Abstract
In a changing digital healthcare environment, Patient-facing Applications (PFAs) are becoming increasingly important to bridge the gap in healthcare access in low- and middle-income countries (LMICs). These digital tools not only allow patients to stay on top of their health information but also enable healthcare professionals to provide patient-centric care regardless of geographic location. PFAs cover a wide range of applications, including telemedicine applications, health information portals, appointment scheduling systems, medication reminders, disease-specific education platforms, and mHealth (mHealth) applications. Much research indicates that PFAs can significantly transform the usability, affordability, availability, and in some cases, even quality of health services in LMICs.
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Keywords
- Healthcare
- Patient application
- Healthcare application
- Low-and middle-income countries (LMIC)
- Telemedicine
1 Introduction
Digitization has revolutionized healthcare and offers promising solutions to enhance access and quality healthcare services worldwide. While high-income countries were among the first to adopt digital health solutions, low- and middle-income countries (LMICs) have also embraced this shift to address their unique health challenges. This chapter examines patient-centric applications of digitization trends in healthcare in LMICs. It highlights the potential benefits, challenges, and existing lessons learned from published research, particularly to enable patients to communicate, stay informed, and enact healthcare processes.
Telemedicine applications, for example, allow healthcare providers to consult patients remotely, breaking down geographic barriers, shortening the patient’s travel time, and escaping long-distance transportation to receive essential healthcare services. These changes in the healthcare system particularly benefit patients living in rural areas, where healthcare infrastructure is often lacking (Labrique et al. 2013).
In digital healthcare, PFAs play a crucial role in overcoming the lack of access to healthcare in LMICs. These tools are not just digital extensions of traditional healthcare but transformative assets that enable patients to take active control of their health and enable healthcare professionals to provide patient-centric care regardless of geographic location (Free et al. 2013). PFAs cover a wide range of applications, including telemedicine applications, health information portals, appointment scheduling systems, medication reminders, disease-specific education platforms, and mHealth (mHealth) applications. Each of these components has distinct but complementary roles in the healthcare ecosystem, contributing to healthcare delivery’s overall efficiency and effectiveness. For example, telemedicine applications provide a virtual space where doctors and patients can interact, thereby breaking down geographic barriers that impede access to quality healthcare. This feature has proven particularly useful in rural or remote communities where health infrastructure may be inadequate or non-existent (Khoja et al. 2013).
Health information portals and mobile health apps enable patients to monitor their health status and the possibility to see the entire picture by accessing medical records and even using this information in aid of decision making. In addition, health information portals provide healthcare professionals with a comprehensive view of patient records to improve diagnostic accuracy and develop personalized treatment plans. Visit scheduling and medication reminder systems contribute to improved care by ensuring medication adherence and reducing missed appointments, which are critical factors in managing chronic diseases (Aikens et al. 2014).
The PFA value proposition is further reinforced through disease-specific educational platforms that promote patient health literacy, enabling them to better understand their health status and actively participate in the healthcare process. Previous research has indicated a positive association between health literacy and health outcomes, making these platforms an important part of digital health strategies in LMICs (Berkman et al. 2011). A wealth of research suggests that PFAs, with their potential to significantly transform the availability, accessibility, and quality of medical care, have a pivotal role in driving the digital health revolution in LMICs (World Health Organization 2021). For those countries struggling with resource scarcity and a high disease burden, HMS can play a key role in alleviating health problems and building resilient and responsive health systems.
However, realizing the full potential of PFA requires an enabling policy environment, infrastructure development, capacity building, and strategic partnerships between stakeholders. It is also important to address issues such as privacy, digital literacy, and cultural acceptance to ensure PFA is accessible, acceptable, and beneficial to all (Mehl and Labrique 2014).
2 Specific Applications
Health information portals enable patients to access and manage their medical records, promote transparency, and encourage patient participation in healthcare decision-making (Ancker et al. 2017). Additionally, these platforms can provide physicians with a comprehensive view of a patient’s medical history, leading to improved diagnostic accuracy and personalized treatment plans. Health information portals are digital platforms designed to empower patients through access to their personal health information. This patient-centric approach promotes transparency in healthcare, promotes the involvement of caretakers in the process, and helps create a sense of ownership and responsibility for their health (Ancker et al. 2017).
Growing evidence shows that patient engagement stimulated by such portals improves adherence to treatment plans, better management of chronic diseases, and improved overall health outcomes. Access to reliable and easy-to-understand health information can support and encourage patients to make informed decisions, thereby reducing the likelihood of unnecessary hospitalizations (Wade-Vuturo et al. 2013). Importantly, these portals serve as platforms for educational resources and can improve patients’ understanding of their health conditions, medications, and potential lifestyle changes. Studies have shown that better patient knowledge correlates with better disease self-management, particularly in chronic diseases such as diabetes and hypertension (Lorig et al. 2006).
Health information portals strengthen patient competence and bring significant benefits to physicians. They provide a comprehensive, longitudinal overview of a patient’s medical history, including past and current diagnoses, medication records, allergy information, and laboratory results. This rich data repository supports clinical decision-making, can reduce diagnostic errors, and facilitates personalized, patient-centric care (Greenhalgh et al. 2009). For example, predictive modeling and risk stratification based on the rich data available in these portals can help healthcare providers identify patients at high risk for certain diseases. This can lead to earlier intervention, better disease management, and potentially better patient outcomes (Amarasingham et al. 2010).
Additionally, these portals can be integrated with other digital tools, such as telemedicine, to create a seamless healthcare experience. This is particularly valuable for patients in remote or underserved areas where access to quality healthcare may be limited (Baird et al. 2020). Despite the benefits, it is important to be aware of the challenges associated with health information portals, such as privacy issues, limited digital literacy among patients, and the challenges associated with integrating different health information systems. Addressing these challenges is an important part of the journey to digital health in LMICs (Kvedar et al. 2014).
Mobile health (mHealth) apps are one of the most visible subsets of PFAs. The widespread use of mobile phones, even in resource-constrained settings, makes mobile health applications a viable and cost-effective approach to health awareness, disease self-management, and treatment adherence (Källander et al. 2013). Mobile health apps, a key category of PFA, have shown great potential for transforming healthcare, including in LMICs. The ubiquity of cell phones, even in resource-constrained settings, makes mobile health apps a cost-effective strategy to increase health awareness, facilitate disease self-management, and promote adherence to treatment protocols (Källander et al. 2013).
MHealth applications range from simple tools that provide general health information and medication reminders to more complex applications that enable remote health monitoring, symptom tracking, and interaction with healthcare providers. These applications take advantage of growing digital literacy and the proliferation of mobile devices, particularly among young people, to fill geographic and infrastructural gaps in healthcare (Lupton 2014).
One of the main advantages of mHealth applications is their potential to facilitate the management of chronic diseases. With the increasing incidence of noncommunicable diseases (NCDs) such as diabetes and cardiovascular diseases in LMICs, mHealth applications can be used to monitor vital signs, provide personalized medical advice and send medication reminders, thereby improving compliance. Treatment planning and burden reduction are also encouraged. (Bloomfield et al. 2014). In addition, mobile health apps can serve as platforms for health promotion and disease prevention. They can provide targeted health education, encourage behavior change, and encourage healthier lifestyles. For example, applications that track physical activity, diet, and sleep patterns have been shown to positively impact behavior and improve health outcomes (Direito et al. 2017).
Importantly, mHealth tools have been proven to be effective in supporting maternal and child health. Apps can provide important information to pregnant women, remind them of appointments and enable remote consultations with healthcare providers. Such interventions have shown significant potential for improving prenatal care and maternal health in LMICs (Tamrat and Kachnowski 2012). From a public health perspective, mHealth applications can support disease surveillance and response, particularly in the fight against infectious diseases. By providing real-time data collection and analysis, these applications can help track disease outbreaks and inform public health action (Bhavnani et al. 2016).
However, the successful implementation of mHealth applications in LMICs is not without its challenges. Issues such as limited internet connectivity, language and reading barriers, cultural acceptance, and privacy and security concerns may limit the acceptance and effectiveness of these tools (Chib et al. 2015). Therefore, digital health strategies need to consider these factors and work with local communities to ensure that mHealth interventions are contextual and user-friendly. MHealth applications show promise for improving healthcare access and outcomes in low- and middle-income countries. However, their full potential can only be realized through thoughtful design and implementation that takes into account the unique challenges and needs of these environments.
Telemedicine has become a powerful tool to increase access to healthcare and improve outcomes in LMICs. Traditionally, healthcare delivery in these regions has been hampered by many challenges, such as geographic barriers, limited healthcare infrastructure, and a lack of trained healthcare workers. Telemedicine, which uses information and communication technologies to provide medical care remotely, can significantly mitigate these problems (Kvedar et al. 2014).
Telehealth applications provide a virtual consultation room where patients can interact with healthcare professionals, overcoming geographic barriers that might otherwise impede access to quality healthcare. This feature is particularly useful in rural or hard-to-reach areas where the lack of on-site medical facilities requires long and often costly medical trips. With the help of telemedicine, patients can receive professional medical advice, diagnostics, and even certain types of treatment without having to leave their place of residence (Mars 2013). In addition, telemedicine can improve healthcare efficiency by enabling healthcare professionals to manage their time and resources more effectively. This is particularly important in LMICs, where healthcare workers are often overwhelmed and understaffed. Telemedicine can reduce the need for non-urgent in-person consultations by allowing healthcare professionals to focus on more critical cases (George et al. 2020).
However, the successful deployment of telemedicine in LMICs requires careful consideration of several factors, including infrastructure development, user education, regulation, and sustainability. For example, unreliable power and internet connections can pose significant challenges to the effective use of telemedicine. Furthermore, promoting digital literacy among both patients and healthcare professionals is crucial to ensure the acceptability and effectiveness of telemedicine interventions (Wootton 2001). Despite the challenges, the potential of telemedicine to transform healthcare in LMICs is enormous. By making healthcare more accessible, efficient, and patient-centric, telemedicine can play an important role in achieving universal healthcare in these regions.
3 Conclusion
The successful implementation of the SBR in LMICs is not without its challenges. Factors such as limited internet connectivity, low digital literacy, lack of localized content, and privacy concerns can hamper the adoption and use of PFA. Therefore, it is crucial to address these barriers through comprehensive digital health strategies and policies coupled with capacity-building initiatives to improve digital literacy among both healthcare providers and patients.
In summary, PFAs have significant potential to democratize health services in LMICs, expand access to health care, engage patients, and improve health outcomes. However, to fully realize the transformative potential of PFA in these contexts, a multi-pronged approach to addressing the challenges involved is crucial.
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Sargsyan, K., Muradyan, A. (2024). Patient Facing Applications. In: Kozlakidis, Z., Muradyan, A., Sargsyan, K. (eds) Digitalization of Medicine in Low- and Middle-Income Countries. Sustainable Development Goals Series. Springer, Cham. https://doi.org/10.1007/978-3-031-62332-5_16
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