Digital Health COVID-19 Impact Assessment: Lessons Learned and Compelling Needs

2022 ◽  
Author(s):  
Peter Lee ◽  
◽  
Amy Abernethy ◽  
David Shaywitz ◽  
Adi Gundlapalli ◽  
...  
Keyword(s):  
Impact Assessment ◽  
Digital Health ◽  
Lessons Learned

A free, open-source, offline digital health system for refugee care (Preprint)

2021 ◽  
Author(s):  
Henry Ashworth ◽  
Senan Ebrahim ◽  
Hassaan Ebrahim ◽  
Zahra Bhaiwala ◽  
Michael Chilazi
Keyword(s):  
Health Systems ◽  
Digital Health ◽  
Healthcare Providers ◽  
Lessons Learned ◽  
Extreme Weather Events ◽  
Mobile Clinic ◽  
Low Resource ◽  
Displaced Populations ◽  
Weather Events ◽  
Displaced People

BACKGROUND Rise of conflict, extreme weather events, and pandemics have led to larger displaced populations worldwide. Displaced populations have unique acute and chronic health needs that need to be met by low resource health systems. Electronic Health Records (EHRs) have been shown to improve health outcomes in displaced populations but need to be adapted to meet the constraints of these health systems. OBJECTIVE To describe the development and deployment of a EHR designed to care for displaced populations in low resource settings. METHODS Using a human-centered design approach we conducted in-depth interviews and focus groups with patients, healthcare providers, and administrators in Lebanon and Jordan to identify the essential EHR features. These features including modular workflows, multilingual interfaces, and offline-first capabilities led to the development of the Hikma Health EHR which has been deployed in Lebanon and Nicaragua. RESULTS We report the successes and challenges from 12 months of Hikma Health EHR deployment in a mobile clinic providing care to Syrian Refugees in the Bekaa Valley, Lebanon. Successes include the EHR’s ability to (1) increase clinical efficacy by providing detailed patient records, (2) prove adaptable to the threats of COVID-19, and (3) improve organizational planning. Lessons learned include technical fixes to methods of identifying patients through name or their medical record ID. CONCLUSIONS As the number of displaced people continues to rise globally, it is imperative that solutions are created to help maximize the healthcare they receive. Free, open-sourced and adaptable EHRs can enable organizations to better provide for displaced populations.

Managing the Digital Disruption Associated with COVID-19-Driven Rapid Digital Transformation in Brisbane, Australia

2021 ◽  
Vol 12 (05) ◽  
pp. 1135-1143
Author(s):  
Amalie Dyda ◽  
Magid Fahim ◽  
Jon Fraser ◽  
Marianne Kirrane ◽  
Ides Wong ◽  
...  
Keyword(s):  
Care Delivery ◽  
Digital Health ◽  
Clinical Care ◽  
Models Of Care ◽  
Digital Transformation ◽  
Lessons Learned ◽  
Digital Data ◽  
Routine Practice ◽  
Action Research Project ◽  
Digital Disruption

Abstract Background The COVID-19 pandemic has forced rapid digital transformation of many health systems. These innovations are now entering the literature, but there is little focus on the resulting disruption. Objective We describe the implementation of digital innovations during the COVID-19 response of Australia's largest health service, Metro North (in Brisbane, Queensland), the challenges of the subsequent digital disruption, how these were managed, and lessons learned. Methods Prior to the COVID-19 pandemic, the Australian state of Queensland created the Queensland Digital Clinical Charter, which provides guidance for the development of digital health programs. The guidelines utilize three horizons: digitizing workflows, leveraging digital data to transform clinical care, and reimagining new and innovative models of care. The technical response to COVID-19 in Metro North is described across these horizons. The rapid digital response caused significant disruption to health care delivery; management of the disruption and the outcomes are detailed. This is a participatory action research project, with members of the research team assisting with leading the implementation project informing the case report content. Results Several digital innovations were introduced across Metro North during the COVID-19 response. This resulted in significant disruption creating digital hypervigilance, digital deceleration, data discordance, and postdigital “depression.” Successful management of the digital disruption minimized the negative effects of rapid digital transformation, and contributed to the effective management of the pandemic in Queensland. Conclusion The rapid digital transformation in Metro North during COVID-19 was successful in several aspects; however, ongoing challenges remain. These include the need to improve data sharing and increase interoperability. Importantly, the innovations need to be evaluated to ensure that Metro North can capitalize on these changes and incorporate them into long-term routine practice. Moving forward, it will be essential to manage not only the pandemic, but increasingly, the resultant digital disruption.

scholarly journals Patients, Families, and Communities COVID-19 Impact Assessment: Lessons Learned and Compelling Needs

2021 ◽  
Vol 11 ◽  
Author(s):  
Frederick Isasi ◽  
◽  
Mary D. Naylor ◽  
David Skorton ◽  
David Grabowski ◽  
...  
Keyword(s):  
Impact Assessment ◽  
Lessons Learned

Implementation of Evidence-based Humanitarian Programs in Military-led Missions: Part I. Qualitative Gap Analysis of Current Military and International Aid Programs

2008 ◽  
Vol 2 (4) ◽  
pp. 230-236 ◽  
Author(s):  
Erik J. Reaves ◽  
Kenneth W. Schor ◽  
Frederick M. Burkle
Keyword(s):  
Impact Assessment ◽  
Department Of Defense ◽  
Gap Analysis ◽  
International Aid ◽  
Humanitarian Assistance ◽  
Lessons Learned ◽  
Assessment Process ◽  
Evidence Based ◽  
Stability Operations ◽  
Measures Of Effectiveness

ABSTRACTBackground: A recent Department of Defense instruction mandates country-specific assessments, identification of interventions, and development of guidance for Department of Defense to plan, train, and prepare for the provision of humanitarian assistance in stability operations. It also directs the use of outcome-based measures of effectiveness and the establishment of processes facilitating transparency of information. Whereas this would align military-led projects closer to the standards of the international aid community, how this process will be developed and implemented within the military has not yet been determined.Methods: To begin developing an evidence-based program for military-led humanitarian aid, we conducted a qualitative gap analysis comparing information from a Web search of Department of Defense medical after-action reports, lessons learned, and expert interviews with the internationally accepted standards in humanitarian assistance impact assessment.Results: There is a major gap in the ability of the Department of Defense to assess the impact of humanitarian assistance in stability operations compared with international development standards. Of the 1000 Department of Defense after-action reports and lessons learned reviewed, only 7 (0.7%) reports refer to, but do not discuss, impact assessment or outcome-based measures of effectiveness.Conclusions: This investigation shows that the Department of Defense humanitarian assistance operations are, historically, recorded without documentation using quantifiable health data identifying which aid activities contributed directly to desired outcomes or favorable public opinion, and rarely are analyzed for effectiveness. As humanitarian assistance operations assume an ever greater role in US military strategy, it is imperative that we investigate useful impact assessment models to meet mission directives and, more important, to maximize coordination in a necessarily integrated and cooperative development environment. These findings provide baseline knowledge for the implementation of an evidence-based impact assessment process to validate future Department of Defense humanitarian assistance operations. (Disaster Med Public Health Preparedness. 2008;2:230–236)

scholarly journals STRATEGIC PLANNING, IMPACT ASSESSMENT, AND TECHNICAL AID: THE SOUSS-MASSA INTEGRATED WATER MANAGEMENT PROJECT

2004 ◽  
Vol 06 (02) ◽  
pp. 245-259 ◽  
Author(s):  
JOHN E. KEITH ◽  
SAID OUATTAR
Keyword(s):  
Water Management ◽  
Strategic Planning ◽  
Impact Assessment ◽  
River Basin ◽  
Model Building ◽  
Integrated Management ◽  
Social Systems ◽  
Lessons Learned ◽  
Decision Makers ◽  
Integrated Water Management

Government agencies, like individuals, can "lose sight" of the impacts of their policies on natural and social systems. Environmental impact analysis (EIA), strategic environmental analysis (SEA), and strategic planning are all aspects of analyzing and projecting the impacts of various management decisions on the public and on natural systems. Integrated river-basin management is another aspect of this type of planning. Integrated management requires several basic conditions. Among these are clear communications among all the actors involved in managing the basin's water resources, one or more sets of data which are shared by all decision-makers, and tools by which the decision-makers can evaluate policies (impact assessment). In the Souss Massa River Basin in Morocco, the result of un-coordinated policies for economic development has led to declining water tables as well as potentially damaging surface and groundwater pollution. The Government of Morocco (GOM), recognizing the need for coordinated and integrated water management, passed a law creating new River Basin Agencies. Aiding those agencies and their partners in developing integrated management is the objective of the USAID-sponsored Souss-Massa Integrated Water Management (SIWM) project. The project activities have been designed to develop and support communications, data sharing and model building within the institutions in the Souss-Massa Basin as a demonstration for all Moroccan river basins but space and time constraints require a more pointed discussion. The focus of this paper is on capacity building for strategic planning and integrated management being undertaken and, to the extent possible, some of the lessons learned.

scholarly journals The Development of an Electronic Clinical Decision and Support System to Improve the Quality of Antenatal Care in Rural Tanzania: Lessons Learned Using Intervention Mapping

2021 ◽  
Vol 9 ◽  
Author(s):  
Sandra van Pelt ◽  
Karlijn Massar ◽  
Laura Shields-Zeeman ◽  
John B. F. de Wit ◽  
Lisette van der Eem ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Support System ◽  
Healthcare Workers ◽  
Digital Health ◽  
Intervention Mapping ◽  
Clinical Decision ◽  
Lessons Learned ◽  
Maternal Deaths ◽  
Nurse Assistant

It is widely recognised that high quality antenatal care is a key element in maternal healthcare. Tanzania has a very high maternal mortality ratio of 524 maternal deaths per 100,000 live births. Most maternal deaths are due to preventable causes that can be detected during pregnancy, and antenatal care therefore plays an important role in reducing maternal morbidity and mortality. Unfortunately, quality of antenatal care in Tanzania is low: Research has shown that healthcare workers show poor adherence to antenatal care guidelines, and the majority of pregnant women miss essential services. Digital health tools might improve the performance of healthcare workers and contribute to improving the quality of antenatal care. To this end, an electronic clinical decision and support system (the Nurse Assistant App) was developed and implemented in Tanzania in 2016 to provide digital assistance during antenatal care consultations to healthcare workers. The current study systematically evaluated the development and implementation process of the Nurse Assistant App in Magu District, Tanzania, with the aim of informing future programme planners about relevant steps in the development of a digital health intervention. Desk research was combined with semi-structured interviews to appraise the development process of the digital health tool. We employed the criteria stipulated by Godin et al., which are based on the six steps of Intervention Mapping [IM; Bartholomew Eldredge et al.]. Findings indicated that five of the six steps of IM were completed during the development and implementation of the Nurse Assistant App. Tasks related to community engagement, adjustment to local context, implementation in the practical context in collaboration with local partners, and rigorous evaluation were accomplished. However, tasks related to identifying theory-based behaviour change methods were not accomplished. Based on the lessons learned during the process of developing and implementing the Nurse Assistant App, we conclude that programme developers are recommended to (1) engage the community and listen to their insights, (2), focus on clear programme goals and the desired change, (3), consult or involve a behaviour change specialist, and (4), anticipate potential problems in unexpected circumstances.

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