Mahmud Nadim, Rodriguez Joce, Nesbit Josh
Stanford University School of Medicine, Stanford, CA, USA.
Technol Health Care. 2010;18(2):137-44. doi: 10.3233/THC-2010-0576.
Healthcare delivery in the rural developing world is limited by a severe shortage of health workers as well as profound communicative and geographic barriers. Understaffed hospitals are forced to provide care for patients that reside at a great distance from the institutions themselves, sometimes more than 100 miles away. Community health workers (CHWs), volunteers from local villages, have been integral in bridging this patient-physician gap, but still lose enormous of amounts of time in transit between hospital and village. We report the results of a retrospective mobile health (mHealth) pilot at St. Gabriel's Hospital in Malawi designed to eliminate many of these trips in favor of communication via text messages. A group of 75 CHWs were supplied with cell phones and trained to utilize the network for a variety of usage cases, including patient adherence reporting, appointment reminders, and physician queries. At the end of the pilot, the hospital saved approximately 2,048 hours of worker time, $2,750 on net ($3,000 in fuel savings minus $250 in operational costs), and doubled the capacity of the tuberculosis treatment program (up to 200 patients). We conclude that mHealth interventions can provide cost-effective solutions to communication barriers in the setting of rural hospitals in the developing world.
农村发展中地区的医疗服务受到卫生工作者严重短缺以及巨大的沟通和地理障碍的限制。人员不足的医院不得不为居住在距离医院很远的患者提供护理，有时距离超过100英里。社区卫生工作者（CHWs），即来自当地村庄的志愿者，在弥合医患差距方面发挥了重要作用，但在医院和村庄之间的往返途中仍会浪费大量时间。我们报告了在马拉维圣加布里埃尔医院进行的一项回顾性移动健康（mHealth）试点的结果，该试点旨在减少许多此类行程，转而通过短信进行沟通。为一组75名社区卫生工作者提供了手机，并对他们进行培训，使其能够在各种使用场景中利用网络，包括患者依从性报告、预约提醒和向医生咨询。在试点结束时，医院节省了约2048小时的工作人员时间，净节省2750美元（节省3000美元的燃料费用减去250美元的运营成本），并使结核病治疗项目的能力提高了一倍（达到200名患者）。我们得出结论：移动健康干预措施可以为发展中世界农村医院环境中的沟通障碍提供具有成本效益的解决方案。
