使用服务设计策略评估服务不足地区的移动医疗干预措施:肯尼亚案例

D. Nyatuka, R. D. L. Harpe
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引用次数: 3

摘要

移动医疗干预措施已在包括肯尼亚在内的卫生系统中广泛采用,试图改善医疗保健服务,特别是在服务不足的情况下。这使得移动医疗比远程医疗更加成熟。然而,干预措施的有效性值得怀疑,因为尽管移动医疗已被采纳为肯尼亚国家电子卫生战略的支柱之一,但缺乏明确的支持和扩大战略来成功实施。显然,缺乏经验证据从设计思维的角度来理解移动医疗服务中技术使用的复杂性。此外,涉众在设计这些服务中的作用还没有得到很好的认识。本文的重点是移动健康作为一种医疗保健服务,由技术,结合移动技术促进。研究的目标包括:(1)识别和吸引相关利益相关者;(2)建立期望解决方案的设计特征;(3)设计和开发特定于环境的解决方案;(4)评估新服务的使用情况。利用服务设计研究和利益相关者理论的视角,提出了一个通用模型来指导移动医疗服务的设计和评估过程。在服务设计的双钻石过程中增加了两个不同的阶段,即:在开始时将“参与环境”作为实施前评估阶段,在过程结束时将“评估使用中”作为实施后评估阶段。新模型由15名参与者(n=15)进行实证检验,其中根据验证记分卡结果符合预期。这样,我们的研究扩展和补充了现有的知识体系。
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Evaluating mHealth Interventions in an Underserved Context Using Service Design Strategy: A Case of Kenya
mHealth interventions have been widely adopted across health systems in attempts to improve healthcare delivery particularly in underserved contexts, Kenya included. This has made mHealth more established as opposed to telemedicine. However, the effectiveness of the interventions is questionable as there lacks a clear sustenance and scale-up strategy for successful implementation, despite mHealth having been adopted as one of the pillars for Kenya's national e-health strategy. Apparently, there is a paucity of empirical evidence to understand the complex nature of technology use in mHealth services from design thinking perspective. Also, the role of stakeholders in designing these services has not been well recognized. This paper focuses on mHealth as a healthcare service facilitated by technologies that incorporate mobile technologies. Objectives of the study include: (1) To identify and engage relevant stakeholders, (2) To establish design characteristics of the desired solution, (3) To design & develop context-specific solutions, (4) To evaluate new services in-use situation. A generic model is proposed to guide design and evaluation process for mHealth services, using both lens of service design research and stakeholder theory. Two distinct phases were added to the double diamond process of service design i.e. 'engage context' as pre-implementation evaluation phase at the start and 'evaluate in-use' as post-implementation evaluation phase at the end of the process. The new model was empirically tested by fifteen participants (n=15), of which the outcome met expectations according to validation scorecard. In so doing, our study extends and complement existing body of knowledge.
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