Developing and deploying a community healthcare worker-driven, digitally-enabled integrated care system for municipalities in rural Nepal
Developing and deploying a community healthcare worker-driven, digitally-enabled integrated care system for municipalities in rural Nepal
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DOI：
10.1016/j.hjdsi.2018.05.002
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发表时间：
2018-09-01
影响因子：
2.5
通讯作者：
Maru, Duncan
中科院分区：
文献类型：
--
作者：
Citrin, David;Thapa, Poshan;Maru, Duncan
在家庭和机构层面整合护理是医疗保健服务系统的一项重要但被忽视的功能。在低收入和中等收入国家的医疗保健服务系统中嵌入可负担得起的、数字化的综合护理方法，在实践中或学术文献中很少有例子。负担得起的数字技术和社区医疗工作者的同步进步为应对这一挑战提供了机会。我们描述了涉及社区医疗保健工作者网络的综合护理系统的开发，该网络利用尼泊尔农村地区的家庭到设施电子健康记录平台。我们与全球受众相关的方法的关键方面包括： 社区医护人员通过每三个月的家访不断与民众互动；社区医护人员在日常临床护理过程中使用数字工具；定期生成的个人和人口层面的数据用于改进方案；并对隐私、安全和人权问题做出回应。我们讨论综合护理服务系统未来方向的实施、经验教训、挑战和机遇。
Integrating care at the home and facility level is a critical yet neglected function of healthcare delivery systems. There are few examples in practice or in the academic literature of affordable, digitally-enabled integrated care approaches embedded within healthcare delivery systems in low-and middle-income countries. Simultaneous advances in affordable digital technologies and community healthcare workers offer an opportunity to address this challenge. We describe the development of an integrated care system involving community healthcare worker networks that utilize a home-to-facility electronic health record platform for rural municipalities in Nepal. Key aspects of our approach of relevance to a global audience include: community healthcare workers continuously engaging with populations through household visits every three months; community healthcare workers using digital tools during the routine course of clinical care; individual and population-level data generated routinely being utilized for program improvement; and being responsive to privacy, security, and human rights concerns. We discuss implementation, lessons learned, challenges, and opportunities for future directions in integrated care delivery systems.