IEEE Technology and Society Magazine - Spring 2013 - 50

(Medical professional
participant, Mweiga Hospital
Focus Group, 2010)
"We can reach more people
through this telemedicine
technology. Doctors would
participate because they
want to reach the people in
the community but (presently) they cannot."
(Medical professional
participant, Outspan Hospital
Focus Group, 2010)
"I think they (doctors) make
these kinds of decisions
(remote triage) already, it
would organize data faster
and move it at a cheaper
cost. I think it is a good idea.
I think it would help someone
far away to make a decision
or if I have a question about a
patient. Let's assume she has
traveled, maybe consultants
can see graphs and data for
themselves to assist in making
a decision."
(Medical professional
participant, PGH
Hospital Focus
Group, 2010)
participants repeatedly stressed
the need for qualified, trained medical personnel to operate and use a
telemedicine system. Throughout
these conversations, we learned the
diverse perceptions of the role of
CHWs working in communities.
participants in the focus groups
described the CHWs as:
"Twenty Community Health
Worker volunteers are responsible for 5000 patients - they
are responsible for those
households- if a patient has
been coughing and has not
gone to the hospital, the CHW
would go to that house and
assess and then refer them to
the hospital. A skin rash- they
might send that patient to the
hospital, but if it is something
50

|

like malaria they can recognize, then they might diagnose
and treat it in the village."
(Medical professional participant, PGH
Hospital Focus Group,
Kenya 2010)

that we cannot handle, then
we refer them, but if we find
something that is in our care,
then we do it."
(Community Health Worker,
PGH Hospital Focus
Group, 2010)

"There is one person (CHW)
per every 20 households.
The community worker is in
charge of the education of
health for these homes."
(Medical professional
participant, Outspan
Hospital Focus Group,
Kenya 2010)

The focus group participants quickly
grasped the concept and practicalities of telemedicine and provided
valuable feedback on the challenges
and opportunities for such a system
in their community:

During discussions with medical
professionals as well as community members, Community Health
Workers were frequently referenced as perfect candidates to use
telemedicine systems and other
technologies:
"When a patient has been
assigned a CHW they might
become attached to those
people. They have a bit of
knowledge on health but
they know the health of every
person in the communitywe need to follow up in the
community."
(Medical professional
participant, PGH Hospital
Focus Group, Kenya 2010)
"The CHWs have a weighing scale and a few drugs.
Some have blood glucose
machines."
(Medical professional participant, PGH Hospital Focus
Group, Kenya, 2010)
"Yes it is difficult (to refer
a patient) when we don't
know the fever and BP, we
are not medics. Sometimes
we cannot refer because we
don't know exactly what the
problem is- sometimes on
the follow-up we can have a
better idea. If we find a case

"We have seen in the past
that digital blood pressure
cuffs break before nondigital cuffs, because of this
we are concerned about the
reliability of the technology.
Also, power sources in rural
and community settings
could be a challenge."
(Medical professional
participant, PGH Hospital
Focus Group, 2010)
"When a Community Health
Worker is in the community,
he has few resources to refer
the people to, he can send
them to the dispensary for
medicine, but this (telemedicine) will help connect the
CHW to a doctor...it could
best be used in places without hospital where transportation is a big problem."
(Medical professional
participant, Outspan
Hospital Focus Group,
Kenya, 2010)
Focus groups held with Kenyan
University students from Kimathi
University and Kenyan Methodist
University proved especially enlightening, as the students offered some of
their own solutions to the constraints
discussed in relation to a telemedicine system. The students suggested:
"If we have diseases that
have similar symptoms like
malaria and typhoid, why

IEEE TECHNOLOGY AND SOCIETY MAGAZINE

|

SprING 2013



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