Stakeholders’ Perceptions of the Implementation of a Patient-Centric Digital Health Application for Primary Healthcare in India
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Objectives: Health systems are shifting from traditional methods of healthcare delivery to delivery using digital applications. This change was introduced at a primary care centre in Chandigarh, India that served a marginalised population. Afterestablishing the digital health system, we explored stakeholders’ perceptions regarding its implementation. Methods: Ethnographicmethods were used to explore stakeholders’ perceptions regarding the implementation of the Integrated Health InformationSystem for Primary Health Care (IHIS4PHC), which was developed as a patient-centric digital health application. Data were collected using focus group discussions and in-depth interviews. Participatory observations were made of day-todayactivities including outpatient visits, outreach field visits, and methods of health practice. The collected information wasanalysed using thematic coding. Results: Healthcare workers highlighted that working with the digital health system was initiallyarduous, but they later realised its usefulness, as the digital system made it easier to search records and generate reports,rapidly providing evidence to make decisions. Auxiliary nurse midwives reported that recording information on computerssaved time when generating reports; however, systematic and mandatory data entry made recording tedious. Staff were apprehensiveabout the use of computer-based data for monitoring their work performance. Patients appreciated that theirprevious records were now available on the computer for easy retrieval. Conclusions: The usefulness of the digital health applicationwas appreciated by various primary healthcare stakeholders. Barriers persisted due to perceived needs for flexibilityin delivering healthcare services, and apprehensions continued because of increased transparency, accountability, and dependenceon computers and digital technicians.
Abstract
Objectives: Health systems are shifting from traditional methods of healthcare delivery to delivery using digital applications. This change was introduced at a primary care centre in Chandigarh, India that served a marginalised population. Afterestablishing the digital health system, we explored stakeholders’ perceptions regarding its implementation. Methods: Ethnographicmethods were used to explore stakeholders’ perceptions regarding the implementation of the Integrated Health InformationSystem for Primary Health Care (IHIS4PHC), which was developed as a patient-centric digital health application. Data were collected using focus group discussions and in-depth interviews. Participatory observations were made of day-todayactivities including outpatient visits, outreach field visits, and methods of health practice. The collected information wasanalysed using thematic coding. Results: Healthcare workers highlighted that working with the digital health system was initiallyarduous, but they later realised its usefulness, as the digital system made it easier to search records and generate reports,rapidly providing evidence to make decisions. Auxiliary nurse midwives reported that recording information on computerssaved time when generating reports; however, systematic and mandatory data entry made recording tedious. Staff were apprehensiveabout the use of computer-based data for monitoring their work performance. Patients appreciated that theirprevious records were now available on the computer for easy retrieval. Conclusions: The usefulness of the digital health applicationwas appreciated by various primary healthcare stakeholders. Barriers persisted due to perceived needs for flexibilityin delivering healthcare services, and apprehensions continued because of increased transparency, accountability, and dependenceon computers and digital technicians.
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