BMJ Open (Mar 2022)

Global eHealth capacity: secondary analysis of WHO data on eHealth and implications for kidney care delivery in low-resource settings

  • Fergus Caskey,
  • Cindy George,
  • Andre P Kengne,
  • David Johnson,
  • Adeera Levin,
  • Vivekanand Jha,
  • Aminu K Bello,
  • Mohamed A Osman,
  • Ikechi G Okpechi,
  • Deenaz Zaidi,
  • Marcello Tonelli,
  • Feng Ye,
  • Syed Saad,
  • Joseph Lunyera,
  • Shezel Muneer,
  • Mohammed M Tinwala,
  • Charu Malik,
  • Anukul Ghimire,
  • Sandrine Damster

DOI
https://doi.org/10.1136/bmjopen-2021-055658
Journal volume & issue
Vol. 12, no. 3

Abstract

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Objective To describe the use of electronic health (eHealth) in support of health coverage for kidney care across International Society of Nephrology (ISN) regions.Design Secondary analysis of WHO survey on eHealth as well as use of data from the World Bank, and Internet World Stats on global eHealth services.Setting A web-based survey on the use of eHealth in support of universal health coverage.Participants 125 WHO member states provided response.Primary outcome measures Availability of eHealth services (eg, electronic health records, telehealth, etc) and governance frameworks (policies) for kidney care across ISN regions.Results The survey conducted by the WHO received responses from 125 (64.4%) member states, representing 4.4 billion people globally. The number of mobile cellular subscriptions was <100% of the population in Africa, South Asia, North America and North East Asia; the percentage of internet users increased from 2015 to 2020 in all regions. Western Europe had the highest percentage of internet users in all the periods: 2015 (82.0%), 2019 (90.7%) and 2020 (93.9%); Africa had the least: 9.8%, 21.8% and 31.4%, respectively. The North East Asia region had the highest availability of national electronic health record system (75%) and electronic learning access in medical schools (100%), with the lowest in Africa (27% and 39%, respectively). Policies concerning governance aspects of eHealth (eg, privacy, liability, data sharing) were more widely available in high-income countries (55%–93%) than in low-income countries (0%–47%), while access to mobile health for treatment adherence was more available in low-income countries (21%) than in high-income countries (7%).Conclusion The penetration of eHealth services across ISN regions is suboptimal, particularly in low-income countries. Increasing utilisation of internet communication technologies provides an opportunity to improve access to kidney education and care globally, especially in low-income countries.