Abstract
This chapter explores the potential for digital health deployment to improve primary care in Indonesia using the theory of change (ToC) framework. By aligning digital health implementation with the ToC framework, the study demonstrates significant improvements in healthcare quality and evidence-based practice within the Indonesian primary care context. The research emphasizes the potential of ToC-guided digital health to revolutionize healthcare delivery and improve outcomes for patients in low- and middle-income countries.
TopIntroduction
As with many other countries in a similar economic bracket, Indonesia faces the “60-30-10 challenge,” highlighting the critical need for creative solutions to transform healthcare (Keikhosrokiani, 2022). One potential strategy for improving healthcare quality and safety in the face of these problems is digital health and, more specifically, electronic health record (EHR) systems (Gatiti et al., 2021). This chapter's goal is to examine how primary care in Indonesia might be significantly enhanced via the use of digital health. We want to show how a contextually sensitive approach to digital health might bridge the gaps in evidence-based practice and healthcare quality in middle-income countries, guided by the Theory of Change (ToC) paradigm. The methodology employed in this chapter relies on a comprehensive literature study, providing a foundation for our exploration. We examine the global landscape of digital health implementation and delve into the nuances of the Theory of Change methodology within healthcare. By doing so, we aim to uncover insights that can inform a strategic and contextually sensitive approach to digital health implementation in Indonesian primary care. The subsequent sections of this chapter will unfold in a structured manner. First, the author will lay the groundwork theoretically by surveying the literature on healthcare IT transformation and the Theory of Change approach (Rhodes et al., 2019). Building on this foundation, we will present the methodology employed in our exploration, emphasizing the rigor and depth of our system. Following this, the results and conclusions of our pilot study will be outlined, highlighting the significant improvements observed in healthcare quality and evidence-based practice within the Indonesian primary care context. As we delve into the details of our study, it will become clear that a powerful solution to the problems caused by the “60-30-10 challenge” may be achieved by strategically aligning the deployment of digital health with the Theory of Change framework (Hamdani et al., 2021). The chapter will conclude by synthesizing the most salient findings from our pilot study, accompanied by proposals to increase access to digital health services in middle-income countries. This research underscores the transformative potential of the Theory of Change-guided digital health, offering a pathway to revolutionize healthcare delivery and improve outcomes for patients in low- and middle-income countries.
Key Terms in this Chapter
Primary Care: Primary care is the first point of contact for individuals seeking healthcare services. It involves the provision of comprehensive, continuous, and coordinated care for a range of health needs. Primary care providers, such as general practitioners and family physicians, play a central role in preventive care, diagnosis, treatment, and management of common health conditions.
Theory of Change: (ToC): The Theory of Change (ToC) is a systematic and participatory approach to planning, implementing, and evaluating social interventions. In the context of this research, ToC provides a framework for understanding the underlying assumptions, causal pathways, and expected outcomes of digital health implementation, guiding a contextually sensitive approach to healthcare transformation.
Digital Health: Digital health uses digital technologies, information, and communication tools to improve health and healthcare delivery. It encompasses many applications, including electronic health records, mobile health (mHealth), telehealth, health information systems, and wearable devices, to enhance healthcare access, efficiency, and patient outcomes.
Indonesia: Indonesia is a Southeast Asian country with thousands of volcanic islands. It is known for its diverse cultures, rich biodiversity, and significant economic growth. The country faces healthcare challenges related to access, infrastructure, and the burden of diseases, and it is actively exploring digital health solutions to address these issues.
Electronic Health Records: (EHR): Electronic Health Records (EHR) are digital versions of patients' paper charts. EHRs contain a patient's medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory test results. They provide a comprehensive and real-time view of a patient's health information and facilitate secure data sharing among healthcare providers.