Employing ehealth to enhance equity in access to and quality of chronic care services in rural primary healthcare settings: The case of Lebanon

background: To facilitate the achievement of equitable health systems, ehealth tools have been advocated as an innovative method, particularly in low-resource settings. purpose: This case study acts a model to enhance the equity in access in underprivileged communities in low-middle income countries such as Lebanon through the employment of different low-cost ehealth tools targeting namely chronic diseases. The study is also distinctive as it targets both the supply and demand components of healthcare services. methods: Sixteen primary healthcare centers were randomly selected from low-resource settings and equally divided as control and intervention groups. The ehealth intervention had two components: community-based and primary healthcare center approaches. The community-based approach involved household screening for diabetes, hypertension and gestational diabetes with data and appointments remotely entered on a designed ehealth tool. Individuals also received electronic Disease Self-Management Education presentations. The primary healthcare center approach targeted healthcare providers and chronically-ill patients. Healthcare providers used designed online modules focusing on clinical guidelines, provider-patient communication strategies and online forums dedicated to peer-to-peer knowledge sharing and communication. On the other hand, patients received Short Message Services (SMSs) including medical information about their respective disease(s) and generic reminders of appointments and regular physician follow-up. In May 2014, the research team pilot tested the ehealth processes for the duration of four weeks. results: Approximately 154 individuals were screened during this period by two trained health professionals. Around 12% of screened individuals were referred to the primary healthcare center for further follow-up by the healthcare providers. Screened individuals, patients and healthcare providers expressed their positive feedback on the ehealth tools used in this study. discussion/conclusions: The pilot testing revealed the need for certain modifications in the developed low-cost ehealth tools and set processes. Cultural and socioeconomic factors will also be taken into consideration during the intervention phase.