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Developing and deploying a community healthcare worker-driven, digitally- enabled integrated care system for municipalities in rural Nepal.


ABSTRACT: Integrating care at the home and facility level is a critical yet neglected function of healthcare delivery systems. There are few examples in practice or in the academic literature of affordable, digitally-enabled integrated care approaches embedded within healthcare delivery systems in low- and middle-income countries. Simultaneous advances in affordable digital technologies and community healthcare workers offer an opportunity to address this challenge. We describe the development of an integrated care system involving community healthcare worker networks that utilize a home-to-facility electronic health record platform for rural municipalities in Nepal. Key aspects of our approach of relevance to a global audience include: community healthcare workers continuously engaging with populations through household visits every three months; community healthcare workers using digital tools during the routine course of clinical care; individual and population-level data generated routinely being utilized for program improvement; and being responsive to privacy, security, and human rights concerns. We discuss implementation, lessons learned, challenges, and opportunities for future directions in integrated care delivery systems.

SUBMITTER: Citrin D 

PROVIDER: S-EPMC7739377 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Developing and deploying a community healthcare worker-driven, digitally- enabled integrated care system for municipalities in rural Nepal.

Citrin David D   Thapa Poshan P   Nirola Isha I   Pandey Sachit S   Kunwar Lal Bahadur LB   Tenpa Jasmine J   Acharya Bibhav B   Rayamazi Hari H   Thapa Aradhana A   Maru Sheela S   Raut Anant A   Poudel Sanjaya S   Timilsina Diwash D   Dhungana Santosh Kumar SK   Adhikari Mukesh M   Khanal Mukti Nath MN   Pratap Kc Naresh N   Acharya Bhim B   Karki Khem Bahadur KB   Singh Dipendra Raman DR   Bangura Alex Harsha AH   Wacksman Jeremy J   Storisteanu Daniel D   Halliday Scott S   Schwarz Ryan R   Schwarz Dan D   Choudhury Nandini N   Kumar Anirudh A   Wu Wan-Ju WJ   Kalaunee S P SP   Chaudhari Pushpa P   Maru Duncan D  

Healthcare (Amsterdam, Netherlands) 20180605 3


Integrating care at the home and facility level is a critical yet neglected function of healthcare delivery systems. There are few examples in practice or in the academic literature of affordable, digitally-enabled integrated care approaches embedded within healthcare delivery systems in low- and middle-income countries. Simultaneous advances in affordable digital technologies and community healthcare workers offer an opportunity to address this challenge. We describe the development of an integ  ...[more]

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