WHO: Telehealth use developing in low- and middle-income countries

Various types of information communication technology (ICT) are being employed by private organizations to address key health system challenges. However, for successful implementation, more sustainable sources of funding, greater support for the adoption of new technologies and better ways of evaluating impact are required, according to an article published in the May 1 issue of the Bulletin of the World Health Organization.

Trevor Lewis, of the Results for Development Institute in Washington, D.C., and colleagues described how ICT is being used by programs that seek to improve private sector health financing and delivery in low- and middle-income countries, including the main uses of the technology and the types of technologies being used.

In-country partners in 16 countries were searched systematically for innovative health programs and compiled profiles in the Center for Health Market Innovations’ database. These data were supplemented through literature reviews and with self-reported data supplied by the programs themselves.

In many low- and middle-income countries, ICT is being increasingly employed for different purposes in various health-related areas. Of ICT-enabled health programs, 42 percent use it to extend geographic access to healthcare, 38 percent to improve data management and 31 percent to facilitate communication between patients and physicians outside the physician’s office.

Other purposes include improving diagnosis and treatment (17 percent), mitigating fraud and abuse (8 percent) and streamlining financial transactions (4 percent). The most common devices used in technology-enabled programs are phones and computers; 71 percent and 39 percent of programs use them, respectively, and the most common applications are voice (34 percent), software (32 percent) and text messages (31 percent). Donors are the primary funders of 47 percent of ICT-based health programs.

“Six major reasons for the use of ICT in health have emerged in this paper,” the authors wrote. “Some, such as extending access to care or improving data management, are rather common, but there are budding uses as well, specifically in fields such as mitigating fraud and abuse and streamlining financial transactions. These fields deserve special attention to ensure their proper development. As e-health continues to evolve, many of the current challenges faced by health systems in low- and middle-income countries, such as the shortage of health workers in rural areas, the variable quality of care, lack of patient compliance and fraud, will potentially be mitigated through the wide deployment of ICT.

“It will be crucial to continue to track which of these purposes are being successfully fulfilled by technology and what devices and use cases are most effective in attaining them,” they concluded. “This will require more systematic evaluations and better codification of lessons learned from existing programs, which in turn will allow programs that are currently struggling to employ technology to make educated decisions about when and how to implement ICT.”

The research was funded by the Rockefeller Foundation and the Bill & Melinda Gates Foundation.