Department of Clinical Pharmacy and Pharmacology, University Medical Centrum Groningen, University of Groningen, Groningen, Netherlands.
Pneumology Hospital Iasi, Iasi, Romania.
JMIR Mhealth Uhealth. 2020 Nov 2;8(11):e18156. doi: 10.2196/18156.
Digitally delivering healthcare services is very attractive for tuberculosis (TB) management as this disease has a complex diagnosis and lengthy management and involves multiple medical and nonmedical specialists. Especially in low- and middle-income countries, eHealth could potentially offer cost-effective solutions to bridge financial, social, time, and distance challenges.
The goal of the research is to understand what would make eHealth globally applicable and gain insight into different TB situations, opportunities, and challenges.
We performed focus group interviews with TB experts and patients from 6 different countries on 4 different continents. The focus group interviews followed the theory of planned behavior framework to offer structured recommendations for a versatile eHealth solution. The focus group interviews were preceded by a general demographic and technology use questionnaire. Questionnaire results were analyzed using basic statistics in Excel (Microsoft Corporation). Focus group interview data were analyzed using ATLAS.ti 8 (ATLAS.ti Scientific Software Development GmbH) by assigning codes to quotations and grouping codes into the 5 domains within the framework.
A total of 29 patients and 32 medical staff members were included in our study. All medical staff had used the internet, whereas 31% (9/61) of patients had never been online. The codes with the most quotations were information in relation to eHealth (144 quotations) and communication (67 quotations). The consensus among all participants from all countries is that there are important communication and information gaps that could be bridged by an eHealth app. Participants from different countries also highlighted different challenges, such as a majority of asylum-seeker patients or lack of infrastructure that could be addressed with an eHealth app.
Within the 6 countries interviewed, there is high enthusiasm toward eHealth in TB. A potential app could first target information and communication gaps in TB, with additional modules aimed at setting-specific challenges.
数字化医疗服务对于结核病（TB）管理极具吸引力，因为该病的诊断复杂，管理过程漫长，需要涉及多个医学和非医学专业人员。特别是在中低收入国家，电子医疗保健有可能提供具有成本效益的解决方案，以克服财务、社会、时间和距离方面的挑战。
本研究旨在了解使电子医疗保健在全球范围内适用的因素，并深入了解不同的结核病情况、机会和挑战。
我们在四大洲六个国家进行了结核病专家和患者的焦点小组访谈。焦点小组访谈遵循计划行为理论框架，为通用的电子医疗保健解决方案提供了结构化建议。在进行焦点小组访谈之前，我们进行了一般人口统计学和技术使用问卷。使用 Excel（Microsoft Corporation）中的基本统计数据对问卷结果进行了分析。使用 ATLAS.ti 8（ATLAS.ti Scientific Software Development GmbH）对焦点小组访谈数据进行了分析，通过给引语分配代码并将代码分组到框架中的五个领域来实现。
共有 29 名患者和 32 名医务人员参加了我们的研究。所有医务人员都使用过互联网，而 31%（9/61）的患者从未上网过。引用最多的代码是与电子医疗保健相关的信息（144 个引语）和交流（67 个引语）。所有国家的所有参与者都一致认为，存在重要的沟通和信息差距，可以通过电子医疗保健应用程序来弥合。来自不同国家的参与者还强调了不同的挑战，例如大多数寻求庇护的患者或缺乏基础设施，这些都可以通过电子医疗保健应用程序来解决。
在所采访的六个国家中，结核病对电子医疗保健有很高的热情。一个潜在的应用程序可以首先针对结核病中的信息和沟通差距，然后添加针对特定国家/地区的挑战的模块。
