Challenges in implementing digital health services in rural India
Introduction: The COVID-19 pandemic, with mandatory social distancing and lockdown, has shown the success of telemedicine in reducing geographical and time obstacles. This has stimulated its ingress into mainstream healthcare services as the safest means of interaction between doctor and patient during the pandemic. There are several barriers that need to be addressed in order to spread these digital services. Aim: This study explores the challenges to adopting telemedicine and its status in remote districts of Himachal Pradesh, India. Methods: A mixed-method approach was used to identify challenges found in remote healthcare facilities. A survey was conducted using a 20-item checklist to capture information regarding infrastructure, telemedicine equipment, manpower and demography of the area. During telephone interviews, questionnaires were used to evaluate the status of acceptance of telemedicine and challenges to its implementation in the remote State of Himachal Pradesh, India. Results: The study identifies the challenges as lack of awareness (75.9%), level of education of patient (44.8%) having primary education, age of the patient (17.2%), technically challenged staff (30%), followed by resistance to change (80%) and high workload with manpower shortage (60%). Conclusion: While there are other barriers, this study provides policymakers with insights into the current perceived challenges to telemedicine implementation, which they can address to increase the penetration of telehealth services, particularly in rural areas.
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