A delay-tolerant network architecture for challenged internets
Proceedings of the 2003 conference on Applications, technologies, architectures, and protocols for computer communications
Proceedings of the second ACM workshop on Challenged networks
Study of a bus-based disruption-tolerant network: mobility modeling and impact on routing
Proceedings of the 13th annual ACM international conference on Mobile computing and networking
Asynchronous remote medical consultation for Ghana
Proceedings of the SIGCHI Conference on Human Factors in Computing Systems
Networking in the land of northern lights: two years of experiences from DTN system deployments
Proceedings of the 2008 ACM workshop on Wireless networks and systems for developing regions
The quest for a killer app for opportunistic and delay tolerant networks: (invited paper)
Proceedings of the 4th ACM workshop on Challenged networks
ICTD for healthcare in Ghana: two parallel case studies
ICTD'09 Proceedings of the 3rd international conference on Information and communication technologies and development
Analysis of information and communication needs in rural primary health care in developing countries
IEEE Transactions on Information Technology in Biomedicine
Delay-tolerant networking: an approach to interplanetary Internet
IEEE Communications Magazine
Computer Methods and Programs in Biomedicine
Computer Methods and Programs in Biomedicine
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Background: Medical Informatics Systems (MIS) have been suggested as having great potential to improve health care delivery in low resource settings. One of the major barriers for adopting MIS in this context is a lack of adequate network/communication infrastructure. Delay Tolerant Networking (DTN) is an approach for establishing network connectivity in situations where it is possible to support physical transport of the digital information. To date most DTN research has been technically oriented, and very few services have been implemented to support healthcare systems using the technology. It is thus unclear about the potential that DTN may have for supporting MIS systems in low resource settings. The goals of the paper are twofold, first, to gain an initial estimate of interest in different services that can be supported by DTN. Second, to find out the necessary frequency associated with each service for supporting health work in low resource settings. Method: Fifty questionnaires were distributed to attendants at the International Conference on Global Health that had acknowledged having health work experience in a poor connectivity context. The respondents were using a 5-point Likert scale regarding if 9 different potential DTN services ''would be useful''. They also were asked how often data delivery would be necessary for these services to be useful. The Chi square was calculated to measure acceptance. Results: 37 responses were received, aggregating the response rate of 74%. The respondents represented having work experience from 8 months to 15 years from 35 resource poor countries. The Chi square test showed very high statistical significance for ''strongly agree and agree'' for the potential usefulness of the proposed DTN services, with a p-value less than 0.001. The frequency of data delivery that would be necessary for services to be useful varied considerably. Conclusion: This study provides evidence of potential for DTN to support useful services that support health work in low resource settings, and that services like access to email, notification of lab results, backup of EHR and teleconsultation are seem to be most important services that can be supported by DTN. The necessary frequency of data delivery for each service, will be highly dependent on context. In a low resource setting with limited mobility, the physical transport of digital data at a frequency of less than once per week should still be sufficient for useful services like notification of lab results and ordering of medical supplies. Research comparing different methods for delivery of DTN data should thus be useful. Further research and collaboration between MIS and Computer Science research communities is recommended in order to help develop DTN services that can be evaluated. Efforts to enhance awareness among stakeholders about how DTN can be used to support health services should be worthwhile.