Accepted for/Published in: JMIR Human Factors
Date Submitted: Oct 29, 2020
Open Peer Review Period: Oct 28, 2020 - Dec 23, 2020
Date Accepted: Sep 10, 2022
(closed for review but you can still tweet)
Development of a digital assistant to support teleconsultations between remote doctors and frontline health workers in India: A User-centered Design Approach
ABSTRACT
Background:
Many low and middle-income countries (LMICs) have adopted telemedicine programs that connect frontline health workers (FHWs) such as nurses, midwives, or community health workers in rural and remote areas with doctors in urban areas to deliver care to patients. By leveraging technology to reduce temporal, financial, and geographic barriers, these health worker-to-doctor telemedicine programs have the potential to increase quality, to expand the specialties available to patients, and to reduce the time and cost required to deliver care.
Objective:
We aimed to identify, validate, prioritize unmet needs in this healthcare space of health worker-to-doctor telemedicine programs, and develop and refine a solution that addresses those needs.
Methods:
We collected information regarding user needs through ethnographic research, direct observation, and semi-structured interviews with 37 stakeholders (5 doctors, 1 public health program manager, 12 community health workers, and 19 patients) at two telemedicine clinics in rural West Bengal, India. We used the Spiral-Innovative Iteration model to design and develop a prototype solution to meet these needs.
Results:
We identified 74 unmet needs through our immersion in health worker-to-doctor telemedicine programs. We identified a critical unmet need that achieving optimal teleconsultations in LMICs often requires shifting tasks such as history taking and physical examination, from high-skilled remote doctors to the frontline health worker (FHW). To solve this need, we developed a prototype digital assistant that would allow frontline health workers to assume some of the tasks carried out by remote clinicians. The user needs of multiple stakeholder groups (patients, FHWs, doctors, and health organizations) informed this task-shifting tool.
Conclusions:
The final prototype developed was released as an open source digital public good and may improve the quality and efficiency of care delivery in health worker-to-doctor telemedicine programs.
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Copyright
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