An mHealth Approach to Addressing Health Inequity

ABSTRACT: Little is known at the local level how mHealth interventions support consumers’ goal of a healthy lifestyle and the impact of mHealth interventions on providing equitable care. This paper investigates: 1) the social determinants of health (SDOH) that affect the ability of people to be healthy and 2) clinicians use of mHealth interventions to facilitate equitable provision of healthcare. Socioeconomic and health data was collected from all 93 Nebraska counties. A positive correlation was found between the ability of people to be healthy and their access to health insurance and fresh food. A correlation was also discovered between poverty and the ability of people to be healthy and access food. A mobile app was then developed to provide information on available community resources for patients of a student-run free clinic. The contribution of this study is determining how mHealth can be used as a sustainable health equity intervention.

Keywords: Health equity, Social determinants of health, mHealth, Systems engineering, Sustainable development

Creating a Better World with Information and Communication Technologies: Health Equity

ABSTRACT: When news broke on 23rd July 2014, that a case of the deadly virus Ebola had been confirmed in Lagos, home to about 21 million people and a major transportation hub, the World held its breath. If not contained, this virus could spread quickly killing a multitude of people around the World. By 15th October, cases of Ebola had been recorded around the World: Liberia reported 4249 cases with 2458 deaths, Sierra Leone reported 3252 cases with 1183 deaths, Guinea 1472 cases with 843 deaths, Nigeria reported 20 cases with 8 deaths, the USA reported 3 cases and 1 death, Spain and Senegal reported 1 case with no deaths (Qureshi et al, 2015).

Keywords: Health equity, Information and Communication Technologies, Mobile signals, Equitable healthcare, social media

Cycles of Electronic Health Records Adaptation by Physicians: How Do the Positive and Negative Experiences with the EHR System Affect Physicians' EHR Adaptation Process?

ABSTRACT: The integration of EHR in IT infrastructures supporting organizations enable improved access and recording of patient data, enhanced ability to make improved decisions, improved quality and reduced errors in patient care. Despite these benefits, there are mixed results as to the use of EHR. The literature suggests that the reasons for the limited use relate to policy, financial and usability considerations, but it does not provide an understanding of reasons for physicians' limited interaction and adaptation of EHR. Following an analysis of qualitative data, collected in a case study at a hospital using interviews, this research explains how physicians interact with EHR. The key contribution of this research is in explaining how physicians interact with EHR in terms of concepts that are grounded in the real world experiences of physicians. The model of positive and negative physician work cycles is introduced and discussed. Contributions to research and practice are presented.

Keywords: EHR Adaption, Electronic Health Records, Physician Adaptation, Qualitative EHR Use

Equitable Healthcare Provision: Uncovering the Impact of the Mobility Effect on Human Development

ABSTRACT: Even though the effects of mobile phone and internet usage on the health and wellbeing of a population are becoming apparent, few studies have uncovered the nature of this relationship to the equitable provision of healthcare. The contribution is in discovering the relationships between mobility effects and human development where inequities in income play an important role, the relationships to socio-economic development and in showing how the mobility effect can assist in addressing health inequities.

Keywords: Human development, Healthcare, socio-economic development, IThealth

How Can Physician's Knowledge Be Activated to Provide Better Healthcare? Explaining Electronic Health Record Adaptation by Physicians

ABSTRACT: Despite the rising costs of healthcare and falling quality of care, the integration of EHR (Electronic Health Records) in supporting collaboration to increase the efficiency and effectiveness of healthcare remains a challenge. It appears that the physicians are at the center of this bottleneck. The literature suggests that the reasons for the limited use relate to policy, financial and usability considerations, but it does not provide an understanding of reasons for physicians' limited interaction and adaptation of EHR. Following an analysis of qualitative data, collected in a case study at a hospital using interviews, this research shows how a collaborative technology architecture can enable the physicians to better interact with their partners using the E.H.R technology for the purpose of improving healthcare provision.

Keywords: Collaboration, Electronic Medical Records, Information technology, Hospitals, Medical diagnostic imaging, Adaptation models

Mobile Access for Patient Centered Care: The Challenges of Activating Knowledge through Health Information Technology

ABSTRACT: With the growing use of mobile technology to access health information, patients are being empowered in their healthcare choices. While specific mobile applications are becoming available for patients to manage their own care, most treatment processes support healthcare professionals and offer little support for patient centered care. In order to address this problem, federal regulations require providers to become "meaningful users" of Health Information Technology (HIT) in an effort to encourage patient centered care through the assessment of health outcomes. This paper contends that addressing meaningful use practices for patient centered care involves the activation of knowledge, which means bringing knowledge into action. A survey of 73 health care providers sought to discover how their knowledge activation affects patient centered care. The results suggest that current HIT usage by providers has limited knowledge activation. The contribution of this research is in that it identifies areas that would to bring about improvements in patient centered care and a model that shows how mobile access to patient records could potentially streamline the patient care process.

Keywords: Mobile communication, Electronic Medical Records, Information technology, Hospitals, Medical diagnostic imaging, Encoding

Outrage and anger in a global pandemic: flipping the script on healthcare

ABSTRACT: Amidst a global pandemic, outrage and anger over the death of a Black man at the hands of a White police officer spread globally. The protests exposed generations of institutional racism and socio-economic inequities in many countries. This editorial explores the socio-economic inequities that have left those in racially segregated marginalized communities most at risk from COVID 19. It offers a cyclical view of the relationship between socio-economic inequities and health outcomes, suggesting that once these inequities are addressed, then health outcomes can improve. There is an important role to be played by ICTs in enabling a positive cycle to take place. The papers in this issue reflect the ways in which the socio-economic indicators can be increased to support better health outcomes for people in low SES communities. They uncover the key issues facing communities offering healthcare service to their constituents and move the field forward by showing the ways in which ICTs may support a positive cycle of development and health outcomes.

Keywords: COVID-19, socio-economic inequities, Healthcare, World Economic Forum, Outrage

Pandemics within the pandemic: confronting socio-economic inequities in a datafied world

ABSTRACT: The pandemic has brought to light and exacerbated inequities that have plagued the world even before COVID-19 spread. Despite its medical and technological advances, much of the western world was unprepared for what its people faced. With a death toll and mortality rates unseen in modern times, the datafied world amidst some populist regimes witnessed additional pandemics within the pandemic of raging infections. In the changing world broadband internet access is becoming more essential to enabling people to lead their lives while locked-down and/or in quarantine. People become accustomed to accessing healthcare information, resources and providers through mobile and or other devices for their COVID 19 information, while tracking and tracing is being carried out using mobile applications. Those at the margins become vulnerable to digital biopolitics or efforts by governments and corporations to maximize knowledge and control of populations using digital means for political and economic power. In this the datafied society, increased data surveillance offered cause for activism and fight for human rights and freedoms. This also referred to as the datafied pandemic in which life revolves on the internet more than ever through access to tools, basic services, and social environments. Within these digital divides, the forces of globalization forge ahead with perils and promises. These issues are explored in this editorial and ways of tackling the pandemics offered in the light of papers in this issue. ICT4D research offers ways in which we may together create a better world for all.

Keywords: COVID-19, Quarantine, mobile application, Datafied pandemic, social environments

Physician Interaction with Electronic Health Records: The Influences on Digital Natives and Digital Immigrants

ABSTRACT: The integration of EHR (Electronic Health Records) in IT infrastructures supporting organizations enable improved access to and recording of patient data, enhanced ability to make better and more-timely decisions, and improved quality and reduced errors. Despite these benefits, there are mixed results as to the use of EHR. The literature suggests that the reasons for the limited use relate to policy, financial and usability considerations, but it does not provide an understanding of reasons for physicians' limited interaction and adaptation of EHR. Following an analysis of qualitative data, collected in a case study at a hospital using interviews, this research explains how physicians interact with EHR. The key contribution of this research is explaining how physicians interact with EHR in terms of concepts that are grounded in the real world experiences of physicians.

Keywords: Electronic Health Records, Digital natives, Digital immigrants, IT infrastructure, patient data access, patient data recording, Qualitative data analysis

Role of Social Determinants of Health in building an mHealth application

ABSTRACT: The pandemic has shown that the health of those with the least resources affects the rest of the population. Social determinants of health effect health disparities leading to greater inequities between those with and those without the resources needed to stay healthy. In order to help people, find resources they need to stay healthy, an mHealth application was created. Data was collected through this mobile application to investigate: what are the social determinants of health resources (SDOH) that are needed to address health inequities? Using this data, an mHealth prototype was developed to help understand whether the application can be useful in addressing the health inequities in a local community. Following a design science approach, the analysis suggests that resources for some social determinants of health are more useful than others. The contribution of this paper is in uncovering the SDOH resources that are needed to address the health inequities.

Keywords: Health equity, Social determinants of health

Social Determinants of Health Inequities and Human Development: Is there a role for mHealth in overcoming health inequities?

ABSTRACT: The spread of the pandemic in recent years has disproportionately affected people who are unable to access the basic resources needed to survive. Such resources include but are not limited to food, shelter, capital and the ability to find the information they need to stay healthy. These socioeconomic factors influence the manner in which people and communities are able to recover. This paper investigates the relationship between social determinants of health and human development and the role of mHealth in overcoming health inequities. Data was collected for 27 variables from 189 countries through the United Nations, World Bank and the World Health Organization’s databases. Following an analysis of a model comprising of indices created to test a set of hypotheses, this paper offers unique insight into the social determinants of health that can be overcome through mHealth. The contribution of this paper is in uncovering the social determinants of health that are related to human development and how mhealth access is related to social determinants of health and the Human Development Index. This has implications for how inequalities may be addressed through mobile health applications to bring about human development.

Keywords: Health equity, Social determinants of health, mHealth, Health inequity

Sustainable Development Through a Mobile Application for a Community Clinic

ABSTRACT: Implementing Information and Communication Technology (ICT) solutions can alleviate pressing problems in society and are a central component of sustainable development. Often, healthcare addresses the symptoms without approaching the socioeconomic limiters that can lead to reduced individual economic freedoms from receiving healthcare. This paper investigates the question: How can technology and training interventions enable clinicians to offer care that addresses the socioeconomic limitations of their patients? This paper observes the implementation of a mobile app designed to offer people who cannot access health resources in Omaha, Nebraska, a city in the Midwestern United States. This study follows the design science and action research approach, with clinicians participating in developing the mobile app. As a result of COVID, patients no longer have access to the free clinic because it was shut down. The app is available to the broader community needing basic resources to stay healthy. Through sets of application revisions and observations of usage, this paper arrives at insights into how such applications can support multi-ethnic and underserved communities. The contribution of this paper is to provide contextually specific and rich descriptions of how to implement sustainable ICT solutions to meet the information needs of patients in underserved communities.

Keywords: Information and Communication Technologies, socioeconomic limiters, Mobile app, Sustainable development

The Effect of Mobile Health and Social Inequalities on Human Development and Health Outcomes: Mhealth for Health Equity

ABSTRACT: The equitable provision of healthcare entails the distribution of resources and other processes to overcome health inequality. The concept of heath equity suggests that differences in social and economic backgrounds of people affect their ability to lead the lives they choose to live. Following a review of what is known about health equity, social determinants of health equity and the role of mobile health, this paper investigates the relationship between mHealth, social inequalities in life expectancy and in education on Human Development and Health and Wellbeing. The analysis discovers a significant relationship between mHealth, social inequalities in human development and health outcomes. These findings have important implications for the use of mHealth applications to achieve health equity. The contribution of this paper is in understanding the role of social inequalities in and mHealth in enabling people to bring about improvements in the lives they lead and in their health outcomes.

Keywords: Health equity, Human development, mHealth, Healthcare, wellbeing

What is the role of ICTs in addressing health outcomes and limitations from socio-economic status?

ABSTRACT: While access to information and communication technologies (ICTs) have been touted as a key determinant for human development, few studies have investigated how ICT implementations assist people with low socioeconomic status (SES) and the impacts this might have on health outcomes. This paper investigates the relation between having access to ICTs, health outcomes, and SES. The association between socioeconomic affluence and health is even recognized by policymakers, which suggests that there is an association between SES status and health. This paper addresses the gap in the literature by investigating the research questions: 1) what is the relation between access to ICTs and fair or poor health? 2) Is there a relation between access to ICTs and socio-economic status? The findings illustrate that having less access to ICTs is related to individuals more frequently reporting fair or poor health and having less access to ICTs relates to low SES communities that are in poverty, have lower education rates, have a high number of uninsured people, have people who experience more physical distress, and live in rural areas. A key contribution is that access to ICTs does have a correlation to health and that access to ICTs have a relation to low SES. This means that ICTs can help people access resources to assist with poverty, insurance, education, physical distress, and people who live in rural populations can take advantage of ICTs to help them lead the lives they choose to live.

Keywords: mHealth, Development as freedom, socioeconomic determinants of health, socio-economic status, freedom

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