A web-based teleprenatology platform for antenatal care management in remote areas

摘要

According to World Health Organization, approximately 289,000 women had died due to complications of pregnancy and childbirth in 2013, largely in developing countries. Indonesia as one of the biggest developing countries in the world; the number of midwives is high while the number of medical specialist is low. In addition, existing ultrasound system is not suitable for midwives to manage high risk pregnancy during remote antenatal check up. As a result, high risk pregnancy cases detected by midwives in rural areas can not be identified and referred to medical specialist immediately. In this study, a new teleprenatology management platform has been designed and implemented for rural areas. This platform enables the communication between midwives in rural area and distant medical specialists. The platform consists of prenatal server, prenatal data assistant and prenatal workstation with two main functions; teleconsultation and electronic medical record. A user-friendly web-based solution was implemented using technologies such as Python with Django framework along with JavaScript, Ajax, Jquery and html in front-ends. To explore and describe the perceived needs and specific requirement for this platform, the adoption of a user-centered design (UCD) approach has been proposed. Research study had been successfully conducted at several clinics in Kampar, Indonesia. After the platform has been designed according to the user’s feedback on their need and specific requirement, the user usability and user acceptance of the proposed platform were tested. User acceptance result showed that all five constructs mean were above 60%. Among the construct, behavioural intention to use had the highest mean values of 90.8% (±15.6). In case of usability testing, analysis also showed an overall mean value of over 60% and ease of navigation had the highest mean value of 84%. Images transmitted during teleconsultation met the standard medical quality of service (m-QoS) and were sufficient for diagnosis purposes. In conclusion, a positive agreement was observed asserting that this low cost teleprenatology platform is acceptable and easy to use. However, further studies are needed to improve the real-life implementation of this platform.