2M) communication protocols are evaluated and compared under realistic operating conditions.

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Telehealth in the developing world: current status and future prospects

In a setting of constant change and confusing terminology, telehealth continues to gain ground in both developed and developing countries within the overarching milieu of eHealth. Evidence shows telehealth has been used in essentially all countries of the world, but is embedded in few. Uses and needs of telehealth vary between the developed and developing world; the latter struggles with both communicable diseases and noncommunicable diseases, and with very few resources. Common clinical applications include teleconsultation, telecardiology (transmission of ECGs), teleradiology, and teledermatology.

Many telehealth projects exist throughout Latin America and the Caribbean, Asia, and Africa, but there is little published evidence and only isolated examples of sustained programs, although several sustained humanitarian networks exist.

Telehealth is poised to improve health and health care in the developing world, driven by both altruistic and profit motives. But to have the desired effect, telehealth must address very specific and evidence-based health "needs" of each facility, region, or country; the shortage of health workers and specialist services; and the required skills upgrading and training, allowing the developing world to establish its own critical mass of experts. This will only be achieved by raising awareness, understanding, and ability regarding telehealth capability and limitations, and by the coordinated political and professional will of all those involved to guide public and private innovation and telehealth integration.

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Barriers and facilitators to health information exchange in low- and middle income country settings: a systematic review protocol

The ability to capture, exchange and use accurate information about patients and services is vital for building strong health systems, providing comprehensive and integrated patient care, managing public health risks and informing policies for public health and health financing. However, the organisational and technological systems necessary to achieve effective health information exchange are lacking in many low- and middle-income countries (LMIC). Developing strategies for addressing this depends on understanding the barriers and facilitators to health information exchange (HIE) at the individual, provider organisational, community, district, provincial and national levels.

This systematic review aims to identify, critically appraise and synthesise the existing published evidence addressing these factors. The objective of the study is to assess what is known, from published/unpublished empirical studies, about barriers and facilitators to HIE in LMIC so as to identify issues that need to be addressed and approaches that can fruitfully be pursued in future improvement strategies.