Acceptability of Information Technology Systems Developed for Distant Philippine Communities among Local Health Providers
Abstract
Introduction. The National Telehealth Service Program (NTSP) has developed Information Technology (IT) systems aimed at improving health services primarily in isolated Philippine communities. These included two electronic health records modalities (Community Health Information Tracking System, or CHITS, and Real-time Regular Routine Reporting for Health, or R4Health), a referral system (Telemedicine), and a remote diagnostic device (RxBox).
Objectives. This study was undertaken to describe the utilization and cost patterns as well as the perceptions of the local health personnel regarding the use of the various NTSP systems. The implications of the end-user perceptions on the acceptability and expanded use of the IT interventions were inferred, from which corresponding policy recommendations were made.
Methods. Twelve NTSP sites, including far-flung and economically depressed communities, where the systems were concurrently available over a defined six month period, were selected. The frequency of respective system transactions for these sites was collected from NTSP files. Interviews and focus group discussions were conducted at the communities, involving physicians, nurses, midwives, and other health workers. Associated costs, and perceptions related to the adoption, operation, and sustained use of the IT systems were elucidated.
Results. Telemedicine, though the least costly modality, was the least utilized of the systems. While both R4Health and CHITS facilitated health data management, CHITS provided more locally-relevant information. The RxBox system, due to its clinical diagnostic device component, was widely accepted and also increased health center consultations, especially among pregnant patients. Technical malfunctions, as well as system failures following natural calamities, were recurrent problems.
Conclusions. The RxBox system, with its bundled health records and specialist consultation functions, is highly accepted by health providers and other community stakeholders. The technology can be expected to be similarly well-regarded in other settings. The stand-alone IT modalities that do not directly or significantly benefit the actual implementers are not as sustainable.
