ehealth transforming the patient experience of health in africa · 2014-02-17 · 1. african...

eHealth transforming the patient experience of health in Africa Dr Sean Broomhead

Chairman: tinTree International eHealth, Advisor: WHO tintree.org

Overview

Africa and its countries eHealth in Africa

eHealth initiatives in Africa eHealth strengthening in Africa

Africa and its countries

GDP

Growing at 5 to 6% per annum Growth forecast to continue

Many opportunities Wide country variation

Role of Regional Economic Communities

Burden of disease

High infant mortality High maternal mortality HIV and TB epidemics

High accidents and trauma Increasing chronic disease incidence


Resourcing

Affordability challenges and competition for resources

Limited health workers and mismatch with diseaese burden

Limited investment in tools for healthworkers

eHealth must show benefits realisation and show socio economic return


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SSA healthcare spend per capita US$ 2008, WHO 2011

eHealth in Africa

1. African solutions

”Solutions need to come from Africa.”

Aaron Motsoaledi Minister of Health South Africa, at #HIS2014 in

Cape Town 20 Jan 2014

2. Patient focus

”When frontline healthcare providers and patients meet with software developers

interesting things happen.”

Jeeshan Chowdhury Founder, Hacking Health

eHealth in Africa

3. mHealth opportunities

”We are interested in providing solutions for health, not simply a pipeline”

Kirsten Miller-Duys Vodacom, South Africa

”Emergence of a new, more patient-centric healthcare value chain. As a result,

conventional business models, which typically place consumers at the

periphery, may soon no longer apply”

PWC Emerging mHealth: Paths for growth

4. Strengthening needed

”Healthcare is complex and so is eHealth. To succeed eHealth has to hit a number

of targets”

”Benefits realisation needs to be managed to show socio economic return to justify

investment”

eHealth initiatives in Africa

Numerous pilots underway Most never scale up to achieve regional or national impact

Assessment of impact is inadeqaute


eHealth News Africa is a growing resource

ehna.org

Below are examples of initiatives that show promise


Tendai Project, Southern Africa

Community health workers use mobile phones to submit data on medicine availability

Data is collated and shared to improve availability Participants: South Africa, Lesotho, Zimbabwe,

Mozambique, Malawi, Zambia, Namibia, Botswana, Swaziland, Angola

”Too many people in Southern Africa suffer from disease

without medical relief.”


Hello Doctor, South Africa

A platform for supporting the relationship between patients and general

practitioners, integrating consultations across web, email and telephone

Registration based business model from less than 10c (US) per day

”Doctors are intent on pulling people out of the river. We get to go upstream and

stop them from jumping in the river. We want to move away from sickness, and

towards health.”

Craig Townsend Hello Doctor Founder


Medicine verification, Kenya

Mobile realtime verification of medicines using their barcode numbers to combat

counterfeit drugs

”The global market for fakes could be worth between US$75-$200 billion a

year in lost revenue for pharmaceutical companies”

Poison Pills: The Economist 2 September 2010

”Why should someone travel 2 days to wait another 2 weeks for an answer that

could be a click away?”

Innovator: Geoffrey Otieno Sproxil Director, East Africa


PING, Botswana

Store-and-forward email of dental images to reduce unnecessary transfers from a rural clinic to central hospital for maxillo-

facial opinions

Partnership with UPenn

”The system saves patients days of travel and hundreds of dollars of out-of-packet

expences they can scarcely afford”


Electronic continuity record

An application that digitizes and integrates a range of forms into a concise clinical

summary to simplify the discharge process and make better the data more

useful to multiple facilities

”Before this, poor information sharing compromised continuity of care”

Ian de Vega Department of Health

Western Cape Province


iDart, South Africa

Open source ARV pharmacy management and dispensing system

It improves drug supply, reduces waiting times and improves treatment

adherence

Developed by Cell-Life, funded by the Desmond Tutu Foundation and the Canadian International Development Agency

”The system has helped change patient behaviour and improve outcomes”

Cell-Life

”When can we drop the m?”

Innovator: Dr Peter Benjamin mHealth Alliance


AfriTox, Southern Africa

An online database of toxins and toxic substances that provides easy access to

potentially life-saving advice

”AfriTox avoids the tedious process of calling a poisons centre for advice.”

Innovator: Dr Clare Roberts Poison’s Centre Director, Red Cross Children’s

Hospital, Cape Town


YoungAfricaLive

Mobile based social media network that engages youth on love, sex and

relationships

Hosted by Praekelt Foundation on Vodafone Live

Wikipedia open health

Free channel for Wikipedia access via mobile phones

”What website gets the most health related hits? Yes – Wikipedia. Health searches

account for 10 times more searches than the next heighest scoring topic.”

Innovator: Gustav Praekelt Praekelt Foundation


Medivate

A mobile platform integrating images, GPS coordinates and real-time reporting to improve resource alloction in rescue

scenarios

Innovator – Dr Julian Flemming Emergency Care Physician

Mobile Xhosa

A free-to-access mobile phone based tool that helps healthcare workers translate

common phrases between isiXhosa and English

Innovator – Saadiq Moola Medical Student


Clinical practice tool

A virtual outreach and support platform built in-house to help provide specialist

surgical guidance 24/7 to general practitioners in surrounding hospitals

and clinics

Innovator – Dr Riaan Duvenhage Surgeon

Diabetes Camera

A device that allows community health workers to take digital images of diabetic

patients’ retinas and send them to specialist centres for comments on

retinopathy and advice on treatment plan

Innovator – Prof Bob Mash Family Care Physician


Vula mobile app

A mobile phone application for screening patients in rural centres for eye

conditions to select conditions requiring specialist referal

Innovators – Dr William Mapham working with Prof Kevin Naidoo

PECS archive

A picture exchange communication system that helps children with Autism

Spectrum Disorder communicate their needs

Innovator – Megan Ellis Speach Therapist


Health Innovators Review 2014

Source for a number of the above initiatives Published by Inclusive Healthcare Innovation


Hacking Health

http://www.youtube.com/watch?v=JjroWVwG4AY

First event in Africa – Cape Town Jan 2014

http://www.youtube.com/watch?v=JjroWVwG4AY

Strengtheing eHealth in Africa

tinTree sees eHealth as a combination of ICT and organisational change

Success needs a range of integrated topics to be addressed. Fierce competition for resources requires Africa to:

Prioritise Understand and plan for positive socio-economic return

Deal with affordability


eHealth Strategy

Affordability, regulation,

human capital

Risk management and realising benefits

Health priorities and eHealth

opportunities


A key issue is regulatory readiness

Findings from study of 48 countries in sub-Saharan Africa

eHealth regulation development follows eHealth Africa relies on telecoms, data protection and cyber-security regulation

SSA about 75% behind good practice:

Brazil, Canada, Estonia, Malaysia, Norway


Regulatory readiness

SSA priorities include:

Privacy and confidentiality Standards and interoperability

Security including cyber-security



Good practice countries have substantially completed frameworks for:

Identification and authentication Information protection and privacy

National eHealth information standards Investment in information communication technology (ICT) infrastructure

National broadband services



Proven fertility for key signs of successful eHealth:

eHealth regulations Established eHealth programmes and initiatives

Governmental support Sustainable funding

Some countries are readier than others


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ESA SSA eHealth Regulation Combined Readiness Scores


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Indices

ESA SSA Ready and Not Ready Differences

Ready Countries Not Ready Countries Difference


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Data andinformation

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Access to data Datacommunication

Technology User data Provision ofeHealthservices

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Comparison of eHealth Regulation Coverage of Five Good Practice Countries, 48 SSA Countries and Ten Ready SSA Countries

Five good practice countries Ten ready SSA countries 48 SSA countries

Conclusion

eHealth is ICT and organisational change

Technology is largely proven Substantial opportunities exist in Africa

Ready countries are well ahead of others Scaling up requires organisational strengthening

Thank you!

Dr Sean Broomhead

[email protected]

ehealth transforming the patient experience of health in africa · 2014-02-17 · 1. african...

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