Long-term health conditions are becoming increasingly more common in low-and-middle-income countries, leading to disability and early death. In Sri Lanka, many people suffer from diabetes, high blood pressure, heart disease, kidney disease, and mental health conditions. When someone has several long-term conditions, it becomes more difficult to manage their care, leading to poor health outcomes.
The DIGIPATHS project aims to improve care for people living with MLTCs by developing and implementing Digitally Integrated Care Pathways (DICPs) that incorporate electronic health records (OpenMRS), a clinical decision support tool, automated feedback mechanisms, and a patient-facing application to support integrated, continuous care.
DIGIPATHS Study is a collaborative project led by the University of Birmingham, in partnership with the University of Jaffna, University of Edinburgh, University of Leicester, and other Sri Lankan partner institutions including the University of Kelaniya, University of Colombo, Sabaragamuwa University of Sri Lanka, Ministry of Health, Sri Lanka. Funded by the UK’s National Institute for Health and Care Research (NIHR).
The research project has six work-packages (WP), which will lead to the development and evaluation of the DICP for patients with diabetes, high blood pressure, heart disease, chronic kidney disease, depression, and anxiety.
Stakeholder Consultation Group (SCG) will be established including People living with MLTC (hypertension, diabetes and associated cardiovascular disease, chronic kidney disease and mental health conditions), Health Care Providers (HCPs), clinical informaticians, policymakers, researchers and the Community Involvement Engagement (CIE) group. This group will help to Selection of clinical guidelines, Design and implementation of the DICP components, and Ensure scalability and sustainability of RCT findings (future adoption & maintenance beyond the project.
In WP2, we will understand the current healthcare pathways in Sri Lanka and get input from local patients and healthcare professionals to make improvements. They will choose the best guidelines for care, so doctors and nurses know how best to support the care of people with multiple long-term conditions.
The DICP will have four key parts developed (WP3), that will connect to an electronic patient record system called OpenMRS. It will include digital guidelines, so doctors have the best information for treatment. There will be a digital referral system for communication and collaboration among healthcare providers. Automated feedback to clinicians will help improve the quality of care. Finally, there will be a digital patient-facing interface for patients to access their health information and take an active role in their care.
To see how well the DICP works, we will test it in 50 primary care centers using a special study called a cluster randomized controlled trial.
This is to evaluate the contextual and organisational factors that influence the scalability and transferability of the DICP across Sri Lanka and countries with similar population and health systems.
Assesses the cost-effectiveness and value for money of the DICP compared to usual care. It estimates long-term costs and health outcomes using economic models to inform policy and future investment decisions.