Ncube Benson, Mars Maurice, Scott Richard E
Department of Telehealth, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Dynamics Research & Development Institute, Gaborone, Botswana.
Digit Health. 2022 May 29;8:20552076221102768. doi: 10.1177/20552076221102768. eCollection 2022 Jan-Dec.
Global efforts to implement national ehealth strategies have occurred, yet specific telemedicine implementations have fallen behind. A weakness inherent within many, perhaps most, national ehealth strategies, including Botswana's - is a lack of telemedicine focus. This is despite its potential to address many current healthcare system needs. The development of a telemedicine-specific strategy, to complement the existing ehealth strategy, has been proposed. This paper reports on an emulated process to determine prioritised health needs, identify broad solutions, consider ehealth and then telemedicine solutions, and prioritise these as insight for telemedicine-specific strategy development.
The eHealth Strategy Development Framework (eHSDF) was adopted and steps 5-7 were emulated. Key informants participated in telephone-based semi-structured interviews in November 2020, using a key informant interview guide. Participants were asked specific questions related to national health needs, proposed solutions, and prioritisation. The interviews were recorded and transcribed for analysis.
Eleven key informants identified the top five perceived health issues as human resource shortages, congestion and overcrowding, prevalence of diseases, poor referral system, and lack of diagnostic and case management skills. Solutions were proposed, some of which included: Telehealth (including telemedicine), health informatics, and elearning. Telemedicine solutions included: a health professional help desk, teleconsultations, and apps for specialist referral. eLearning solutions were training, mentoring, and continuing professional development.
A telemedicine-specific strategy, addressing the identified health issues and aligned to the existing national ehealth strategy, would provide the required focus to enable the development and deployment of telemedicine activities in the country.
全球已在努力实施国家电子健康战略，但具体的远程医疗实施却落后了。许多国家（或许是大多数国家），包括博茨瓦纳的国家电子健康战略，其内在的一个弱点是缺乏对远程医疗的关注。尽管远程医疗有潜力满足当前医疗系统的许多需求，但情况依然如此。有人提议制定一项专门针对远程医疗的战略，以补充现有的电子健康战略。本文报告了一个模拟过程，该过程用于确定优先的健康需求、识别广泛的解决方案、考虑电子健康然后是远程医疗解决方案，并将这些作为制定专门针对远程医疗战略的见解进行优先排序。
采用电子健康战略发展框架（eHSDF）并模拟步骤5 - 7。关键信息提供者于2020年11月参加了基于电话的半结构化访谈，使用关键信息提供者访谈指南。向参与者询问了与国家健康需求、提议的解决方案和优先排序相关的具体问题。访谈进行了录音和转录以供分析。
11名关键信息提供者将最受关注的五大健康问题确定为人力资源短缺、拥堵和过度拥挤、疾病流行、转诊系统不佳以及缺乏诊断和病例管理技能。提出了一些解决方案，其中包括：远程健康（包括远程医疗）、健康信息学和电子学习。远程医疗解决方案包括：健康专业人员帮助台、远程会诊以及专科转诊应用程序。电子学习解决方案包括培训、指导和持续专业发展。
一项专门针对远程医疗的战略，解决已确定的健康问题并与现有的国家电子健康战略保持一致，将提供必要的重点关注，以推动该国远程医疗活动的开发和部署。
