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  • Expect more cyber-attacks on healthcare

    The next cyber-attack never seems far away, and healthcare may be in criminals’ sights. A UK conference organised by The Guardian, a newspaper, and supported by technology company DXC, has some dark, ominous warnings for the UK’s NHS. They apply to healthcare everywhere.

    The report says some NHS employees expect another cyber-attack similar to WannaCry. In 2017, it caused widespread disruption to hospitals and GP surgeries. Not enough has changed to seek to avoid it.

    Poor leadership, budgetary constraints, deficient ICT systems and a lack of qualified staff combine to make the NHS vulnerable. A member of parliament and chair of the UK parliament’s public accounts committee commented that these limitations are exacerbated by:

    No particular benefit for patients from good eHealtheHealth isn’t a big enough issueIt’s not an instant winMany NHS staff don’t trust their IT systems.

    Lack of clarity on patients’ benefits is another theme that needs attention. It reveals inappropriate eHealth investment.

    A report on the WannaCry incident by the National Audit Office (NAO) found that the attack could have been prevented by basic ICT practices. Cyber-security was weak too. An NHS Digital cyber-security assessment of 88 England’s NHS trusts, about 37%, before WannaCry found none passed. NHS Digital has no power to require action. Consequently, the NHS remained vulnerable.

    These commentaries and findings provide a vital checklist for all health systems’ cyber-security and eHealth investment activities and goals. Waiting for the next attack without preparation’s a high risk approach.

  • Rome Business School has a short course on using the Digital Health Investment Framework

    eHealth finance and economics are core components of the  Masters in eHealth and Telemedicine Management at Rome Business School. The module includes an assignment on using outputs for the Digital Health Investment Framework (DHIF), an Asian Development Bank initiative.

    An important theme in DHIF is equipping users with the skills and knowledge to begin using it to support eHealth investment decisions. Building on this, the School now has a short course of five sessions on DHIF, all available online.

    The first course starts in February 2019. Participants can Enrol now.

    The course objectives are:

    Identify the architecture, characteristics and the roles of a DHIF modelUnderstand the concepts and methodology using illustrative DHIF modelsApply DHIF to real-life projectsReview DHIF illustrative models.

    Learning outcomes are:

    Understand and develop investment goals of health, healthcare, and digital health strategiesDefine different stakeholders’ types, user requirements and required functionalityHow to develop DHIF architecture and contentIdentify appropriate network requirements, and data and capacity dependencies from other eHealth investmentsDevelop personal skills in stakeholder engagement, human capacity building in using the DHIF and change management skills

    Contents are:

    Introduction to DHIFIntroduction to eHealth costs and benefitsIntroduction to decision makingPutting it into practice, using participants own DHIF models.

    Two organisations, Società per la Salute Digitale e la Telemedicina (SIT) and Acfee are patrons of the School's Masters in eHealth and Telemedicine Management. The DHIF short course is linked to its eHealth finance and economics module.

    The DHIF course is appropriate for Acfee’s eHealth Investment Model for Africa (eHIMA), reported in eHNA. It will enable participants from Africa’s health systems to achieve a fast start up.

  • A telemedicine toolkit from Novartis Foundation supported by CWCDH

    As telemedicine moves further into the mHealth environment, it can become more widespread. To help its expansion, Novartis Foundation, with the Commonwealth Centre for Digital Health (CWCDH) as a messanger, has have compiled a telemedicine toolkit.

    It covers a wide range:

    High-level overviewInteractive implementation guide Business continuity planCommunicationFact sheetFever overview, protocol and role play templates Postpartum haemorrhage overview and protocolReferencesRollout templateWhat to look out for.

    There are two videos:

    Ghana Telmed Toolkit Video 1Ghana Telmed Toolkit Video 2.

    Ghana Health Service and Ministry of Health are core collaborators. Ghana telemedicine has more background information.

    Two objectives for the toolkit are:

    Increased healthcare access for people in low- and middle-income countriesLeverage eHealth best practiced and benefits.

    It sees telemedicine as vital to connect Community Health Workers (CHW) to medical specialists in 24-hour tele-consultation centres. Doctors, nurses and midwives in the centres mentor, coach and advise CHWs in managing emergency cases that are beyond their capabilities. Ghana’s experience shows that telemedicine’s strengthened healthcare capacity can result in:

    Over half of tele-consultations can be solved directly by phone, so mHealth has a core roleHospital referrals can reduce by 31%Empowered CHWsBetter healthcare qualityReduced travel times and costs for patients.

    Developed in Africa, the telemedicine toolkit can help African countries' health systems expand towards a shared, successful model. This can lay a platform for sharing and developing the required eHealth regulation.

  • AI, blockchain, cold chain and motorbikes improve blood donations and save lives in Nigeria

    Blood shortages are common in many health systems. An initiative in Nigeria uses mHealth to create a community of voluntary blood donors, and connects hospitals with blood banks, and blood banks with donors. Life Bank, a Lagos start-up also provides a discovery platform on for hospitals to order blood

    LifeBank delivers requested blood in less than 45 minutes, in a WHO Blood Transfusion Safety compliant cold chain. An article in Disrupt Africa says it’ll add other medical products such as oxygen, vaccines and rare drugs to its services.

    Its founder, Giwa-Tubosun, began a non-profit service to encourage people to donate blood. She then moved on to address supply shortages and poor logistics. Two main goals are:

    Increasing access to bloodReducing the number of Nigerian women who die from birth complications.

    LifeBank’s resources include:

    AIBlockchainCold chainmHealthMotorbikes.

    These combine to provide information about blood availability and avoid health workers’ wasted time and frustration seeking blood products. They also minimise ineffective blood transports that result in bacteria proliferation and consequences of health complications.

    Supporters include:

    Co-Creation Hub (CcHub) in 2016 that raised pre-seed fundingEchoVC Partners, a venture capitalistParticipation in Merck’s Lagos-based satellite accelerator this yearSelection for MIT Solv2018 that added grants and access to other resources.

    Its impact is considerable. To date, LifeBank’s delivered some 11,000 products for over 400 hospitals. Over 6,300 people are registered as voluntary blood donors, with over 20% donating blood in the last two years. The result: over 2,100 lives saved.

    A challenge is convincing blood bank partners to use LifeBank. As this is  overcome, it’s it easy to envisage LifeBank eventually operating across Africa.

  • A manual for Africa to use Asia's Digital Health Impact Framework

    Following the completion of the Digital Health Impact Framework (DHIF), an Asian Development Bank project, Acfee is completing its version for Africa. It draws directly from DHIF, and emphasises ways that Africa’s health systems can start simply and use it as a platform for increasing sophistication in appraising planned eHealth investment.

    The prototype, eHealth Investment Model Africa (eHIMA), mirrors the development track of DHIF’s forerunners that include the eHealth Impact model and the Five Case Model for business cases.  Both methodologies were less sophisticated in their original formats, and have been enhanced to meet increasing needs of decision takers. eHIMA is at the equivalent entry point for African health systems.

    eHIMA combines socio-economic , financial and accounting concepts to estimate eHealth projects’ Value for Money (VFM) and affordability over time.  These are dealt with in DHIF’s ten steps:

    Identify timescalesIdentify stakeholdersIdentify benefitsIdentify resources neededEstimate socio-economic benefits' monetary valuesEstimate socio-economic costsAdjust for sensitivity, optimism and riskCalculate net benefits, the Socio-Economic Returns (SERs)Estimate financial costs and affordabilityRefine and iterate SERs and affordability to find an optimal link

    eHIMA will guide Africa’s users in selecting which steps are the most important to being modelling and appraising for decision-takers’

    A  report on eHNA describes DHIF in more detail. It was presented to the Asia eHealth Information Network (AeHIN) conference in Sri Lanka in October.

    Acfee’s overall aim is to help Africa’s eHealth decision-takers and analysts in dealing effectively with increasingly complex eHealth investment scenarios and options. Good, affordable eHealth strategies are the starting point.  eHIMA will be available in January 2019. eHNA will post updates on progress.

  • Heidelberg University launches an eHealth policy course.

    Three entities have combined to create a five-day residential course on eHealth policy at Heidelberg University. The other two are evaplan, a University Hospital Heidelberg consultancy, and the Institute for Global Health.

    Developing national digital health policy: Laying the Foundations is designed for health planners and policy advisers. It will help them to explain eHealth’s national requirements for success. A specific emphasis is on low and middle income countries. It aims to help participants to:

    Understand how well-crafted eHealth strategies support smart investment Use available toolkits to design and improve country’s eHealth policiesStrengthen participants’ eHealth adviser roles Support decision making for interoperable eHealth and avoid further fragmentation Understand organisational and behavioural changes needed to maximise eHealth benefits.

    The curriculum for the first four days includes: 

    Health Strategies and eHealth strategies in developing countriesDeveloping eHealth strategiesPlanning for interoperabilityManagement and behavioural change. 

    The dates are 4 to 8 February 2019 at the university’s Internationales Wissenschaftsforum Heidelberg (IWH), Germany. The final day includes a guided tour of Heidelberg and time for mentoring and networking. Presenters are Peter Drury and Michael Stahl, The course is in English. Applications close on 15 November 2018.

  • Commonwealth Centre for Digital Health and ECH Alliance to launch their joint action plan

    Working and sharing with eHealth agencies offers mutual benefits. At the Digital Heath Week 2018 in Sri Lanka, the Commonwealth Centre for Digital Health (CWCDH) and the European Connected Health Alliance (ECH Alliance) met and agreed their joint action plan. It was originally envisaged in the partnership agreement announced in May 2018.

    The full action plan will be announced shortly. It will include:

    On 20 November 2018, launch of an ecosystem in Malta, both a European and a Commonwealth countryUganda’s ecosystem will be a nexus for collaboration across East Africa for CWCDH. HealthOrganisation of a Commonwealth Digital Health Skills Summit early in 2019 to connect existing skills programmes with the needs of many Commonwealth countriesLaunch of ecosystems in Sri Lanka and Uganda in early 2019. 

    These will comprise the beginnings of the Commonwealth Connected Health Alliance. Its aim will be exemplars for ecosystems across the Commonwealth. 

    Prof Dissanayake’s chair of CWCDH. He said “We decided to work together because we share the same mission and values and by joining forces we hoped we could deliver faster and do more better.” He is satisfied that considerable progress has been achieved in just a few months. The plan now’s to build on the value of the partnership with ECH Alliance and move forward with constructive activities as part of the commitment to work jointly with.

    COO of CWCDH, Anoop Singh said the partnership’s main goal’s to deliver real benefits, not to try to do everything. Bringing together eHealth stakeholders and collaborators from Europe, the Commonwealth and beyond will contribute to meeting numerous needs and opportunities.

    ECHAlliance chair Brian O’Connor is convinced that the collaboration will bring mutual benefits to everyone involved. His view’s based on discussions with people from over 40 Commonwealth countries. He sees their progress, innovations, determination and passion as a vital ingredient for future success.

    CWCDH will hold an event during the World Health Assembly (WHA) in Geneva in May 2019. The goal’s to obtain the commitment of Commonwealth governments to CWCDH’s planned activities. 

    Nineteen countries are Commonwealth members. If the benefits spill into the rest of Africa, the partnership will have proven its worth.

     

  • How far into the future should eHealth strategies look?

    By definition, eHealth strategies are about investing in the future. They’re also about taking existing eHealth investments forward, either by switching, enhancing and rolling out further. In 2006, Rosabeth Kanter identified several lesson for innovation strategies. They included an “innovation pyramid” where:

    Not every innovation idea has to be a blockbusterSufficient numbers of small or incremental innovations can lead to big gainsBig bets at the top that get most of the investmentA portfolio of promising midrange ideas in test stageA broad base of early stage ideas or incremental innovations.

    The last one’s relevant for a perspective set out in an eBook from Oracle. Technology Takes Healthcare to Next Level proposes strategies for disruptive technologies of:

    AIBlockchainChatbotsIoT. 

    Each one offers promise for healthcare. Combined, Oracle sees the sum of the parts as greater than the whole. Combining blockchain and IoT allows frictionless data exchange. AI and machine learning put data in motion with minimal human intervention. AI tools can study blockchain’s large volumes of data to find patterns that need responses

    For Africa’s health systems, investment in ICT foundations and patients’ clinical and demographic data’s needed to. The strategic challenge is to choose between sequential investment and progress in an innovation pyramid where these four technologies start their journey. While leaving the disruptive technologies into the future, it can defer the costs. It will also defer the benefits.

     

  • EHR’s financial benefits may be elusive

    Acfee’s stance on EHRs is that they’re an investment in health and healthcare, not an initiative to increase healthcare organisations’ income. The Acfee eHealth Impact Database contains over 60 evaluations. A common theme is that the extra cash needed for eHealth exceeds its cash savings. Healthcare quality and productivity are the main sources of benefits. The affordability planning and management lessons are clear for Africa’s health systems.

    It seems that US healthcare may see it differently. An article in Modern Healthcare says hospitals and health systems each spent millions and sometimes billions of dollars on EHRs. Examples are: 

    Trinity Health reported a US$107.8 million asset impairment charge in 2018 to switch to a single version of Epic EHR and revenue cycle management software over four years and undisclosed costsMayo Clinic spent US$1.5 billion on Epic HERPartners HealthCare spent $1.2 billion on an Epic HERScripps Health reporting weakened financial results when started an EHR conversion budgeted at US$300 million over ten years, with estimated operating costs of US$360.5 million, 20% more than the non-recurring costsBanner’s US$45 million project contributed to a US$92 million hit to university delivery operations 2017 when it spent US$24.3 million on EHR conversion.

    Modern Healthcare says the promised clinical and financial benefits have been elusive. Some healthcare organisations have suffered financial problems when eHealth has worked against them. In particular, hospitals and health systems have faced financial stress when implementation costs drive up operating costs, a Capex Opex imbalance.

    Doctors and other clinicians have been wary of embracing eHealth too enthusiastically. Concerned that they may feel held back by it and causing clinician burnout.

    A literature review in the Journal of the American Medical Informatics Association said it revealed evidence that “Data entry requirements, inefficiently designed user interfaces, insufficient health information exchange from outside institutions, information overload, and interference with the patient–physician relationship are … factors associated with physician stress.”

    Some explanations are: 

    There’s going to be some disruption when implementing EHRs so budgeting and financial planning, including contingencies helps to avoid financial crisesTo ensure successful EHRs may need extra resources after implementation to mitigate financial risksLooking at EHRs in the long-term, rather than two- or three-year returns, can be helpfulIt’s inevitable that new eHealth, especially large-scale EHRs, will slow patient volume temporarily as providers learning to use them, so are less productivePlan for eHealth complexities that diminish returns from EHRs, including procurement costs, deployment and increases in higher ICT operating costs, higher departmental operating costs and lower productivity and lower employee satisfaction. 

    Africa’s health systems can’t afford these outcomes. Rigorous business cases, an emphasis on health and healthcare benefits and top class eHealth leadership can help to avoid them.

     

  • Rural India uses eHealth with containers

    Shipping containers re-appear in many guises, from roadside cafés to holiday homes. It should come as no surprise that they should have become part of the future of India’s eHealth network.

    A report in The Nation Online says in 2013, Dr. Anurag Agrawal, of the New Delhi-based Institute of Genomics and Integrative Biology (IGIB), saw the possibilities of including shipping containers’ versatility in his work towards a link between genes and lung disease. His plan was to use the movable containers to house and collate health records in rural areas so specialists could analyse the data to identify links between height, weight and predisposition for developing specific lung diseases. The analysis leads on to developing and delivering treatments.

    A container appeared in a village in Uttar Pradesh. Villagers soon had video access to a doctor and could see a paramedic in person. They could also leave blood samples and submit cardiograms.

    This initial success was hindered by IGIB’s link to government. It is one of India’s 39 state-funded Council for Scientific and Industrial Research laboratories, and is limited its scope to expand.

    Then IGIB partnered with the Indian hospital chain Narayana Health (NH) and Hewlett-Packard (HP) to install over 40 eHealth container centres across India. The service includes EMRs, bio-metric patient identification and integrated diagnostic devices. It’s a business model that could be appropriate for Africa’s drive towards UHC.

    India has one doctor for every 11,000 people, well below WHO’s recommended rate of one per 1,000lth. The eHealth container with HP cloud technology offered a dynamic solution. Clinical and administrative data is monitored and medical advice provided remotely.

    Dr Agrawal believes more benefits are available. Telemedicine has improved access to second opinions and international consultation in urban areas. It’s benefits in rural India may be more limited.

  • Robots could be good for your health

    In his book The Rise of the Robots, published by One World, Martin Ford proposes social and economic scenarios for robots that are good for output, but not so good for people. He sees significant upheaval and displacement from employment across a wide range of commercial and industrial activities and across middle and low income families. The drop in income, so spending power, will degrade economies.

    Simultaneously, robots aren’t paid and don’t spend money. He sees this as exacerbating the social and economic impact.

    Healthcare’s the activity that’s different. He sees the robots marching into healthcare that’s already over-stretched as needs and demands continuously outstrip supply. Four roles are crucial:

    Artificial intelligence in medicineHospital and pharmacy roboticsRobots that care for the elderlyUnleashing the power of data. 

    For low and middle income countries and health systems, sustained investment in robots could be part of the solution. They can improve healthcare professionals’ productivity and help to meet demand.

    They should find a place in Africa’s eHealth strategies. Small scale investment will lay out a trajectory for the future.

  • Acfee’s director supporting SIL-Asia

    eHealth proponents know the importance of standards and interoperability. In Asia, it has an effective regional umbrella. The Standards and Interoperability Lab – Asia (SIL-Asia)’s powered by the Asia eHealth Information Network (AeHIN). It has significant, sustained support from the Asian Development Bank (ADB) and co-sponsorship by the People's Republic of China Poverty Reduction and Regional Cooperation Fund (PRCF).

    This substantial support has enabled SIL-Asia to provide a wide range of services to its members. Its Tooling page includes:

    Investing in Digital Health: Digital Health Impact Framework (DHIF)Guidance on Investing in Digital HealthDigital Health Terminology GuideTransforming Health Systems with Good Digital Health Governance: Health Governance Architecture FrameworkHealth Enterprise Architecture FrameworkSIL-Asia Cloud Set-upSIL-Asia FHIR Service.

    Countries can use SIL-Asia’s tools for their digital health implementation programmes. There’s more to come, including :

    A technology benchmarking frameworkInteroperability toolkitImplementation guide.

    SIL-Asia’s assets for countries’ use include:

    RxBox, a telemedicine device OpenMRSCHITS, an OpenMRS EMRBahmni,a HIS based on OpenMRSZato.io, a python based Enterprise Service BusWSO2, a Java-based, open source enterprise service busMedicCR, a Master Patient Index (MPI) developed by Mohawk LabOpenHIM, a JS-based mediator developed by Jembi Lab. OpenEMPI, a Java-based MPIOpenInfoMan, a health worker and facility registryDHIS2.

    Having completed his initial work on the DHIF, Acfee’s Tom Jones has taken on the role as a SIL-Asia partner. As Acfee’s Director of Strategy and Impact, it will provide a valuable bridge between Asian and African eHealth initiatives and challenges. Acfee envisages that Africa’s health systems will benefit considerably.

  • Asian Development Bank presents eHealth guidance at AeHIN conference

    Weak eHealth strategies lead to weak digital health investment. Maximising success and minimizing failure’s a core ADB eHealth theme. It sees effective eHealth strategies as requirement, and it presented its Guidance for Investing in Digital Health to the Asia eHealth Information Network (AeHIN) 6th annual conference this week in Colombo, Sri Lanka

    The guidance describes the healthcare context that’s needed for eHealth strategies. Peter Drury, the project lead, then set out essential issues that included identifying and engaging with stakeholders and pursuing digital health strategies that are drawn from health and healthcare strategies and that achieve a balance between value for money and affordability.

    He sees strategies as only part of the process, and similar to his word association of fish and chips and bacon and egg. For eHealth, it’s strategies and investment. Sharing experiences of the two are important.  There are examples of effective strategies that he’s seen across Asia available from AeHIN’s Standards and Interoperability Lab (SILA). These provide valuable insights for Africa’s health systems and for African countries contemplating new national eHealth strategies. 

  • Mongolia’s completing a big scale eHealth project

    Remote, large and sparsely populated; Mongolia offers a lesson on pursing a wide range of eHealth investment. Tucked in between Russia and China, it’s a country of about 3.1m people spread across 1.5m km. About half the population live in Ulaanbaatar, the capital.

    Dr Sereenen Enkhbold, Mongolia's eHealth Project Coordinator presented his country’s Role of E-Health Project in improving health information interoperability in Mongolia at Asia eHealth Information Network (AeHIN) 6th annual conference in Colombo, Sri Lanka. The objective’s to improve integration and utilisation of health information and eHealth solutions for better health service delivery. It’s about half way through four-year the project that started in 2016.

    The project, financed extensively by the World Bank incorporates:

    Health sector enterprise architectureHealth data and information technology standards DICOM, LOINC and HL7Health data dictionariesHIE platformHealth statistics and dashboardeHealth appsInvestments in primary healthcare facilities.

    The next phase includes benefits realisation and change management. Taken together, the project is a benchmark for Africa’s health systems.

  • Sri Lanka’s eHealth story stretches over 20 years

    The reputation of Sri Lanka’s continuing eHealth story is considerable. At the Asia eHealth Information Network (AeHIN) conference in Colombo, Prof Vajira Dissanayake of the Health Informatics Society of Sri Lanka (HISSL) described the from1998 to 2108 and beyond.

    It’s set out in Digital Health in Sri Lanka. This describes the sustainable implementation of digital health solutions through local capacity building. The lessons for Africa’s health systems are essential reading. It extends over 17 topics, including:

    Strategic planningPersonal health numbers and master patient indexElectronic indoor Morbidity and Mortality Register (eIMMR)Hospital Health Information Management System (HHIMS)HIMSElectronic Patient Information Management System of the National Programme for Tuberculosis and Respiratory DisordersElectronic Reproductive Health Information Management System (eRHIMS)Electronic Non Communicable Diseases System (eNCD)Registering and Verification of the Electronic Health Information SystemsSuwasariya telehealth programmeStroke Clinical RegistryEssential Drug Stock Alert Tracker Sri Lank Journal of Biomedical Informatics (SLBMI)HISSLS’s short history.

    Beyond 2018, other initiatives are coming through. Partners include UNICEF and Bloomberg Philanthropies. UNICEF provided finance for the app District Nutrition Monitoring System. Children’s nutrition won the prize for the best early stage app in South Asia.

    The sequence reveals a continuing strategic eHealth trajectory. Equivalents for Africa will be valuable in learning from the past and setting strategic trajectories, road maps and investment plans.

  • Asian Development Bank presents its Digital Health Impact Framework at AeHIN conference

    eHealth investment decisions usually end up by balancing value for money with affordability. It’s a regular end point for business cases for eHealth and a core ADB eHealth theme for its Digital Health Impact Framework (DHIF). It presented this and other components to the Asia eHealth Information Network (AeHIN) 6th annual conference this week in Colombo, Sri Lanka

    DHIF is a methodology for estimating and analysing socio-economic costs and benefits over time to identifying value for money and how long it takes to achieve it. Then it converts these into financial and accounting estimates to assess affordability. Tom Jones, the project lead, set out these issues that included:

    Deriving eHealth benefit requirements for health and healthcare strategiesIdentifying and engaging with stakeholdersManaging assumptions and estimateseHealth leadership, change management and new business models.

    The methodology has ten steps, but modellers and decision takers using DHIF for the time should choose only those components that are critical to the immediate decisions. From these, they can build up expertise and move towards using the full set.

    Risk is a constant in eHealth investment. DHIF can be used to estimate risk exposure that leads on to risk mitigation plans.

    Optimism is also common. DHIF provides adjustments for optimism bias, which can increase cost estimates with a range of lower than 40% up to 200%.

    Other material from the presentation is available from AeHIN’s Standards andInteroperability Lab (SILA). They can help Africa’s health systems improve their Health decisions, especially where parallel investment is needs in healthcare resources and new business models.

  • How do Africa’s mHealth strategies match the modern profile?

    With mHealth a standard component of Africa’s eHealth strategies, what’s a good benchmark to test them against? Spok, a US communications firm, as a profile of mHealth strategies that can help. Its eighth annual survey shows some marked priorities.

    Mobile Strategies in Healthcare Results Revealed says mHealth that reflects overall clinical goals for the health system or hospital are most successful. It also underpins larger eHealth strategies to deliver more efficient, higher quality care and increase satisfaction for patients, carers and health workers.

    mHealth strategies extend across a wide range of information and areas. The top two are:

    mHealth management and security, for 56% of respondents Device selection, at 52%.

    The bottom two are mobile, and business development and reporting strategies. 

    The full profile’s:

    Management and security 56%Device selection 52%EHR integration 48%Infrastructure assessment 45%Clinical workflow evaluation 43%Device ownership, including BYOD 34%Mobile app strategy 29%Mobile app catalogue 16%Mobile strategy governance 14%Business development and reporting strategy 12% 

    The third item, EHR integration, matches findings from another Spok survey of hospital CIOs. They said integrating with the EHR was their top priority for respondents. Clinical workflow evaluation’s high score on is seen as revealing. It’s an indication that doctors, nurses, and other health workers in direct patient care roles use mHealth to define safe, efficient and effectively managed workflows.

  • Biggest financial support achieved by Egyptian start-up Vezeeta

    Start-ups need a financial prop in their early years. They often need a second wave to finance expansion. A report in Disrupt Africa says Egyptian start-up Vezeeta has raised US$12m. It’s the largest single investment ever received by an Egyptian start-up. It builds on its US$5m support achieved in 2017, as reported in Disrupt Africa. 

    Set up by its Ceo Amir Barsoum in Cairo in 2015, Vezeeta’s eHealth enables users to find and book appointments with over 10,000 doctors. It’s available in Jordan and Saudi Arabia too. For the region, it manages three million bookings for 2.5m patients. It also provides Software as a Service (SaaS) solutions using cloud computing and big data for patients and doctors.

    The financing round was led by the Saudi Arabia-based STV Capital. It included existing investors BECO Capital, Vostok New Ventures, Silicon Badia and CE-Ventures. Vezeeta’s will deploy its extra finance to two initiatives.

    One’s to continue its expansion in Saudi Arabia. The other’s to develop new products. 

    Will a subsequent investment phase turn Vezeeta’s attention towards the rest of Africa? For this, it may need expanded commercial opportunities driven by large numbers of users.

  • eHealth and a new business model can reduce inpatients’ mortality

    It’s more than just ICT. A current research programme in Germany shows how eHealth’s role in precision medicine can reduce hospital patient’s mortality when it’s integrated with investment in a part of a new business model. A report in HealthManagemnet.org on continuing research in Germany says how to optimise and streamline hospital care by separating patients into routine and complex groups improves quality and saves lives, so major benefits.

    Separate and concentrate – a sustainable business model for general hospitals describes how a new business model can use new technologies to support precision medicine and improve effective bespoke healthcare.  It assigns patients to routine and complex care pathways.

    Routine patients are not emergencies and have up to two co-morbidities. Complex patients are emergencies and have three or more co-morbidities. Both groups benefits from better quality. Routine patients’ mortality has dropped by more than 13%; complex patients; by more than 11%. These are attributed to the new business models opportunities to:

    Optimise the impact and benefits of precision medicineAddress the specific critical care management differences of the two patient groups Minimise the impact of operational factors on healthcare qualityReduce hospitals’ management complexity.

    The research’s currently in phase two of three phases. So far, it has disrupted the conventional view that greater patient volumes achieve better mortality results. The new business model emphasises that:

    Specialisation as a crucial determinant of quality and mortalityBusiness as usual with eHealth may not optimise its opportunities to maximise healthcare quality gains.

    It also confirms that eHealth is more than just ICT. The report confirms that redesigning routine and complex patient flows and care pathways has implementation challenges. It also shows that eHealth can offer more benefits when integrated with investment in new business models. 

  • Will the new Apple watch be a big hit?

    Apple is renowned for technological advancement and innovation.  During their annual product launch this year, Apple announced the new series 4 watch.  It’s not your average wearable.  This watch boasts mHealth features such as electrocardiogram (ECG) monitoring and fall detection, and allows you to share this data with your healthcare practitioner.

    These features are impressive.  Apple is snapping up opportunities to break into the rapidly expanding mHealth market, from fitness tracking to a health app and now wearable ECG.  But there’s a nagging concern too.  What impact will this wearable ECG have on the healthcare system?  Could Apple’s new innovation spur an increase in unnecessary healthcare utilisation?

    These are concerns that I seem to share with other healthcare practitioners who worry that consumers may incorrectly attempt to diagnose complex cardiac conditions themselves.  There are also concerns about the sensitivity and specificity of the device, which if not great, could spark a mass of panic-stricken consumers due to false positives.

    While this new innovation is an important movement towards better patient management, it is vital that the counsel of healthcare practitioners is not diminished.  Consumers must be advised to use it cautiously to augment their healthcare management rather than replace professional management. 

    Similarly, the medical community needs to work more closely with companies like Apple who drive much needed innovation.