Impacts of digital technologies on public health: Project development and inception

This project seeks to develop research on the impacts of digital technologies on public health in Myanmar in partnership with Koe Koe Tech, a Yangon-based social enterprise specialising in information technology and public health. The project has two main foci, the first on assessing the impact of installing digital record keeping in hospitals and the second on assessing the impact of mobile health apps in conjunction with the mobile network expansion.

We will provide initial evidence on the effectiveness of the installation of a hospital information system (HIS) with electronic medical records (EMR) at Yangon General Hospital (YGH), Myanmar's flagship public hospital. This technology has the potential to provide a cost-effective way to roll-out electronic medical records in a setting where virtually all health institutions are dependent on paper-based systems. This lack of easily-referenced digital records has the potential to lead to mistakes in diagnosis and prescription, less efficient performance of hospitals, ultimately potentially leading to adverse outcomes for public health. Thus far HIS has been installed in two of YGH’s twenty-two wards, so we seek to qualitatively evaluate this initial roll-out, to provide insights into designing a randomized control trial to evaluate the roll-out of HIS through the remainder of the hospital. We will also explore potential constraints to uptake of the new technology amongst hospital staff, considering strategies to evaluate approaches to overcome such constraints. This study has the potential to provide important inputs to policy makers considering the broader roll-out of HIS to health institutions across Myanmar and in other resource-constrained environments. It also ties into the fast-growing literature on management and organizational performance.

In a nation with 4 doctors per 10,000 citizens, mobile phones represent a powerful instrument to overcome gaps in state capacity by providing healthcare information, advice and feedback in rural as well as urban areas. Implementation partner Koe Koe Tech is developing a suite of mobile health apps and other information interventions in conjunction with the ongoing mobile network expansion in Myanmar, which began in August, 2014. Koe Koe Tech’s initial app is a maternal and child health app ('maymay') (see, e.g., http://www.koekoetech.com/maymay/). While we are ultimately concerned about the application’s impact on maternal and infant health, our initial goal is to develop rigorous research designs to study the determinants of app take-up and use. This ties into broader literature in economics on the takeup of new technologies, and the diffusion of technologies through social ties and networks.