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  • Articles (2,352)
  • Can Africa’s eHealth projects avoid human burnout?

    As countries’ health systems move towards Universal Health Coverage (UHC), a challenge is to afford a new and optimum and sustained balance of resources to meet the increased demand. It includes a mix of extra health workers, more and better eHealth, and resultant gains in quality, access and efficiency. It’s an extremely demanding, integrated strategy.

    It’s also starting from a modest base. Africa’s eHealth investment needs boosting significantly and recruiting and retaining extra health workers is a long-term challenge. A report from Athena Insight shows its starting point may have even more constraints.

    In The business case for physician capability, US doctors’ burn out is identified as “48% of physicians think they’ll have trouble maintaining their workload over the long term.” The equivalent in Africa’s health systems for all health workers doesn’t offer an effective platform for the sustained engagement needed to expand eHealth for UHC. The time needed away from clinical activities will exacerbate burn out.

    On these findings, it’s important to include in eHealth programmes initiatives to fix burn out. Better capability reduces burn out from about to 51% to 27%. It includes skills and organisational changes. Jessica Sweeney-Platt, the report author, says “In an organization that emphasizes capability, team members have clearly defined roles and responsibilities. Leaders listen to the frontline and prioritize training, communication, and alignment. Innovation is prized and rewarded — especially innovation that results in fewer administrative tasks performed by physicians and other providers.”

    While the report doesn’t offer the business case one would expect from its title, it sets out some essential themes for organisational development that successful eHealth depends on. 

  • Japan extends healthcare to the home

    Welby My Karute is an innovative app developed by Welby Inc, a Tokyo based IT company to support the management of healthcare. The use of such apps for monitoring patient's lifestyles and chronic diseases is a growing trend in Japan.  Medical institutions using this app rely on the information provided to improve treatment and care and reduce the incidence of healthcare visits.  

    The aim of this app is to encourage patients to keep a record of their lifestyle at home, which is then shared with dieticians, doctors and other medical workers. This serves as a “watcher” as it keeps an eye on the patient without them seeing a doctor. Data such as meal choices, blood pressure, pulse, sleep patterns and whether they take drugs appropriately can be shared with computers at the hospital to inform patient management and disease monitoring. 

    Patients have stated that the app makes it convenient for them as they tend to miss hospital checkups due to having other commitments such as work.  This provides a useful use case for Africa, where patients struggle with similar challenges.  Coupling this app with suitable patient incentives can help patients and clinicians shift healthcare away from being reactive, but rather proactive and preventative.

  • mHealth can improve communication and teamwork

    Good football teams talk constantly during a game to ensure high levels of concentration and performance needed for success are sustained. Effective healthcare teams need to do the equivalent. Anmed Health Medical Center, a 461-bed acute care hospital in Anderson, South Carolina, uses mHealth to achieve effective communications and alerts for hospital teams.

    In 2015, it started to integrate its phone system, nurse call system, patient monitoring alerts, secure texting and EPIC into a unified mHealth service. Other providers, including Philips Healthcare, Voalte and Connexall, are included too. The goal was to bring stakeholders together to improve and streamline connectivity, coordination and clinical workflows. Choosing the right phone was essential for success.  PIVOT smartphones from Spectralink were selected.

    The company has described the initiative in a case study. It has several lessons for Africa’s mHealth strategies. A major benefit’s the capacity to connect quickly with the most appropriate available people as different needs arise. Direct and effective messaging has increased response times, helping to provide more effective and personalised patient care.

    While Africa’s mHealth has priorities for remote communities and healthcare workers, hospital teams need mHealth too. A challenge’s to find an appropriate investment balance within constrained resources.


  • Managing and mapping EHRs after implementation's essential

    While EHRs may be a solution, implementing them’s not enough. They need managing effectively to sustain their benefits. A white paper from ServiceNow describes a way to do it.

    Because EHRs are complicated, mission-critical and support high quality patient outcomes, visibility of their reach into all healthcare’s parts enables effective and efficient EHR management. Service visibility: A road map for IT Operations and managing your EHR system says healthcare ICT teams need an EHR  map that shows its infrastructure and the services that rely on it. A service-level view’s needed to. This should show how EHR modules, features and hospital and clinical services are routed over the ICT infrastructure. 

    It’s a considerable project. Automated mapping services can help. A solution should:

    Automatically map complete services within a few hoursDoesn’t need significant input from your domain expertsTraces hospital business services across entire ICT and clinical environments, not just a few technology domainsMaps custom-built business services, not just standard services such as email or Enterprise Resource Planning (ERP) systems. 

    Benefits of EHR mapping include:

    Pinpointing disruptions to EHRs that affect critical hospital and clinical servicesIdentifying root causes of hospital service issuesInstantly seeing the impact of planned changes to specific EHR environments, reducing the time needed for manual analysis Easily optimising architecture of EHR-related hospital and clinical services, saving time, reducing costs and improving reliabilitySecuring and simplifying major transformation initiatives, such as data centre consolidations, upgrades, new modules and migrations. 

    These combine into sustained support for benefits realisation and embedding them into daily clinical and working practices. It’s an essential part of EHR investment that Africa’s health systems should consider to ensure that EHR implementation isn’t the end, but the start of improved healthcare. 

  • Interoperability across all healthcare’s needed

    Unlike most organisations, healthcare’s an huge array of integrated services. Ensuring that its information in interoperable across the range’s a daunting task. A white paper from Verato, a patient matching service, says comprehensive and effective healthcare needs a new architecture for patient identity interoperability (IOp).

    Its thesis has four themes:

    Healthcare involves extensive co-ordination across the healthcare continuumAccessing patient information’s the cornerstone of co-ordinationResolving patient identities across disparate systems and enterprises is critical to accessing informationExisting Master Patient Index (MPI) technologies can’t resolve patient identities consistently enough or well enough to support emerging needs.

    The task’s easier is if each citizen or visitor has a unique national patient ID number (UPI). These should be assigned at birth or on entry into countries. Issuing and maintaining UPI’s is challenging and needs sustained resources.

    Where these aren’t in place, MPI technologies are used but may be obsolete. Verato says they may not cope successfully with routine factors such as maiden names, old addresses, second home addresses, misspellings, default entries such as 1/1/1900 for birthdates and hyphenated names. Probabilistic matching fills in the gaps.

    A national database that healthcare organisations can access is seen as a better option. It can be managed effectively and updated regularly more efficiently than each healthcare organisation can achieve.

    The model offers Africa’s health systems an option in improving their UPIs. While many of these may be in their infancy, it creates an opportunity to set up a reliable way ahead to set up IOp rather than switch at a later stage of maturity.

  • Saudi Arabia’s RAH@H aims to improve healthcare quality

    Connecting and integrating healthcare resources to improve quality’s a core eHealth goal. In Riyadh, the Remotely Accessible Healthcare at Home (RAH@H) initiative offers a daily, patient centric, connected health model to achieve it. Five themes are integrated: 


    Achieving these depends on RAH@H operating at the centre of a technological hub.

    Available both on Android and IOS, RAH@H uses modern technologies for telemedicine, webinars, and observations from medical devices to serve patients. Healthcare needs of vulnerable communities that don’t have ready access to services. They include pregnant women, especially with complications such as hypertension, gestational diabetes and cardiac conditions.

    Interventions include:

    Improved nutritionPrevention and protection against diseases and illness.

    These aim for outcomes of:

    Better life qualityCreating satisfied and empowered patientsIncreased treatment compliance.

    Based in Riyadh, RAH@H’s project custodian’s the Director General of Prince Naif Bin AbdulAziz Health Research Center at King Saud University in Riyadh. It's concept and technology can have a role in African countries and their vulnerable, underserved communities.

  • eHealth start-up Redbird can expand access to rapid diagnoses across Ghana

    Africans suffer from diabetes at more than twice the global average. Resource constraints mean that millions lack proper access to healthcare to help them manage the disease. Launched this year, July has been a month of swift advances for Redbird Health Tech (Redbird HT) to try to bridge the gap.

    Chronic diseases, such as diabetes and hypertension, account for half of Ghana’s healthcare activity. Responses require treatment and long-term monitoring and management. Travelling to a hospital and waiting was the only the services for chronic disease patients. Risks of patients ignoring their conditions, either by necessity or willfulness, are very high. Consequences can be devastating.

    An interview  with Patrick Beattie, Redbird’s CEO, in Disrupt Africa, says his team could leverage existing, approved, under-utilised Rapid Diagnostic Test (RDT) technology to create convenient health monitoring points for routine health questions and, alleviating pressure on overburdened physician. Redbird secured funding from Gray Matters Capital an Atlanta-based impact investor. Redbird’s success with third place in the Ghanaian round of the DEMO Africa Innovation Tour seems to have helped its case.The solution develops a network of locations for primary care diagnoses and personal health monitoring to offer patients local access to healthcare at minimum disruption and cost. Existing national networks of pharmacies are part of the service. Redbird supplies them with verified RDTs, health monitoring software, and trained staff to interpret RDTs’ data.

    Having secured finance, Redbird’s plans to expand its pharmacy partnership from two to thirty in the next three months. The project’s scalable, and could become regional. Eventually, it could expand across all Africa’s health systems.

     CureAid pharmacy in Adenta advertising Redbird health monitoring services. Image from the Redbird website.

  • AI needs faster data access for researchers and analysts

    Maximising AI’s potential for clinical research and breakthroughs needs access to large data volumes to train then deploy AI models. A white paper by International Data Corporation (IDC), sponsored by: Pure Storage, says Hard Disk Drives (HDD) are too slow for the task. It says All-Flash Arrays (AFAs) are faster and more accurate. 

    An AFA’s a Solid State Disks (SSD) storage system with several flash memory drives. Instead of searching for data on spinning HDDs, SSDs have no moving parts, so are faster to access. The Tech Republic has an entry-level guide on AFAs. It says they’re disrupting traditional data storage resources. 

    IDC’s white paper emphasises AI as a learning process where researchers and analysts need prompt access to data for clinical projects. It has two main benefits:

    Shortens the clinical innovation time from desk to bedsideAttracting and retaining scarce clinical researchers and data scientists who look for leading-edge AI investment and infrastructure to succeed.

    Improved data response times with AFA benefits clinical teams that need access to clinical data for direct patient care too. Faster response times help to improve their productivity and efficiency. They also help to minimise eHealth frustrations and improve job satisfaction. 

    As eHealth foundations are vital parts of eHealth strategies, Africa’s health systems should consider SSDs along with expanding network capacity and connectivity capacity.  

  • Ada Lovelace’s 19th century computer book sold at auction

    The first female computer expert translated and expanded the Sketch of the Analytical Engine, published in 1843. She worked with Charles Babbage who invented the Analytical Engine, a mechanical calculator. It had four components that match modern computers. They were: 

    Mill, the calculating unit, the equivalent of the Central Processing Unit (CPU)Store, where data was held before processingReader, an input functionPrinter, an output function. 

    He unveiled his machine at a seminar at University of Turin in 1840. Italian military engineer and mathematician LF Menabrea, subsequently a prime minister, reported on the presentation. Babbage encouraged Lovelace to translate it into English. She added her own, substantial explanatory notes, which more than doubled the length of Menabrea's article and included an Analytic Engine’s algorithm.

    A report in the Antiques Trade Gazette say the book sold for auction in England for £95,000 (US$124,000). It’s one of seven known copies. It’s significant because she was the first person to recognise that the machine had applications beyond pure calculation, and published the first algorithm. She’s referred to as the Countess of Computing, reflecting her social standing and formal, title of Lady Lovelace, and the World’s First Computer Programmer, recognising her pioneering role in computer programming. When it was published, she was not credited as author. In 1848, she was, four years before her death, aged 36. 

    Her father was the poet Lord Byron. Her mother, Lady Byron, was educated in science and mathematics. It may be that inherited traits such as creativity and analysis combined in Ada Lovelace with a resultant impact on computer science and creation of the Ada Lovelace Institute.   

    How much will these abilities reflected in manuals of modern algorithms sell for in about 180 years from now? Presumably they’ll be in an eBook.

  • Villgro Kenya financing Uganda’s MamaOPe and clinicPesa

    East Africa’s startup ecosystem is growing. clinicPesa and MamaOpe, two innovative Ugandan enterprises, are set to take up capital from Villgro Kenya, an investment firm with its HG in India. The goals are to raise clinicPesa’s and MamaOpe’s  profiles, underpin the initial growth, and enhance the availability and accessibility of eHealth services in economically vulnerable areas.  

    clinicPesa’s support’s USD$40,000. MamaOpe’s USD$25,000

    An article in Wee Tracker says Villgro focuses on finance, mentoring and networking support for social enterprise startups. Its business model focuses on projects in agriculture, education, energy and health. Its partners are usually early-stage for-profit solutions for disadvantaged individuals and communities. The outfit’s recent extension into Kenya expands the reach of these broader.

    clinicPesa’s a digital micro-savings and loans platform. It provides users with convenient and affordable access to quality healthcare services by accessing their savings and loans for a range of registered health services providers. Many families slip further in to poverty after accidents or meeting unexpected medical emergencies. clinicPesa reduces out-of-pocket spending on medical bills, medicines or treatments so users to avoid excessive debt or property sales to cope.

    MamaOpe group’s a biomedical initiative. It aims to minimise pneumonia misdiagnoses and associated delayed treatments. These are primary reasons many deaths from the disease.   The MamaOpe team’s developed a biomedical smart jacket to help healthcare workers who are not doctors in low resource areas to gauge pneumonia’s primary symptoms and diagnose it accurately.

    Villgro’s been keen to add East African startups to its portfolio. Kenya’s Villgro Innovations Foundation offers a structured programme that includes finance, mentoring and connections to wider healthcare networks. These contribute to steps towards East Africa’s Universal Health Coverage (UHC). Will Villgro be offering these opportunities across all Africa soon?

    Watch this YouTube clip about clinicPesa.

  • Singapore health system hacked

    About 5.9m people live in Singapore. About 25% of their demographic and personal data has been stolen from SingHealth. A report in Channel News Asia says theft of 1.5m records by the cyber-attack was the “most serious breach of personal data.” Some 160,000 patients had their dispensed medicines’ records stolen too. 

    The Ministries of Health and Communications and Information revealed that Prime Minister Lee Hsien Loong’s records were “specifically and repeatedly” targeted. It included his outpatient dispensed medicines details. Several other ministers were also affected. 

    Data taken included names, National Registration Identity Card (NRIC) numbers, addresses, genders, dates of birth and racial origins. Hackers didn’t amend or delete records. Nor did they steal medical records, such as diagnoses, doctors’ notes and health scans

    Database administrators detected unusual activity on a SingHealth’s IT database on July 4. They immediately to stopped it.

    Cyber Security Agency of Singapore (CSA) and the Integrated Health Information System (IHIS) investigations found that the cyber-attack was “deliberate, targeted and well-planned.” They concluded that it was not the work of casual hackers or criminal gangs. They are not revealing more because of operational security reasons.

    Channel News Asia hints at a country’s behind it, with only a few that have the sophistication required. The motivation’s not known. 

    The incident’s another reminder for Africa’s health systems that cyber-security’s essential. Technical measures are not enough. SingHealth’s database managers’ rapid intervention shows that constant vigilance’s needed too. Without them, the breach could have affected more than 25% of the population.

  • Stethee reinvents the stethoscope with AI

    The worlds first Al enabled stethoscope system has been launched by M3DICINE Inc.

    The design itself is revolutionary and operates as easily as the traditional stethoscope. However, it allows users to listen to the lung and heart sounds with a more sophisticated amplification and filtering technology. Heart and respiratory sounds captured are sent via Bluetooth to the Stethee Android or iOS App which enables a wider range of diagnostic capabilities.

    The Stethee system comes in three core products:

    FDA cleared Stethee Pro for medical and healthcare professionalsStethee Vet for veterinarians and animal professionalsStethee Edu developed specifically as an education and research tool

    The technology platform behind the Stethee AI engine , named “Aida” can analyze the heart and lung sounds to build a unique personal biometric signature.  In addition to this, Aida automatically tags geo-location and environment data to each sample in real time.  This offers a completely new dimension of data analytics for public health planning by allowing one to understand what effects environmental factors such as pollution, temperature or humidity have on our heart and lungs.

    Aida also analyzes this encrypted and anonymised data in order to learn and report back quantitative clinically actionable data to vets, doctors and other healthcare professionals. Not only does it identify and analyze heart sounds and respiratory activity but also patterns that may indicate a disease condition. The data is represented in real time in the Stethee App, therefore making it easy to understand vital signs.

    The potential for the Stethee to be used in remote rural areas is quite vast because its relatively easy to use and results can be shared and analyzed promptly by a medical specialist anywhere in the world. This is invaluable to the improvement of patient care, more especially to remote rural areas where access to screening services or a cardiologist is very difficult.

  • Better eHealth can improve HIV monitoring and surveillance

    Ambitions to eliminate HIV are enthusiastically in place. Achieving them, such as the 90-90-90 goals can benefit from better eHealth. An article in the Journal of Medical Internet Research (JMIR) says questions remain about the sustainability of the programmes and the value of data initiatives. 

    Five principles identified in Sustainable Monitoring and Surveillance Systems to Improve HIV Programs: Review are:

    Better quality, local, granular, and disaggregated data to design and support a sustainable responses to ending the AIDS epidemicSupporting the health services cascade needs a cascade of linked dataUsing surveillance data is an intervention in itself, allowing programmes and communities to improve services’ responsesSurveillance needs systematic investment of at least 5 to 10% of programme budgets so that remaining resources address the epidemic and its impact can be assessedIncreased support for routine, integrated, district health data as part of health information systems, including sexually transmitted infections and hepatitis, linked to real-time health decisions.

    The study found that data’s been removed from healthcare settings and communities. It’s part of anonymous testing, national surveys, and modelling. It says that routine data’s part of implementation and an essential part of public health interventions,  packages of prevention and care. Without routine data availability, it’s difficult to achieve an effective public health or community responses. 

    This highlights the need for Africa’s health systems to review their HIV data components to test how they fit the service requirements identified by the study. It seems that some development or resetting may be needed.

  • Planning, stumbling blocks and learning: Argentina’s advancing health centre eHealth programme

    While considerable challenges remain, Argentina’s eHealth revolution’s gaining ground.

    A report in eHealth Reporter Latin America says it’s the view from the Argentine Association of Users of Information Technology and Telecommunications, (USAIRA) at its 8th Forum of IT Health Argentina  at the National Academy of Medicine in Buenos Aires 

    Dr Daniel Rizzato Lede, Director of Development of Healthcare Information Systems at the Ministry of Health, described how the Argentinian National Digital Health Strategy will promote connectivity between different health centres and develop a dialogue between information systems in provinces. It’s part of a digital strategy for Ministry of Universal Health Coverage (CUS) project that connects 14 provinces and a unique EMR for all patients, regardless of local government, medical institution or facility. 

    Defining national eHealth standards is planned before the end of 2019. It’ll enable implementation of a national eHealth infrastructure with scalable projects in provinces that operate within regulatory and legal frameworks. Before 2023, these services will be in all Argentinian provinces. 

    Guidelines for a strategy for a paper-free environment are underway at the Hospital de Alta Complejidad en Red “El Cruce”, Buenos Aires. Matías Said, functional analyst and project coordinator says it’ll be in place in the 180-bed hospital before 2022. 

    The In addition, , from Swiss Medical Group (SMG) has a long-term project for a unique health information system that integrates management of 30 health care units. It began in 2014. Daniel Castro said it involves 11,000 doctors and dentists, 1,500 nurses, 1,200 administrative employees, 300 telemarketers and 1,700 assistants.

    Gonzalo Rojo, a pediatrician, shared the step by step EMR implementation in the Hospital Britanico de Buenos Aires. The project started from scratch in August 2016. There are 80 project team members, and 200 direct collaborators. Doctors are on the hospital group leading the initiative. His crucial insight that’s a lesson for all eHealth project’s is that “Sometimes, we lose sight how easy it is for the doctor to use paper.” 

    Other contributors included the collaborations between RedHat and the Massachusetts Open Cloud (MOC). Its aim’s to increase processing imaging speeds and diagnostics precision. OMINT in Brazil, presented research into chatbots. They show that only 16% of 1,700 calls required the intervention by a human operator. Some 95% os users registered satisfactory responses.  Here come the robots.

  • England’s NHS tale of two technologies

    While some of England’s NHS is leading the way with AI, as previously reported in eHNA, other parts seem heavily reliant on FAX machines. This tale of two technologies, with apologies to Charles Dickens for modifying his book’s title, was revealed in a survey by the Royal College of Surgeons (RCS).

    The Independent, a newspaper, says the RCS finding’s that the NHS remains "stubbornly attached" to fax machines. It identified almost 9,000 FAX machines in about 75% of NHS trusts. Using this archaic technology for a significant proportion of their communications looks even more odd when at the other extreme, aspirations for AI are underway and being fulfilled.

    The BBC has highlighted that one NHS trust has 603 machines, over 6.5% of the total identified. Nest in line are 400 and 369 at England's biggest trust. Taken together, the three organisations have about 15% of the total. It’s a heavily skewed distribution.

    In its blog last year, Deep Mind had identified that the NHS was the world’s biggest buyer of FAX machines. The RCS findings are not a surprise. 

    Another dimension of the ICT legacy is that National Health Executive, a blog, highlighted that most NHS trusts had about 160 different computer systems. It seem that one end of the NHS’s two technology continuum’s a long way from the other, AI end. It reveals a legacy and investment challenge that all healthcare organisations face.

  • Wearable heart rate monitors don’t tick the box

    A cynical insight from Napoleon Bonaparte was “If you wish to be a success in the world, promise everything, deliver nothing.” I doesn’t fit wearable mHealth, where reliable results are everything.

    Research in the Journal of Medical Internet Research (JMIR) says some wearables have considerable promise, but have to do much better at delivery.

    It sees an important role for wearable sensor technology in clinical research and healthcare. Before it can, it must undergo rigorous evaluation prior to market launch and its performance should be supported by evidences. The researchers found that match between three heart rate monitoring devices and an electrocardiography (ECG) reference was weak.

    Many studies have tried to validate wrist-worn photoplethysmography (PPG) heart rate monitors, but contrasting results question their utility. A big problem’s inadequate methodologies.

    Validation strategies should consider the nature of data provided by both the investigational and reference devices. There must be uniformity in the statistical approach to the analyses too. Investigators should test the technology in user populations and in appropriate settings for the planned uses. Developers, suppliers and scientific communities need robust standards to validate new wearable sensor technology. 

    There’s a lot more to do before wearables can become mainstream clinical devices. The findings and recommendations should be considered be Africa’s health systems as they advance their mHealth strategies and plans.

  • AI in England’s NHS improves precision and saves time

    The UK’s NHS is 70 years old this year. It was born on 5 July 1948, so happy birthday Since then, it’s seen a continuous surge in new technologies and techniques leading to transformation. eHealth’s been an increasing component over the last 30 years or so. Now, AI’s coming into the investment frame.

    The Guardian has an article on AI at  Addenbooke’s Hospital, Cambridge. It’s used to delineate tumours. AI completes the work in minutes. Doctors use InnerEye from Microsof to mark-up scans prostate cancer patients. Images from completed scans are anonymised, encrypted and sent to InnerEye to create 3D models. It’s learnt to do by training with previous patients

    Brain tumours are next on the list. For some cancer patients, may have to review over 100 images doctors to plan their radiotherapy treatment. It’s obviously time-consuming, both for doctors, their colleagues and can defer the start of treatment for patients.

    The other significant AI benefit’s greater precision, so improved effectiveness. By focusing more precisely on cancer cells, it helps doctors providing radiotherapy treatments to avoid healthy tissues. 

    Both benefits, precision and time-saving, are leading to more streamlined, more effective and more efficient healthcare. These are some of eHealth’s main goals.

    The NHS has also Heart Flow, developed by Stanford University. It’s AI uses routine CT scans from patients with suspected heart disease AI to create personalised 3D models of their hearts and blood flow. It reveals how specific blockages disrupt blood flow in individual blood vessels, leading to better treatment decision, or none where appropriate. Over half the patients with HeartFlow data avoided angiograms. 

    London’s Royal Free Hospital has an AI development underway. It analyses and refines blood test results and to predict which patients are most likely to die, or have serious problems such as kidney failure. It’s trained from almost 1 billion blood test results from 20 hospitals, and identifies subtle changes in red and white blood cells and electrolytes such as sodium and potassium. It reveals which patients’ health may be deteriorating. 

    Other AI services include:

    Skin cancer diagnosesEye disorders from retinal scansHeart disease from echocardiogramsStrokes.

    The results are encouraging. Africa’s eHealth strategies and plans need a place for AI the data it needs.

  • Intermountain Healthcare integrates telehealth and mHealth in a connected care platform

    Information silos are huge obstacles to integrated healthcare. And integrated care is the kind most of us want for ourselves and for our loved ones. It's a key eHealth challenge.

    In a report in Research Information, research platform outfit Dimensions says they’re usually created unintentionally, and are a phenomenon to “escape” from.

    Intermountain Healthcare, based on Salt Lake City, US, seems to be free of these troubles. A report in mHealth Intelligence says it’s integrated 35 different telehealth and mHealth services into Connect Care Pro, a single connected care platform. Objectives are to improve care coordination and keep care in communities, both of which could be good for patients and health systems. It took five years to plan. 

    The services it supports include: 

    Virtual or tele-programmesTelestrokeTelehealth programmes for behavioural healthTelehealth programmes for newborn critical careTelepharmacy serviceseHealth services using connected health devices.

    The legacy was a history of launches of several telehealth and mHealth programs and pilots that didn’t integrate easily. Intermountain sees their integration initiative as the next telehealth phase.

    The initiative has valuable lessons for our African countries' mHealth and telehealth programmes. It makes sense to start constructing equivalent platforms without delay. It’ll be easier and cheaper than waiting until more silos need integrating. Even more important, it’ll bring extra patient and healthcare benefits, sooner, for our patients, our families and ourselves. 

  • What does eHealth have to do for radiology services?

    Radiologists are in short supply.  Radiology workloads and demand are rising. A report from Digital Health explores the opportunities to use AI and Radiology Information Systems (RIS) in the UK’s NHS to fill the gap. It identifies essential requirements for national eHealth too.

    Two solutions are proposed, both needing RIS: 

    Sharing reporting workloads across healthcare organisations

    Using AI to automate some of the clinical workload.

    Current images and workflow sharing relies on  an Image Exchange Portal run by Sectra. It’s fast, but seems it needs replacing to meet radiologists’ needs of: 

    Knowing when an image is there for reviewA single system that displays their own images and other clinicians’ images for individual patientsAccess to each patient’s reporting history and images needed for full and useful reports.

    This needs a specific organisational structure, a lesson for Africa’s health systems. In the days before England’s National Programme for IT (NPfIT) was abandoned, radiology information could be shared across each of England’s five NPfIT regions.

    Since then, smaller geographic consortia have emerged to procure Picture Archiving and Communications Systems (PACS) and RIS from single vendors. It achieves lower costs, smoother, more efficient workflows and makes their sharing easier. Patients, radiologists and organisations outside these consortia don’t benefit.

    Vendor-neutral standards are the solution. Two, Soliton and Wellbeing Software, provide solutions share radiology reporting across several sites with different RIS vendors. Their impacts are constrained because there isn’t a single or unified procurement organisation.

    Is RIS becoming obsolete? EPRs and PACS may be able to deal with scheduling and remote reporting. Some radiologists see it differently. They may be increasingly dependent on RIS.

    AI may be a solution too. It’s already dealing with some basic reporting. Wellbeing has a platform for  an AI algorithm to report directly into its RIS. 

    Agfa uses the term Augmented Imaging (AI). It’s exploring the potential for its AI to automate some administrative tasks. Algorithms are already available to detect TB on chest X-rays. Partnering’s already in place with hospitals and research institutes that need Agfa’s workflow engine to develop their own algorithms. 

    Lessons for Africa’s eHealth are clear. Radiology needs its own eHealth engagement, strategy, plans and procurement.

  • There’s a comprehensive cyber-security manual from KnowBe4

    Cyber-security firms regularly release short cyber-security white papers dealing with a single theme. Now, there’s an updated, big-scale, 221-page manual, and it’s free.

    Cyberheist 2018 fromKnowBe4 extends across cyber-security’s wide range. Written by Stu Sjouwerman, Sunbelt Software co-founder and anti-spyware specialist, and a supporting team, Cyberheist’s 19 chapters provides Africa’s eHealth programmes with a comprehensive view of their cyber-security requirements. While there’s an emphasis on commercial and business activities, such as banking, retailer and ePayment scams, cyber-security principles in these chapters are relevant for eHealth. 

    Cyberheist deals with:

    What drives cybercrime?How and why scams survive, thrive, and succeedTypes and methods of attacksPhishing explored and explained Phishing variations: smishing and vishingTargeted scams, including spear phishing, whalingUnderstanding cyber-crime losses and exposureScary cyber-crime reports and statisticsBank scamsCredit card and ePayment scamsMortgage rescue scamsAutomated clearing house scamsRetailer scamsSocial networking scams Safe computing fundamentalsSyncing security policies, user training and monitoringSecurity technology to protect people and assetsManaging online banking securityFostering cyber-security awareness. 

    It has two main goals. One is to help organisations recognise the increasing danger that they, and individuals, face when they use the Internet. The other’s to enable organisations to take proactive measures to protect them from cyber-threats. After reading Cyberheist, strategies and techniques are needed for protection. These should be core to Africa’s eHealth strategies.