Provision of healthcare at a distance is not a new concept. However, with the advancement of Info... more Provision of healthcare at a distance is not a new concept. However, with the advancement of Information and Communication Technologies (ICT), the term „Telehealth ‟ has been cited frequently in the health/medical literature. Similar terms such as „Online Health‟, „eHealth‟ and Telemedicine ‟ are also begining to appear. The purpose of this article is to provide readers with an understanding of telehealth with special reference to Sri Lanka. First, different terms and definitions related to telehealth will be reviewed. Then, the history of telehealth and evolutionary milestones of telecommunication activities will be examined. Next, telecommunication activities in Sri Lanka and its trend will be explored. Later, telehealth effectiveness will be examined briefly. Finally, a brief overview of telehealth activities related to Sri Lanka will be presented before suggesting a way forward.
Background In 2007, the Faculty of Medical Sciences, University of Sri Jayewardenepura revised it... more Background In 2007, the Faculty of Medical Sciences, University of Sri Jayewardenepura revised its medical curriculum from discipline-based to one that was student-centered and integrated. This study aimed to evaluate the perceptions of students regarding the educational environment and compare them to those prior to curricular revision. Methods The Dundee Ready Education Environment Measure (DREEM) questionnaire was administered to all volunteering students enrolled in the medical degree programme at the time of the study (n = 595). Results were compared to DREEM scores obtained prior to curricular revision. Results The overall DREEM score and sub-scale scores were positive and showed improvement compared to previous scores. The score for Students’ Perceptions of Atmosphere showed progression from ‘there are many issues which need changing’ to the next highest category ‘a more positive attitude’. The mean scores in pre-clinical, para-clinical and clinical phases also showed an impr...
This study investigated the level of current use of ICT in general practice in Sri Lanka. The tot... more This study investigated the level of current use of ICT in general practice in Sri Lanka. The total number of 52 (74 percent) doctors completed and returned the questionnaire which was designed to examine the types of applications, the level of ICT use and the perceptions of GPs about the use of technology in their routine practice. This study found that the tools such as telephone and mobile phones are widely used in healthcare settings. However, the use of technologies including computers, PDAs and the Internet is very limited. Doctors have a positive attitude towards the technologies, and they are keen to use these tools assuming that the ICT may provide them opportunity to improve efficiency and the quality of service. The limited access to new technologies and poor infrastructure are some of the main barriers to wider use of ICT in healthcare settings.
Logic suggests that employing information and communication technology (ICT) to deliver health ca... more Logic suggests that employing information and communication technology (ICT) to deliver health care at distance (i.e. telehealth or e-health) would be useful to address at least some of the problems in developing countries. There is a growing body of literature to attest to this argument. In the early 1990s, there was a general expectation that e-health would solve the main problems in health care in developing countries. However, the progress actually made with e-health in developing countries has been rather limited to date. It is also true that the use of e-health in industrialized countries is limited.
This chapter reviews the rare use of telemental health modalities in Sri Lanka and challenges fac... more This chapter reviews the rare use of telemental health modalities in Sri Lanka and challenges facing nationwide implementation of these services in this resource-limited setting. As in other developing countries, cost of, and access to, appropriate infrastructure are key constraints in using such advanced technologies in health service delivery. While healthcare providers and policymakers have realized the value of telemental health as a useful tool, challenges to its implementation remain. These challenges include lack of technology, appropriate infrastructure, knowledge, and skills. This chapter will delve into discussing the current approaches to implement TMH through educating the General public and disseminating mental health services in Sri Lanka.
We developed an electronic Health Information Management System (HIMS) for Public Health Midwives... more We developed an electronic Health Information Management System (HIMS) for Public Health Midwives (PHMs) in Sri Lanka. We conducted a needs analysis amongst 16 PHMs, which found that they spent most of their time managing health records. The HIMS was designed so that it could accept data from the PHMs, and generate reports which could be used by the PHMs themselves as well as by their supervisors. The HIMS was trialled by a group of 16 PHMs in a remote area of the Ratnapura district of Sri Lanka. Mini-laptops with the software were distributed to the PHMs and they were given the necessary training. They started entering historical data from the registers into the system by themselves. Nearly 10,000 public health records were generated in the first three months. In a subsequent survey, the PHMs all gave positive answers indicating that they were happy with the pilot system, they would like to continue using it to enhance their service and they wanted to see it expanded across the whole of Ratnapura district. The system seems to be a practical solution for the field activities of PHMs in Sri Lanka.
We developed, implemented and evaluated a web-based continuing professional development (CPD) pro... more We developed, implemented and evaluated a web-based continuing professional development (CPD) programme on medical genetics. Development of the CPD programme followed the ADDIE model, i.e. Analysis, Design, Develop, Implement and Evaluation. An invitation to participate in a needs analysis survey was sent to all doctors on the email list of the Sri Lanka Medical Association. A total of 129 completed surveys was received (57% of the 228 who accessed the online survey). The average age of respondents was 42 years (range 27-81). The male: female ratio was approximately 2 : 1. Almost all respondents (96%) selected web-based CPD programmes, or web-based and conventional lectures, as their preferred method of learning. The programme was piloted on a group of 10 doctors. The average pre-knowledge score was 40.3 and the post-knowledge score was 62.1 marks out of 100 ( P = 0.002). We conclude that a web-based CPD programme on medical genetics is feasible in Sri Lanka.
Human Resources in Healthcare, Health Informatics and Healthcare Systems
The pressures on the health workforce have a profound impact on the quality of care. The solution... more The pressures on the health workforce have a profound impact on the quality of care. The solution to health workforce issues is a global concern and governments and health systems around the world are seeking solutions to the problems of worker shortages and access to health services. Education and training of more doctors, nurses, and other health professionals require long-term policy changes, funding, and infrastructure development. Telehealth has been identified as an alternative solution to address some of these critical issues and this chapter outlines the potential of telehealth to address some challenges facing the health workforce. The discussion will provide evidence for feasible and effective adoption of telehealth solutions.
2007 9th International Conference on e-Health Networking, Application and Services, 2007
ABSTRACT It is believed that the use of information and communication technologies (ICT) can be a... more ABSTRACT It is believed that the use of information and communication technologies (ICT) can be a potential alternative to address some of the daunting problems in healthcare sector in developing countries. Knowledge, skills and acceptance of e- health by health professionals are essential attributes of a successful integration of this new tool. This study investigates the knowledge of medical students in Sri Lanka in regard to e-health. We also examined the barriers which impede them to develop knowledge and skills in e-health within their medical curriculum. A questionnaire focusing on the knowledge and attitudes of medical students towards e-health was distributed to all final year students (n=136) at the Faculty of Medicine, Sri Jayewardenepura University, Sri Lanka. 100 surveys (74%) were completed and returned. Fifty one per cent rated their knowledge of e-health applications as minimal. The majority (88%) admitted that they had no e-health education or training of any kind. Similar number of respondents (80%) thought that e-health had an important role to play in health sector, particularly in developing countries. We also found that respondents had very poor access to computers and Internet use was rare. A large number of respondents (77%) admitted that their medical curriculum did not provide them knowledge and skills in e-health.
The health-care system in Sri Lanka is similar to those in other developing countries and access ... more The health-care system in Sri Lanka is similar to those in other developing countries and access to health services for remote communities is extremely limited. We reviewed the literature about e-health in Sri Lanka. The use of information and communication technologies (ICTs) in private hospitals is more common than in public hospitals. The use of ICT in general practice is increasing. A number of international organizations have initiated various pilot projects, including disaster relief efforts, education initiatives and telemedicine. In addition, several institutions and organizations are dedicated to the promotion of e-health and a range of Web-based health consultancy services have begun. Although e-health seems to have a limited role in Sri Lanka at present, there is growing interest in the opportunities it may offer in terms of improving the delivery and access to services, especially in remote locations.
Provision of healthcare at a distance is not a new concept. However, with the advancement of Info... more Provision of healthcare at a distance is not a new concept. However, with the advancement of Information and Communication Technologies (ICT), the term „Telehealth ‟ has been cited frequently in the health/medical literature. Similar terms such as „Online Health‟, „eHealth‟ and Telemedicine ‟ are also begining to appear. The purpose of this article is to provide readers with an understanding of telehealth with special reference to Sri Lanka. First, different terms and definitions related to telehealth will be reviewed. Then, the history of telehealth and evolutionary milestones of telecommunication activities will be examined. Next, telecommunication activities in Sri Lanka and its trend will be explored. Later, telehealth effectiveness will be examined briefly. Finally, a brief overview of telehealth activities related to Sri Lanka will be presented before suggesting a way forward.
Background In 2007, the Faculty of Medical Sciences, University of Sri Jayewardenepura revised it... more Background In 2007, the Faculty of Medical Sciences, University of Sri Jayewardenepura revised its medical curriculum from discipline-based to one that was student-centered and integrated. This study aimed to evaluate the perceptions of students regarding the educational environment and compare them to those prior to curricular revision. Methods The Dundee Ready Education Environment Measure (DREEM) questionnaire was administered to all volunteering students enrolled in the medical degree programme at the time of the study (n = 595). Results were compared to DREEM scores obtained prior to curricular revision. Results The overall DREEM score and sub-scale scores were positive and showed improvement compared to previous scores. The score for Students’ Perceptions of Atmosphere showed progression from ‘there are many issues which need changing’ to the next highest category ‘a more positive attitude’. The mean scores in pre-clinical, para-clinical and clinical phases also showed an impr...
This study investigated the level of current use of ICT in general practice in Sri Lanka. The tot... more This study investigated the level of current use of ICT in general practice in Sri Lanka. The total number of 52 (74 percent) doctors completed and returned the questionnaire which was designed to examine the types of applications, the level of ICT use and the perceptions of GPs about the use of technology in their routine practice. This study found that the tools such as telephone and mobile phones are widely used in healthcare settings. However, the use of technologies including computers, PDAs and the Internet is very limited. Doctors have a positive attitude towards the technologies, and they are keen to use these tools assuming that the ICT may provide them opportunity to improve efficiency and the quality of service. The limited access to new technologies and poor infrastructure are some of the main barriers to wider use of ICT in healthcare settings.
Logic suggests that employing information and communication technology (ICT) to deliver health ca... more Logic suggests that employing information and communication technology (ICT) to deliver health care at distance (i.e. telehealth or e-health) would be useful to address at least some of the problems in developing countries. There is a growing body of literature to attest to this argument. In the early 1990s, there was a general expectation that e-health would solve the main problems in health care in developing countries. However, the progress actually made with e-health in developing countries has been rather limited to date. It is also true that the use of e-health in industrialized countries is limited.
This chapter reviews the rare use of telemental health modalities in Sri Lanka and challenges fac... more This chapter reviews the rare use of telemental health modalities in Sri Lanka and challenges facing nationwide implementation of these services in this resource-limited setting. As in other developing countries, cost of, and access to, appropriate infrastructure are key constraints in using such advanced technologies in health service delivery. While healthcare providers and policymakers have realized the value of telemental health as a useful tool, challenges to its implementation remain. These challenges include lack of technology, appropriate infrastructure, knowledge, and skills. This chapter will delve into discussing the current approaches to implement TMH through educating the General public and disseminating mental health services in Sri Lanka.
We developed an electronic Health Information Management System (HIMS) for Public Health Midwives... more We developed an electronic Health Information Management System (HIMS) for Public Health Midwives (PHMs) in Sri Lanka. We conducted a needs analysis amongst 16 PHMs, which found that they spent most of their time managing health records. The HIMS was designed so that it could accept data from the PHMs, and generate reports which could be used by the PHMs themselves as well as by their supervisors. The HIMS was trialled by a group of 16 PHMs in a remote area of the Ratnapura district of Sri Lanka. Mini-laptops with the software were distributed to the PHMs and they were given the necessary training. They started entering historical data from the registers into the system by themselves. Nearly 10,000 public health records were generated in the first three months. In a subsequent survey, the PHMs all gave positive answers indicating that they were happy with the pilot system, they would like to continue using it to enhance their service and they wanted to see it expanded across the whole of Ratnapura district. The system seems to be a practical solution for the field activities of PHMs in Sri Lanka.
We developed, implemented and evaluated a web-based continuing professional development (CPD) pro... more We developed, implemented and evaluated a web-based continuing professional development (CPD) programme on medical genetics. Development of the CPD programme followed the ADDIE model, i.e. Analysis, Design, Develop, Implement and Evaluation. An invitation to participate in a needs analysis survey was sent to all doctors on the email list of the Sri Lanka Medical Association. A total of 129 completed surveys was received (57% of the 228 who accessed the online survey). The average age of respondents was 42 years (range 27-81). The male: female ratio was approximately 2 : 1. Almost all respondents (96%) selected web-based CPD programmes, or web-based and conventional lectures, as their preferred method of learning. The programme was piloted on a group of 10 doctors. The average pre-knowledge score was 40.3 and the post-knowledge score was 62.1 marks out of 100 ( P = 0.002). We conclude that a web-based CPD programme on medical genetics is feasible in Sri Lanka.
Human Resources in Healthcare, Health Informatics and Healthcare Systems
The pressures on the health workforce have a profound impact on the quality of care. The solution... more The pressures on the health workforce have a profound impact on the quality of care. The solution to health workforce issues is a global concern and governments and health systems around the world are seeking solutions to the problems of worker shortages and access to health services. Education and training of more doctors, nurses, and other health professionals require long-term policy changes, funding, and infrastructure development. Telehealth has been identified as an alternative solution to address some of these critical issues and this chapter outlines the potential of telehealth to address some challenges facing the health workforce. The discussion will provide evidence for feasible and effective adoption of telehealth solutions.
2007 9th International Conference on e-Health Networking, Application and Services, 2007
ABSTRACT It is believed that the use of information and communication technologies (ICT) can be a... more ABSTRACT It is believed that the use of information and communication technologies (ICT) can be a potential alternative to address some of the daunting problems in healthcare sector in developing countries. Knowledge, skills and acceptance of e- health by health professionals are essential attributes of a successful integration of this new tool. This study investigates the knowledge of medical students in Sri Lanka in regard to e-health. We also examined the barriers which impede them to develop knowledge and skills in e-health within their medical curriculum. A questionnaire focusing on the knowledge and attitudes of medical students towards e-health was distributed to all final year students (n=136) at the Faculty of Medicine, Sri Jayewardenepura University, Sri Lanka. 100 surveys (74%) were completed and returned. Fifty one per cent rated their knowledge of e-health applications as minimal. The majority (88%) admitted that they had no e-health education or training of any kind. Similar number of respondents (80%) thought that e-health had an important role to play in health sector, particularly in developing countries. We also found that respondents had very poor access to computers and Internet use was rare. A large number of respondents (77%) admitted that their medical curriculum did not provide them knowledge and skills in e-health.
The health-care system in Sri Lanka is similar to those in other developing countries and access ... more The health-care system in Sri Lanka is similar to those in other developing countries and access to health services for remote communities is extremely limited. We reviewed the literature about e-health in Sri Lanka. The use of information and communication technologies (ICTs) in private hospitals is more common than in public hospitals. The use of ICT in general practice is increasing. A number of international organizations have initiated various pilot projects, including disaster relief efforts, education initiatives and telemedicine. In addition, several institutions and organizations are dedicated to the promotion of e-health and a range of Web-based health consultancy services have begun. Although e-health seems to have a limited role in Sri Lanka at present, there is growing interest in the opportunities it may offer in terms of improving the delivery and access to services, especially in remote locations.
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