Designing a Healthcare Technology Platform Framework for Purpose-Driven Oncology in a Developing Country Healthcare Context (Preprint)

2021 ◽  
Author(s):  
Ramachandran Venkataramanan ◽  
Bharat Kumar Sarvepalli ◽  
Akash Pradhan ◽  
Rengaswamy Sankaranarayanan ◽  
Moni Abraham Kuriakose ◽  
...  
Keyword(s):  
Developing Country ◽  
Value Chain ◽  
Health Care Services ◽  
Digital Health ◽  
Healthcare Delivery ◽  
Healthcare Technology ◽  
Technology Platform ◽  
Care Services ◽  
Care Outcomes ◽  
Out Of Pocket Expenses

UNSTRUCTURED The rising cases of cancer in India and the unequal care has given rise to large out-of-pocket expenses and late stage of detection of cares, leading to higher mortality rates in many states across rural India. Investing in digital health in resource-constrained countries could provide cancer diagnosis and treatment at affordable costs, improve availability and health outcomes for the citizens. This paper introduces the framework and features of a healthcare technology platform for a developing country to democratise oncology health care services. The framework relies on participatory systems, patient first algorithms and digital health exchange mechanisms. The proposed platform is built on three key pillars of Technology, Managed Healthcare and Advisory, each with a unique value proposition, yet will be complementary, and tries to address specific requirements across the healthcare delivery value chain, thereby, providing a comprehensive solution to the overall problem of the ecosystem. We discuss the application of the framework and usage of curated data and robust workflow and rules engine to enable seamless flow of information across all levels, while bringing close home care to people. We propose that a technology platform, build on a connected care ecosystem, could improve cancer care outcomes in a developing country healthcare context.

scholarly journals Transportation barriers to care among frequent health care users during the COVID pandemic

2021 ◽  
Author(s):  
Abigail L. Cochran ◽  
Noreen McDonald ◽  
Lauren Prunkl ◽  
Emma Vinella-Brusher ◽  
Jueyu Wang ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Web Based ◽  
Health Care Outcomes ◽  
Response Data ◽  
Care Services ◽  
Transportation Barriers ◽  
Text Response ◽  
Care Outcomes ◽  
Barriers To Health

Objective: To investigate transportation barriers to accessing health care services during the COVID-19 pandemic among high-frequency health care users.Data Sources: Between June 21 and July 23, 2021, primary survey data were collected for a sample of patients in North Carolina.Study Design: The study analyzed the prevalence of arriving late to, delaying, or missing medical care and examined how transportation barriers contributed to negative health care outcomes. Data Collection Methods: A web-based survey was administered to North Carolina residents aged 18 and older in the UNC Health system who were enrolled in Medicaid or Medicare and had at least six outpatient medical appointments in the past year. 323 complete responses were analyzed to investigate the prevalence of reporting transportation barriers that resulted in having arrived late to, delayed, or missed care, as well as relationships between demographic and other independent variables and transportation barriers. Qualitative analyses were performed on text response data to explain transportation barriers.Principal Findings: Approximately 1 in 3 respondents experienced transportation barriers to health care between June 2020 and June 2021. Multivariate logistic regressions indicate individuals aged 18–64 were significantly more likely to encounter transportation barriers. Costs of traveling for medical appointments and a lack of driver or car availability emerged as major transportation barriers; however, respondents explained that barriers were often complex, involving circumstantial problems related to one’s ability to access and pay for transportation as well as to personal health.Conclusions: To address transportation barriers, we recommend more coordination between transportation and health professionals and the implementation of programs that expand access to and improve patient awareness of health care mobility services. We also recommend transportation and health entities direct resources to address transportation barriers equitably, as barriers disproportionately burden younger adults under age 65 enrolled in public insurance programs.

The evaluation of long term follow-up (LTFU) of children with osteosarcoma: The first report from a center in a developing country.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e21512-e21512
Author(s):  
Nurdan Tacyildiz ◽  
Emel Cabi Unal ◽  
Handan Dincaslan ◽  
Mine cakmak Tokuc ◽  
Gulsah Oktay Tanyildiz ◽  
...  
Keyword(s):  
Health Care ◽  
Survival Rate ◽  
Alcohol Consumption ◽  
Kidney Disease ◽  
Developing Country ◽  
Health Care Services ◽  
Care Services ◽  
Significant Difference ◽  
Use Of Health Care

e21512 Background: The increased survival rate of childhood cancers resulted in long term side effects (LTSE). The aim was to investigate LTSE in our osteosarcoma survivors and compare the quality of life (QOL criteria with their own siblings as a developing country experience with no National LTFU guideline yet . Methods: At Ankara University Department of Pediatric Oncology 54 osteosarcoma pts have been followed between 2003- 2019 . Rate of heart, kidney disease, hearing difficulty, neurological problems, Life style parameters like; smoking, alcohol consumption, marital status, parenthood, education, the use of health care services and pain status of the 39 survivors were compared with their siblings (n = 77). Amputated and non-amputated groups were compared for QOL. Information obtained retrospectively from the patient charts, and phone calls. Kaplan-Meier, Chi-square, independent sample t-test were used. Results: The age and gender ratios were similar in the groups. The 16-year overall survival rate (OSR) was 72.4%. Patients with the poor risk criteria were in the Euramos MAP + IE regimen with 71.4% OSR ; 94.1%, in the low risk patients in Euramos MAP (p = 0.023) and 50.0% in the previous HDMTX regimens (p = 0.012). The rates of kidney (p = 0.045), heart disease (p < 0.001), neurological problems (p = 0.045), use of health care services (p < 0.001), limitations of physical function (p < 0.001) and pain (p = 0.002) were significantly higher in the survivors than siblings. The physical functions were normal in 76 siblings (98.7%) and in 14 of the survivors (35.9%) (p < 0.001). Being married (p = 0.001), having parenthood (p < 0.001), educated (p = 0.014) and employed (p < 0.001) were significantly higher in the siblings than in the survivors. The rates of hearing problems, smoking, alcohol consumption and psychiatric problems were similar in both groups. Secondary malignancy (1 leukemia, 1 bone tumor) was detected in two survivors while no cancer was found in the control group. The OS was 55.6% and 75.6% respectively in patients with amputation and with no amputation with no significant difference in the QOL (p = 0.424). Conclusions: Heart, neurological and kidney disease, physical dysfunction, and pain rates were significantly higher in survivors of osteosarcoma than their siblings in almost 2 decades. The social status (marriage, parenthood, education) of the survivors was also found to be markedly affected negatively. As we planned, development of risk-based LTFU guidelines are required to increase QOL during LTFU of these patients in our country.

Digital Health Care Services to Control and Eliminate Malaria in India

2020 ◽  
Author(s):  
Shrikant Nema ◽  
Anil Kumar Verma ◽  
Archana Tiwari ◽  
Praveen Kumar Bharti
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Digital Health ◽  
Care Services

scholarly journals Mediator – enabler for successful digital health care

2017 ◽  
Vol 9 (4) ◽  
pp. 284-298 ◽  
Author(s):  
Janne Lahtiranta
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Digital Health ◽  
Oecd Countries ◽  
Care Services ◽  
The Future ◽  
Electronic Health ◽  
Near Future

It is no news that as in any other field of industry, digitalization is changing health care. This change is ongoing and profound as it affects every aspect imaginable; from provisioning to funding, and from roles to responsibilities. The magnitude of this change is such that some label it as the ‘health care revolution’. Not all individuals are ready for this ‘revolution’. Some rebel against it while others are simply not able to cope with it. Regardless of the underlying reason, it can be estimated that in the near future, roughly 10 % of the population in the OECD countries will drift outside the reach of the modern electronic health care services. These individuals, the digital orphan, need to be brought back in order to prevent the future of health care from becoming more marginalized and discriminatory than it is today. Mediators, individuals in the crux of health care and technology, are one way to prevent this unwelcome eventuality from coming true. In the following, the focus of examination is on the mediators and mediation. The role of a mediator is critically examined from different perspectives, and a framework for mediation is presented.  

Just in time elements extraction and prioritization for health care unit using decision making approach

2019 ◽  
Vol 36 (7) ◽  
pp. 1243-1263 ◽  
Author(s):  
Mahender Singh Kaswan ◽  
Rajeev Rathi ◽  
Mahipal Singh
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Services ◽  
Healthcare Delivery ◽  
Deep Understanding ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Just In Time ◽  
Content Type ◽  
Care Services

Purpose The purpose of this paper is to identify and prioritize prime just-in-time (JIT) elements in Indian healthcare sector based on the degree of importance and difficulty. This facilitates the implementation of JIT philosophy in healthcare services without any failure as well as provides quality services to patients at low cost. Design/methodology/approach JIT elements related to health care services have been sorted out from comprehensive literature survey. Moreover, important and difficult JIT elements have been ranked on the basis of score obtained by the quantitative method using statistical tools. Furthermore, validation and prioritization of important JIT elements based on the degree of importance have been computed using the analytical hierarchy process (AHP) and best worst method (BWM). Findings The present work provides important, difficult and easy to implement JIT elements in healthcare services. Besides, this work justifies the application of decision-making tool (AHP, BWM) for the prioritization of JIT elements in the health care sector. Practical implications The present study develops a deep understanding of JIT concepts in health care services. Furthermore, it motivates professionals for implementing JIT in healthcare services with healthy situation for both hospital and supplier. Social implications The present work is beneficial for all the dimensions of sustainable development (social, economic and environmental). The implementation of JIT with a proper understanding of its elements results in an improved patient care, lesser cost of healthcare delivery, time and better management of associated medical items. This work also facilitates the proper management of inventory items together with the reduction in various Lean wastes with the proper implementation of JIT in healthcare. The reduction in various associated wastes leads to cleaner surrounding and lesser environmental degradation. Originality/value This paper outlines the need of a robust JIT approach in the healthcare sector for quality services. The efficacy of JIT, AHP and BWM has been explored to find out critical elements for successful JIT implementation in health care.

scholarly journals Conceptions of patients and their roles in healthcare

2016 ◽  
Vol 30 (2) ◽  
pp. 194-206 ◽  
Author(s):  
Aoife M. McDermott ◽  
Anne Reff Pedersen
Keyword(s):  
Service Delivery ◽  
Health Care Services ◽  
Healthcare Delivery ◽  
Personal Characteristics ◽  
Special Issue ◽  
Research Attention ◽  
Content Type ◽  
Care Services ◽  
Copenhagen Business School ◽  
The Individual

Purpose – The purpose of this paper is two-fold. First, it sets the context for the special issue by considering conceptions of patients and their roles in service delivery and improvement. Second, it introduces the contributions to the special issue, and identifies thematic resonance. Design/methodology/approach – The paper utilises a literature synthesis and thematic analysis of the special issue submissions. These emanated from the Ninth International Organisational Behaviour in Healthcare Conference, hosted by Copenhagen Business School on behalf of the Learned Society for Studies in Organizing Healthcare. Findings – The articles evidence a range of perspectives on patients’ roles in healthcare. These range from their being subject to, a mobilising focus for, and active participants in service delivery and improvement. Building upon the potential patient roles identified, this editorial develops five “ideal type” patient positions in healthcare delivery and improvement. These recognise that patients’ engagement with health care services is influenced both by personal characteristics and circumstances, which affect patients’ openness to engaging with health services, as well as the opportunities afforded to patients to engage, by organisations and their employees. Originality/value – The paper explores the relationally embedded nature of patient involvement in healthcare, inherent in the interdependence between patient and providers’ roles. The typology aims to prompt discussion regarding the conceptualisation patients’ roles in healthcare organisations, and the individual, employee, organisational and contextual factors that may help and hinder their involvement in service delivery and improvement. The authors close by noting four areas meriting further research attention, and potentially useful theoretical lenses.

scholarly journals COMPARATIVE STUDY OF HOME CARE DIGITALIZATION FOR ELDERLY PEOPLE IN BRAZIL AND FINLAND

2019 ◽  
Vol 3 ◽  
pp. 52
Author(s):  
Minna Korpela ◽  
Piia Holmström
Keyword(s):  
Health Care ◽  
Health Services ◽  
Elderly People ◽  
Health Care Services ◽  
Digital Health ◽  
The Elderly ◽  
Health Technology ◽  
Care Services ◽  
Digital Services ◽  
Home Living

ABSTRACTThis thesis describes health care services for elderly people in Finland and Brazil, as well as health technology in both countries. The aim of the thesis is to provide information on the health technology for the elderly and to bring out their opinion about the need for digital services and what kind of digital solutions they would find useful as they get older. Our thesis is a qualitative research in which the observation material is in form of a questionnaire. The material is compared between the target countries. The target group is people who are over 75 years old in Finland and over 65 years old in Brazil and who are still living at home. The main objective is to identify the need for digital health services and solutions expressed by elderly citizens living in Brazil and Finland. Our research tasks: What kind of digital services home living elderly over 75 years old in Finland and over 65 years old in Brazil think it might be useful in connection with their health care? What kind of health services and digital solutions have an offer in Brazil and Finland? How is customer- oriented service implemented with digital solutions? According to the results, both in Finland and Brazil, elderly people felt that technology could be useful in terms of access to information and security and they were looking for ways to get help in everyday activities. In Finland, more technological solutions were available than in Brazil for healthcare.Keywords: Digitalization. Ethics. Succesful aging. RESUMOEsta tese descreve os serviços de saúde para idosos na Finlândia e no Brasil, bem como a tecnologia em saúde nos dois países. O objetivo da tese é fornecer informações sobre a tecnologia de saúde para idosos e expor suas opiniões sobre a necessidade de serviços digitais e que tipo de soluções digitais eles acham úteis à medida que envelhecem. Nossa tese é uma pesquisa qualitativa na qual o material de observação é em forma de questionário. O material é comparado entre os países-alvo. O público-alvo são pessoas com mais de 75 anos na Finlândia e com mais de 65 anos no Brasil e que ainda moram em casa. O objetivo principal é identificar a necessidade de soluções e serviços digitais de saúde expressos por idosos residentes no Brasil e na Finlândia. Nossas tarefas de pesquisa: Que tipo de serviços digitais para idosos que têm mais de 75 anos na Finlândia e mais de 65 anos no Brasil acham que pode ser útil em conexão com seus cuidados de saúde? Que tipo de serviços de saúde e soluções digitais oferecem no Brasil e na Finlândia? Como o serviço orientado ao cliente é implementado com soluções digitais? De acordo com os resultados, tanto na Finlândia quanto no Brasil, os idosos sentiram que a tecnologia poderia ser útil em termos de acesso à informação e segurança e estavam procurando maneiras de obter ajuda nas atividades cotidianas. Na Finlândia, mais soluções tecnológicas estavam disponíveis do que no Brasil para a saúde.Palavras-chave: Digitalização. Ética. Envelhecimento bem-sucedido.

scholarly journals Digital Health Interventions for Adults With Type 2 Diabetes: Qualitative Study of Patient Perspectives on Diabetes Self-Management Education and Support (Preprint)

2017 ◽  
Author(s):  
Kingshuk Pal ◽  
Charlotte Dack ◽  
Jamie Ross ◽  
Susan Michie ◽  
Carl May ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care Services ◽  
Unmet Needs ◽  
Management Education ◽  
Digital Health ◽  
Health Interventions ◽  
Self Management ◽  
Behavioral Support ◽  
Care Services

BACKGROUND The prevalence of type 2 diabetes is increasing globally, and health services in many countries are struggling with the morbidity, mortality, and costs associated with the complications of this long-term condition. Diabetes self-management education (DSME) and behavioral support can reduce the risks of developing diabetes-related complications and improve glycemic control. However, their uptake is low. Digital health interventions (DHI) can provide sustained support and may overcome challenges associated with attending diabetes self-management sessions. They have the potential for delivery at multiple locations at convenient times, anonymity, and presentation of content in attractive and tailored formats. This study investigates the needs and wants of patients with type 2 diabetes to inform the development of digital self-management education and support. OBJECTIVE The objective of this study was to explore patient perspectives on unmet needs for self-management and support and the role of DHI in adults living with type 2 diabetes. METHODS This study used a qualitative approach based on data generated from 4 focus groups with 20 patients. RESULTS The data generated by the focus groups illustrated the significant burden that the diagnosis of diabetes places on many patients and the negative impacts on their emotional well-being, work, social life, and physical health. Although patients’ experiences of the health care services varied, there was agreement that even the best services were unable to meet all users’ needs to support the emotional regulation, psychological adjustment, and behavioral changes needed for successful self-management. CONCLUSIONS By focusing on medical management and information provision, existing health care services and education programs may not be adequately meeting all the needs of patients with type 2 diabetes. DHIs have the potential to improve access to DSME and behavioral support and extend the range of content offered by health services to fit with a wider range of patient needs. Features that could help DHIs address some of the unmet needs described by participants in this study included placing an emphasis on emotional and role management, being available at all times, having up-to-date evidence-based guidance for patients, and providing access to peer-generated and professional advice.

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