Addressing the challenges of diagnostics demand and supply: insights from an online global health discussion platform.
Addressing the challenges of diagnostics demand and supply: insights from an online global health discussion platform.
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DOI：
10.1136/bmjgh-2016-000132
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发表时间：
2016
影响因子：
8.1
通讯作者：
Weintraub R
中科院分区：
文献类型：
--
作者：
Engel N;Wachter K;Pai M;Gallarda J;Boehme C;Celentano I;Weintraub R
低收入和中等收入国家诊断技术的开发、采用和扩大面临着一些障碍。创新的全球健康讨论平台可以从全球健康界获取有关驱动诊断需求和供应因素的见解。我们对哈佛大学全球健康服务项目 (GHD) (http://www.ghdonline.org/) 组织的在线讨论“推进医疗服务：推动诊断的需求和供应”进行了定性内容分析。此次讨论由 12 名专家小组成员推动，探讨了必须采取哪些措施来开发交付系统、商业模式、新技术、互操作性标准和治理机制，以确保患者在正确的时间获得正确的诊断。 GHD Online (GHDonline) 平台拥有来自 185 个国家的 19 000 多名会员。诊断讨论的参与者 (N=99) 包括学者、非政府组织、制造商、政策制定者和医生。使用定性数据分析软件对数据进行编码并分析总体类别。与会者认为，与物流、不符合用户需求、成本、劳动力、基础设施、准入、监管薄弱和政治承诺等运营和卫生系统挑战相比，诊断的技术特征是有效使用诊断的障碍较小。建议的解决方案包括：通过以患者为中心的服务来加强卫生系统；加强创新流程；改进的知识库；统一的指导方针和评估；供应链创新；确保质量和能力的机制。让参与诊断开发和使用的不同参与者参与和联系对于改进诊断至关重要。虽然讨论参与者并不代表所有参与者，但该平台使全球公认的专家和在不同国家工作的医生之间进行了讨论。
Several barriers challenge development, adoption and scale-up of diagnostics in low and middle income countries. An innovative global health discussion platform allows capturing insights from the global health community on factors driving demand and supply for diagnostics. We conducted a qualitative content analysis of the online discussion ‘Advancing Care Delivery: Driving Demand and Supply of Diagnostics’ organised by the Global Health Delivery Project (GHD) (http://www.ghdonline.org/) at Harvard University. The discussion, driven by 12 expert panellists, explored what must be done to develop delivery systems, business models, new technologies, interoperability standards, and governance mechanisms to ensure that patients receive the right diagnostic at the right time. The GHD Online (GHDonline) platform reaches over 19 000 members from 185 countries. Participants (N=99) in the diagnostics discussion included academics, non-governmental organisations, manufacturers, policymakers, and physicians. Data was coded and overarching categories analysed using qualitative data analysis software. Participants considered technical characteristics of diagnostics as smaller barriers to effective use of diagnostics compared with operational and health system challenges, such as logistics, poor fit with user needs, cost, workforce, infrastructure, access, weak regulation and political commitment. Suggested solutions included: health system strengthening with patient-centred delivery; strengthened innovation processes; improved knowledge base; harmonised guidelines and evaluation; supply chain innovations; and mechanisms for ensuring quality and capacity. Engaging and connecting different actors involved with diagnostic development and use is paramount for improving diagnostics. While the discussion participants were not representative of all actors involved, the platform enabled a discussion between globally acknowledged experts and physicians working in different countries.