Table 3.

Advantages and disadvantages to using technology to aid remote and rural workers

Group 1: Health data collected at a patient visit to facilitate patient care
Advantages	Examples	Author
Acceptability	Positive acceptance	Chaiyachat et al, 2013; Surka et al., 2014
	Fuel savings	Chang et al, 2013
	Unrestricted use generated a sense of ownership and empowerment	Little et al, 2013
Data Quality	Improved data quality	Gisore et al, 2012; Surka et al., 2014
	Increased subject enrollment	Gisore et al, 2012 Mamud et al, 2010
Cost	Maintenance was inexpensive, after an initial capital cost	Gisore et al, 2012; Chaplin et al.,
Disadvantages	Examples	Author
Acceptability	Low actual use, despite positive acceptance	Chaiyachat et al, 2013
	Concerns with job security	Chang et al, 2013
	Limited personal motivation to use the phone without incentive	Chaiyachat et al, 2013
	Patient confidentiality problems, especially when phones are shared between family members	Chang et al, 2013 Haberer et al, 2010 Velez et al, 2013
	Interferes with the human side of the community health worker and patient interaction	Chang et al, 2013
	Community health workers feared making mistakes	Haberer et al, 2010
Usability	Application updates were disruptive and caused screen freezing	Chaiyachat et al, 2013
	Patients registered multiple times	Little et al, 2013
	Small keyboard caused data entry errors	Velez et al, 2013
Technical Infrastructure	Limited internet access made it difficult to upload data Graphic presentation of data on phones inferior to paper	Chaiyachat et al, 2013 Chang et al, 2013 Surka et al., 2014
	Limited electricity caused problems with battery charging	Chang et al, 2013
	Some phones were lost, stolen, or damaged, but this was rare. Some community health workers were worried that smartphones would make them a target for theft.	Chang et al, 2013 Little et al, 2013 Gisore et al, 2012
Group 2: Communication between a health worker and patient
Advantages	Examples	Author
Acceptability	Fuel savings	Mamud et al, 2010
Health outcome	Higher odds of skilled delivery attendance	Lund et al, 2012
Data Quality	Increased subject enrollment	Mamud et al, 2010
Group 3: Communication between a health worker in the field and a health worker at a higher institution
Advantages	Examples	Author
Acceptability	Improved morale	Chang et al, 2011
	High acceptance among community health workers	Jones et al, 2012
Usability	Decrease in time to contact and receive feedback from supervisor	Lemay et al, 2012
	Increased subject enrollment	Ngabo et al, 2012
Health outcome	Improved patient compliance when they realized direct accountability to clinic	Chang et al, 2011
	Improved medication management	Zurovac et al, 2011
Data Quality	Enhanced protocol compliance	Florez-arango et al, 2014
Cost	Decrease in costs, mostly due to a decrease in travel expense	Lemay et al, 2012
Disadvantages	Examples	Author
Usability	Health worker concern with becoming desensitized to repetitive and frequent messages	Jones et al, 2012
Health outcome	No demonstrated impact on medication adherence	Bruxvoort et al., 2014
Group 4: Data collection for surveillance or research-based purposes
Advantages	Examples	Author
Acceptability	High acceptance among interviewers	VanHerden et al, 2013
Usability	Convenient to carry around because of small size	Onono et al, 2011
	Technology facilitated interaction with interviewees	Rajput et al, 2012
Data Quality	Improved data quality Limited to no errors	Onono et al, 2011 Zhang et al, 2012
	Real time information allowed identification of technical issues, data entry issues, and data fabrication	Tomlinson et al, 2009
Cost	Technology was more cost efficient that pen-and-paper surveys because data entry was not required	Rajput et al, 2012 Tomlinson et al, 2009
Disadvantages	Examples	Author
Technical Infrastructure	Limited electricity caused problems with battery charging	Onono et al, 2011
	Limited internet access made it difficult to upload data	Onono et al, 2011
Cost	High initial capital costs	Zhang et al, 2012