Mobile Medicine and Peripatetic Providers: Investigation of Impact of Tablet PCs on Healthcare Service in Rural Thailand

TitleMobile Medicine and Peripatetic Providers: Investigation of Impact of Tablet PCs on Healthcare Service in Rural Thailand
Publication TypeConference Paper
Author(s)Chib, A., Q. Jiang, S. Struckmann, V. Chong, M. Lim, and R. Rodricks
Affiliation (1st Author)Nanyang Technological University, Singapore
Section or WGHealth Communication and Change Working Group
DateFri 28 June
Slot CodeCHAF3a
Slot Code (Keyword)CHAF3a
Time of Session14:00-15:30
Session TitleE-Health: Current and Emerging Issues for Research and Policy
Submission ID4840

Research in mobile healthcare (mHealth) has shown that the rise of mobile technologies can positively affect healthcare provision in developing countries, particularly by transcending spatial distances between rural communities and urban-based medical infrastructure (Author, 2012, 2011, 2008). Regarding the problems of mal-distribution of health workers and lack of a reliable medical data system in rural areas, the Family Folder Collector (FFC) project was launched by the National Electronics and Computer Technology Center of Thailand in April 2011. To fill the gap in current mHealth literature, this study examined the use of tablet PCs in the context of mHealth, precisely, the Android-based FFC healthcare application on Samsung Galaxy Tablet, which was developed to replace the physical paper-based system of medical data-collection. Instead of simply underpinning a techno-optimistic stance, this study provides a point of departure based on a more nuanced “double-edged” approach. To investigate beneficial outcomes and areas of conflict, in-depth interviews were conducted among 41 respondents at healthcare centers and patients’ homes in rural Thailand, including 24 community health workers, three volunteers, eight patients, and six project administrators. The findings suggest that the tablet PCs helped the health workers obtain medical data in a more timely and actionable manner (“The device makes it more convenient and it is easier.”); strengthen social ties and communication links within medical system (“I use Facebook with my co-workers as well as networking organizations like the district office department for coordination work. I also use Facebook to contact the doctor in order to get his suggestions.”); increase medical education and training (“We were trained on the installation process, how to use the device, how to transfer information into the database, and how to use the information to visit the family.”); provide healthcare service in a more effective manner (“The Google map in the device can help us directly go to the patients’ house without consulting the volunteers, so it saves times.”); and improve health worker’s ability to diagnose and manage illnesses (“To contact doctors, I think it’s better by using Skype because using Skype allows us to see moving images and sound and it’s better than the phone.”). Therefore, the mobility and ubiquitous access of tablet PCs have transformative impact on the fabric of everyday healthcare work. While these transformations can benefit rural healthcare provision, they create tensions between newly arising, flexible mobile practices and the existing fixed healthcare structure, causing conflicts in information nodes and social interaction (“I use the Internet to search for information about the condition of the patient when I am not sure after examining the patient. …If there is emergency case for any disease, this information will be posted on web board of district office. And we are to use ooVoo to keep us alert and get information from one another.”). We discuss critical perspectives to analyze the impact of the implementation and appropriation of mobile technologies into well-established, fixed healthcare systems and consider how to translate these findings into policy and practice.

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