eHEALTH DIGEST

Improving Medication Adherence in Stroke Patients through Short Text Messages (SMS4Stroke)-study Protocol for a Randomized, Controlled Trial

Stroke is a major cause of morbidity and mortality, especially in low and middle income countries (LMICs). Medical management is the mainstay of therapy to prevent recurrence of stroke. Current estimates are that only 1 in 6 patients have perfect adherence to medication schedules. Using SMS (Short Messaging Service) as reminders to take medicines have been used previously for diseases such as diabetes and HIV with moderate success. This paper aims to explore the effectiveness and acceptability of SMS in increasing adherence to medications in patients with stroke.

The SMS for Stroke Study will provide evidence for feasibility and effectiveness of SMS in improving post stroke medication adherence in a LMIC setting.

---

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.

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.

---

Mobile Technology Applications in the Healthcare Industry for Disease Management and Wellness

In the healthcare industry, mobile applications provide better personalized health care, disease management and services to patients and their relatives, as well as a better and flexible way of communicating with physicians, patients and medical suppliers. Mobile technology technologies have the potential to improve disease management. In this paper, the current mobile technology utilized in healthcare such as relapse prevention in schizophrenia, aged people's care and wellness, diagnosis and management of attention-deficit is reviewed outlining the current mobile technologies and wireless revolution of today and examining some of the applications using these technologies in the clinical area.

---

Health Informatics in Developing Countries: Going Beyond Pilot Practices to Sustainable Implementations: A Review of the Current Challenges

Information technology is an essential tool to improve patient safety and the quality of care, and to reduce healthcare costs. This paper reviews the challenges faced by developing countries to achieve sustainable implementations in health informatics and possible ways to address them.

In this non-systematic review of the literature, articles were searched using various keywords in scholarly journals. The authors, after reading the literature, reached a consensus to classify the challenges into six broad categories. The authors describe the problems faced by developing countries arising from the lack of adequate infrastructure and the ways these can be bypassed; the fundamental need to develop nationwide eHealth agendas to achieve sustainable implementations; ways to overcome public uncertainty with respect to privacy and security; the difficulties shared with developed countries in achieving interoperability; the need for a trained workforce in health informatics and existing initiatives for its development; and strategies to achieve regional integration.

Central to the success of any implementation in health informatics is knowledge of the challenges to be faced. This is even more important in developing countries, where uncertainty and instability are common. The authors hope this article will assist policy makers, healthcare managers, and project leaders to successfully plan their implementations and make them sustainable, avoiding unexpected barriers and making better use of their resources.

---

User Acceptance of Health Information Technology (HIT) in Developing Countries: A Conceptual Model

Health Information Technology (HIT) has the potential to improve the quality, efficiency, outcomes, patient safety and reduce the cost of healthcare. But HIT systems are not widely available, and even if available are not properly utilized. This paper reviewed some available HIT systems in order to have an idea on their availability. Works on acceptance of HIT systems were also reviewed to understand the level of research done in the area. The problems identified from this work include lack of availability of these systems especially in developing countries, insufficient works on user acceptance of HIT systems, etc. These limitations can be overcome when researchers study the factors that will affect the user acceptance of these systems, and then consider the factors while developing the systems. Finally, a conceptual model of HIT acceptance in developing countries is proposed.