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  • What GDPR means for African countries

    If you struggled to access your favourite news site this morning, due to pop-ups insisting that you refresh your privacy settings, you are not alone. And the site is invariably based in the European Union (EU), or doing business with individuals in the EU.

    Today is GDPR Day. The General Data Protection Regulation (GDPR) is a regulation created in EU law to protect the privacy of individuals’ data. It applies to data of all individuals in the EU, whether that data is used within the EU, or anywhere else in the world. It comes into force today, May 25 2018.

    GDPR brings in sweeping changes to how businesses and public sector organisations can handle information. Under the new rules, permission is required before any personal data can be used and how long it is kept is now closely controlled. Anyone can ask a company to delete their personal information too. Read the statement from the European Commission and its links to resources.

    “Personal data is the gold of the 21st century. And we leave our data basically at every step we take, especially in the digital world. When it comes to personal data today, people are naked in an aquarium" said Vera Jourová, Commissioner for Justice, Consumers and Gender Equality.

    The GDPR sets out key principles:

    Lawfulness, fairness and transparencyPurpose limitationData minimisationAccuracyStorage limitationIntegrity and confidentiality (security)Accountability

    The accountability principle requires those who use data to take responsibility for complying with the principles, and to have appropriate processes and records in place to demonstrate that compliance, including appropriate technical and organisational measures to ensure accountability. Regular testing and reviews are required to make certain that the measures remain effective, or to guide remedial action id required.

    These principles form the building blocks of the legislation. Compliance with the spirit of the principles is regarded as critical for good data protection practice. Even though the principles to don’t include fixed rules, penalties for ignoring them are substantial. Failure to comply with the basic principles are subject to fines of up to €20 million, or 4% of total worldwide annual turnover, whichever is higher.

    Individuals have:The right to be informedThe right of accessThe right to rectificationThe right to erasureThe right to restrict processingThe right to data portabilityThe right to objectRights in relation to automated decision making and profiling.

    The GDPR introduces a duty on all organisations to report certain types of personal data breach within 72 hours of becoming aware of the breach, and if the breach is likely to result in a high risk of adversely affecting individuals’ rights and freedoms, companies must also inform those individuals without undue delay. This requires that robust breach detection, investigation and internal reporting procedures are place to facilitate detection and decision-making.

    Close Circuit Television (CCTV) falls under the GDPR too.

    The UK Information Commissioners Office has extensive guidance. Many companies, such as IBM and Oracle, offer guidance too.

    While the GDPR does not apply to African countries directly, many African businesses will already be affected, due to their business relationships with the EU or its people. Whether you're affected yet or not, GDPR provides a best-practice model for incorporating into business practices and regulatory strengthening.

    African countries' regulatory strengthening is well underway. South Africa's Protection of Personal Information "POPI" Act is one example and provides many components of the GDPR.

    First steps towards compliance could be to:

    Brush up your cyber-security policy, andImplement a privacy management framework to help embed accountability measures and create a culture of privacy across your organisation.

    The commissions’ seven steps for businesses provide pointers too. They are:Check the personal data you review and process, the purpose for which you do it, and on what legal basisInform your customers, employees and other individuals when you collect their personal dataKeep the personal data for only as long as necessarySecure the personal data you are processingKeep documentation on your data processing activitiesMake sure your sub-contractors follow the same rulesConsider additional provisions, such as :Organisations might have to appoint a Data Protection Officer, particularly if processing of personal data is a core part of your businessData Protection Impact Assessment Such an impact assessment is reserved for those that pose more risk to personal data, for instance they do a large-scale monitoring of a publicly accessible area, including video-surveillance.

    In the meantime, dealing with your privacy preference update requests will ensure that data protection remains in the forefront of your mind, at least for today. Happy GDPR Day.

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    Image from this tweet by @EU_Commission

  • eHealth for SDG promoted at East African Ministerial Conference

    Kigali, Rwanda has been a magnanimous host to eHealth events, this Autumn. Following on from last week’s EAC Regional eHealth and Telemedicine Workshop, the 2nd EAC Regional eHealth and Telemedicine Ministerial Conference was Thursday 17 April. The Ministerial Conference considered the report and recommendations of the workshop, under the theme “harnessing science, technology and innovation to transform healthcare delivery  and accelerate the attainment of sustainable development goals in East Africa". It’s yet another high level African meeting exploring the role of eHealth in helping us to achieve universal health coverage, hosted by the East African Science and Technology Commission (EASTECO).

    “Discuss how technology can be used to enhance healthcare delivery” was a challenge posed by Rt Hon Dr Ali H Kirunda Kivejinja, Chairperson of the EAC Council of Ministers, to conference delegates, in his opening remarks. He emphasised the importance of cooperation to secure the technologies’ “ultimate goal of improving standards of living and increasing life expectancy of East Africans”.

    Clear directives were provided on the way forward. The Ministerial Conference: The 2nd EAC Regional e-Health and Telemedicine Ministerial Conference:

    "Urged the EAC Partner States that do not have a National e-Health Strategy develop it in line with the WHO - ITU National e-Health Strategy Toolkit [to develop one] by 2020;Directed EASTECO to conduct an EAC regional e-Health readiness assessment incorporating aspects of systems interoperability, costs and benefits of investing in e-Health by 30th December 2019 in collaboration with the EAC Secretariat, East African Health Research Commission, Partner States’ National Science and Technology Commissions/Councils and Partners;Directed EASTECO to promote incubation of local digital health solutions in collaboration with the EAC Secretariat and the Partner States’ Ministries and Agencies responsible for ICT, Science, Technology and Innovation and submit progress reports to relevant Sectoral Councils and the Council of Ministers every two years;Urged the Sectoral Council on Health to coordinate the development of regional policies, laws, regulations, guidelines, standards, on health facility/patient safety, data sharing, data security and privacy to facilitate e-health enabled in country and cross border patient referrals within the EAC Partner States by 30th June 2020 directed the EAC Regional Centre of Excellence for Biomedical Engineering and eHealth to conduct a study in the application of eLearning systems for training Health Professional in the Region and IUCEA to develop a regional framework to enhance regional and south-south collaboration in capacity building for e-Health by Jan 2020;Directed EASTECO to take leadership in convening the EAC regional e-health and telemedicine workshops, ministerial conferences and international exhibitions every two years on a rotational basis among the Partner States in last week of October as part of the meetings of the EAC Sectoral Council of Ministers responsible for Health in collaboration with the EAC Secretariat, the EAHRC and the EAC Regional Center for Excellence for Biomedical Engineering and e-Health; andApproved hosting of the 3rd EAC regional e-health and telemedicine workshops, ministerial conferences and international exhibitions by the Republic of Uganda from 28th to 30th October 2020 as approved by the 16th Ordinary Meeting of the EAC Sectoral Council of Ministers of Health."

    Collaboration and cooperation for eHealth for impact is a growing theme in African regional communities. Congratulations to the organising team and it’s tireless leader, Ms Gertrude Ngabirano Executive Secretary, EASTECO. It is a timely theme for eHealth to realise its potential and its critical role I supporting UHC.

    Photo – Ministerial Panel Picture, from left to right: Dr. Rashid Aman, Chief Administrative Secretary in the Ministry of Health, Republic of Kenya; Hon. Ken. Obura, Chief Administrative Secretary, Ministry of East African Community and Norther Corridor Development, Republic of Kenya; Rt. Hon. Dr. Ali H. Kirunda Kivejinja, Second Deputy Prime Minister and Minister for EAC Affairs, Republic of Uganda and Chairperson of EAC Council of Ministers; Hon. Sarah Achieng Opendi, State Minister for Health - General Duties, Republic of Uganda;  Dr. Patrick Ndimubanzi, Minister of State in the Ministry of Health in charge of Public Health and Primary Health Care, Republic of Rwanda; Mr. Toritoi Ngosayon Bunto, Ag. High Commissioner of the United Republic of Tanzania in Rwanda; representing Hon. Dr. Ummy Ally Mwalimu, Minister of Health, Community Development, Gender, Seniors and Children in URT.

    Photo - Ms. Gertrude Ngabirano, Executive Secretary of EASTECO

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    Cover photo – Rt. Hon. Dr. Ali H. Kirunda Kivejinja, Second Second Deputy Prime Minister and Minister for EAC Affairs, Republic of Uganda and Chairperson of EAC Council of Ministers giving remarks

  • Is AI set to take off in a London hospital?

    As marches go, AI in healthcare’s still in its early stages. It may be that it’s about to make a big leap forward. The UK’s Guardian newspaper  reports that University College London Hospitals (UCLH) and the Alan Turing Institute has agreed a three-year partnership to realise AI’s benefits to healthcare on an “unprecedented scale.” Planned projects include using AI to: 

    Improve UCLH’s A&E department’s performance, currently below 77% of patients needed urgent care treated within four hours, well below the standard set for England and stuck at 2010 levelsAnalyse CT scans of 25,000 former smokers recruited as part of a research projectAutomate cervical smear tests assessments. 

    A challenge is avoiding learned helplessness. It’s where health professionals become too reliant on automated instructions and abandon common sense. AI’s algorithms might be correct 99.999% times, but are rarely 100% reliable.

    Another’s sustaining rigorous data governance standards, especially privacy and confidentiality. The plan’s to apply algorithms to UCLH’s servers to avoid breaches. Private companies won’t have access. 

    A previous AI project in Engalnd’s NHS was a collaboration between London’s Royal Free Hospital and Google’s DeepMind. The Royal Free accidently gave Google access to 1.6 million records of identifiable patients.

    Alan Turing was an English computer scientist, mathematician, logician, cryptanalyst. He was highly influential in developing theoretical computer science, formalising concepts of algorithm and computation using the Turing machine. In the 1940s at Bletchley Park, he was instrumental in developing the Bombe machine to crack enemy’s complex and rapidly changing Enigma code.

     

  • US EHR solution judged not up to the job

    eHealth has risks. A report from the US Office of the Secretary of Defense, and available from EHR intelligence, highlights some of these. They provide valuable themes for Africa’s health systems to use in their EHR assessments and procurements. Is says “a partial  IOT&E [Initial Operational Test and Evaluation] was adequate to determine that MHS GENESIS was neither operationally effective nor operationally suitable.” It raises an important challenge: how could this have been established before procurement? 

    Inappropriate performance included: 

    MHS GENESIS is neither operationally effective nor operationally suitable. DOT&E recommends that the Under Secretary of Defense for Acquisition and Sustainment delay further fielding until JITC completes the IOT&E and the PMO corrects any outstanding deficiencies. Detailed recommendations are included in the main body of this report;

    It doesn’t demonstrate enough workable functionality to manage and document patient care in 56% of the 197 tasksof performance Poorly defined user roles and workflows increased the time needed for health care providers to complete daily tasks, including overtime and seeing fewer patients a dayUsers questioned information accuracy in exchanges between external systems and MHS GenesisPoor usability of 37%, on the System Usability Scale (SUS), well below the 70% thresholdInsufficient trainingInadequate help desk supportSystem unplanned downtime outages indicated that the end-to-end system and supporting network didn’t have sufficient availability to support operations at the four IOT&E locationsUsers reported increased lag times when other IOT&E sites went live, suggesting the supporting network configuration wouldn’t support the hundreds of additional planned sitesSurvivability is undetermined because cybersecurity testing isn’t complete. 

    This salutary experience shows the importance of rigorous assessment processes before procurement. Across the global eHealth community, it’s not the first time, and it’s not likely to be last. Africa’s health systems can afford this type of risk exposure experience. 

  • Robot Tug to help aid nurses in hospitals

    The field of robotics is making great leaps in health care today.  Take for example, Tug, the robot nurse. The aim of this robot is to improve patient care in hospitals by doing the mundane tasks like hauling food, linens, specimens and medications around the facility. This enables the healthcare workers to focus on other relevant duties and patient care.

    Appearance wise, Tug does not look like a typical humanoid robot. Instead, it looks like an oven that has wheels.  Staff begin the day by uploading activities that they would like Tug to do and then it wheels itself around the hospital performing those duties. It is programmed in such a way that employees can change the order of the tasks based on urgency.

    Tug navigates a facility using dozens of lasers therefore it is able to make quick decisions such as stopping when a person is in the way. It can carry up to a 1000 pounds on its back which can also be swapped with different models to meet other needs besides medical deliveries and food.

    This is a great use case for the overburdened, understaffed hospitals in Africa – a robot to aid nurses and health workers with their daily activities.  Will we being seeing Tug in African hospitals soon?

  • Blockchain for beginners is still needed

    Blockchain is a hot topic everywhere, including in healthcare. I have been writing about it for eHNA, exploring use cases and applications. I've had lots of positive feedback, yet a question remains for many: how does blockchain technology actually work? Today's piece introduces some basic concepts. 

    Firstly, bitcoin and blockchain are not the same thing. Bitcoin is a digital currency or cryptocurrency that is administered on blockchain technology.  It combines many existing concepts, including large databases, voluntary participation, peer-to-peer networks, distributed ledgers, and cryptography, to protect users' information against fraud.

    There are three levels of how blockchain technology is currently being used:

    Storage of digital recordsExchange of digital assets in the form of tokens, and Execution of smart contracts.

    Smart contracts set the ground rules for how transactions take place. They execute the contracts while monitoring compliance and automatically validate the results of each transaction.

    To work, blockchain relies on consensus. This gives rise to the concept of mining. Each new block added to a given blockchain follows a consensus model which is approved by the network of connected nodes.  The level of agreement in consensus models may vary across blockchain networks.

    Encryption of information on a blockchain is achieved by hash functions. These map data of arbitrary size to data of a fixed size through a cryptographic method or algorithm. Hash function outputs are unique, asymmetric and random, ensuring security on the blockchain.

    That's probably not enough information to get you started on mining your own blockchain, but hopefully sufficient to tweak your curiosity about this elegant technology.  I'll post more over the next few weeks.

  • How can online health information avoid negative results?

    Type “health information” into your favourite search tool.  Then, prepare to scroll through over 2.6 million results. The negative effect of these sources on users hasn’t been examined.  A study led by Reem El Sherif at the Department of Family Medicine at McGill University in Montreal, and published in the Journal of Medical Internet Research (JMIR), aims to deal with it.

    Two goals are:

    Describe negative outcomes in primary careIdentify potential preventive strategies from users, health practitioners and health librarians.

    It found three types of interdependent negative outcomes:

    Internal, such as increased worryingInterpersonal, such as a tension in patient-clinician relationshipsService-related, such as postponing clinical encounters.

    The study links them as:

    Three types of strategies were identified that aim to reduce these negative outcomes. They were:

    Providing users with reliable informationEducating users on how to assess websites that provide health informationHelping users to present and discuss their online information with health professionals, their social networks or librarians.

    These are integrated too:

    Librarians have a core role in minimising negative outcomes. Responsible for providing reliable health information and advocating the advantages of using health websites, they’re well positioned to implement the preventive strategies. Their work with users and health practitioners can integrate them with users’ health information–seeking and ensure the reliability of the information they find and use. Improving health literacy can lead to fewer internal tensions. Librarians can also develop discussions with health practitioners, leading to fewer interpersonal tensions. Their third contribution’s helping users to find relevant information so they can make better health and health care decisions, leading to fewer service-related tensions.

    While this might seem a bit obvious, the researchers identified two barriers that needed overcoming. One’s a lack of awareness of available health librarian services. The other’s a lack of access to health librarians by the public. A possible solution is to train community librarians working in public facilities, such as libraries, on how to provide health information services.

    Africa’s health systems should consider these additional costs of online health information. Without these resources, their investments in online health information may not realise the benefits requires of them, so an inadequate return.

  • African Alliance of Digital Health Networks to rally support for African countries

    “We want to go far” said Olasupo Oyedepo, Tuesday, announcing the launch of the African Alliance of Digital Health Networks on LinkedIn. Olasupo is Project Director at ICT4HEALTH Project and Director of the new Alliance. He is a bold man with a bold vision of renewal, to:

    Connect the eHealth and digital health networks emerging in AfricaExpand the platform of support for African countries and their eHealth initiatives.

    The launch was at the Transform Africa Summit in Kigali, Rwanda on 8 May 2018. The Alliance was first conceptualised at the 2016 Global Digital Health Forum that took place in Maryland, USA. A key aim's to ensure that African countries have the support and resources needed to develop strong eHealth “helping to grow a cadre of digital health leaders and entrepreneurs in Africa”. Its programmes will focus on digital health leadership, entrepreneurship, mentorship and peer learning. The leadership and capacity development emphasis is well matched with Acfee's priorities.

    Our African countries’ eHealth expertise and initiatives are growing fast, and beginning to contribute to health systems strengthening. Growth will continue and the additional resources and support that initiatives such as the Alliance may bring will accelerate these efforts. Acfee congratulates Olasupo and the new Alliance and looks forward to learning soon about its programmes and how collaboration plans to make a rapid and significant impact on Africa's eHealth, so the Alliance can go far and fast.

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    Photo from launch, left to right:

    Gaelle GisubizoDykki Settle – PATHCaren Althauser – PATHHuguette Diakabana – Deputy Director, African AllianceOlasupo Oyedepo – Director, African AllianceBen Aliwa – PATH

  • HearX Group makes hearing screening more accessible

    In 2015, eHNA reported on a South African start-up, HearX Group, founded by Prof De Wet Swanepoel and Dr Herman Myburgh.  They developed a low-cost smartphone app that detects hearing loss and connects patients to health services.  

    The product uses a smartphone and headphones along with a custom-developed software application to detect hearing loss.  This inexpensive alternative to conventional screening is 50-70% less expensive and can be administered by non-specialists and screeners with even basic literacy and low digital skills.

    Today, the company boasts a suite of apps and mHealth devices geared towards improving hearing screening in underserved and remote communities, and especially among children.  Other products included in their collection include hearZA, mHealthStudio, hearTest and hearDigits, as well as a partner product in vision called Peek Acuity.  

    Now, HearX group has taken their solution beyond Africa.  A recent collaboration with the American Academy of Audiology saw the launch of America’s first-ever intensive hearing screening mobile app, hearScreen USA.  This was launched at the Academy’s annual conference April 2018 and is freely available on smartphone devices.

    In many nations, the general awareness of hearing impairment is low and shortage of resources has caused a lack of screening programmes.  HearX Group could soon be turning this into a problem of the past with further collaborations in Africa, Europe and Asia.

  • ATM pharmacy will help SA achieve 90-90-90 goals

    Over 7.1 million people in South Africa (SA) are living with HIV.  This is the largest epidemic of HIV in the world.  The country has the world’s largest ART programme, which helps towards achieving 90-90-90 targets.

    Also helping to achieve targets is an innovative Pharmacy Dispensing Unit (PDU), developed by Right To Care in collaboration with Gauteng Department of Health.  The PDU works like an ATM for medication; tele-pharmacists, cloud based electronic software and robotic technology combine to enable medication dispensing.

    This pioneering solution allows patients to quickly and conveniently collect their repeat prescriptions at various community shopping centres where it is being piloted.  It’s even online over weekends and public holidays so that patients can collect medications at their convenience.  Patients are also offered service in all eleven languages and there is a support site to help understand the technology for first time users. 

    The PDU system which is run by qualified pharmacists and pharmacy assistants integrates with the clinical management of patients with chronic conditions at public facilities. It also supports adherence.  Medication receipts indicate the date for the next collection and patients even receive collection reminders by SMS.  If a patient collects their medication late, they are flagged for follow-up at the facility. 

    This ATM-like approach to dispensing medication demonstrates innovative thinking to overcome challenges in ensuring people stay on HIV treatment or treatment for other chronic illnesses.

  • New Commonwealth Digital Health Centre emphasises eHealth’s coming of age

    When we founded Acfee, late 2013, there were few centres focusing on eHealth or digital health. eHealth’s opportunities, and risks, were poorly recognised and a lot of our time was spent talking with health’s academics and government leaders about what it means. This led to Acfee setting its focus for the last five years on stimulating the industry; developing eHealth leadership and capacity and creating a more fertile environment to help the fledgling initiatives mushrooming across African countries to succeed.

    Now that the industry is growing, regional centres are just as important, and the role or organisations like Acfee is switching from clarifying the opportunity to providing tools that the growing eHealth network will use to deliver health benefits for our people. There is lots of work to be done and more Centres are appearing to help make progress.

    Acfee welcomes the Commonwealth Centre for Digital Health, launched in London on 20 April 2018 at a side event to the Commonwealth Heads of Government Meeting 2018. The theme of the event was ‘Global Health Security & the Digital Health Society 2030 - Innovation & Investment for One Planetary Health & Universal Health Coverage’. It’s a fitting focus for the new Centre's digital health efforts too.

    Acfee commends the leadership provided by Prof Vajira Dissanayake, Commonwealth Medical Association President, and his colleagues. We look forward to collaborating with the Centre to jointly support realising digital health’s enormous potential to transform our health systems.

    Watch this Video Message from WHO

    WHO’s Director General, His Excellency Dr Tedros Adhanom Ghebreyesus, welcomed the establishment of the centre and “its focus on fostering innovative technologies for health that are appropriate for low income countries”. He reiterated WHO’s support for efforts to harness digital technologies for a healthier, safer and fairer world.

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    The picture was provided by the Commonwealth Medical Association. It shows from left to right:

    Denis Gilhooly, Executive Director, Global Health 2030 Innovation TaskforceProf Vajira Dissanayake, President, Commonwealth Medical AssociationDr Pascale A. Allotey, Director, International Institute for Global Health, United Nations University (UNU), MalaysiaHis Excellency Maithripala Sirisena, President of Sri LankaProfessor Dame Sally Davis, Chief Medical Officer (CMO) for England, Chief Medical Advisor to the UK Government, Co-Convener, United Nations Interagency Coordination Group on Antimicrobial Resistance (AMR)Right Honorauble Christopher Fearne, Deputy Prime Minister and Health Minister, Malta

  • GIS software helps optimise health efforts

    Graphic information systems (GIS) software could change the way countries tackle public healthcare issues. GIS helps capture, store, combine, analyse and display aggregated data from censuses and national health information systems and then overlays this data onto regional maps.  This visual representation of data then allows departments of health and ministries to better manage resources and plan accordingly. 

    A great advantage of using GIS technology in healthcare application is the spatial dependency of health related factors.  Several countries and organisations have already started to invest in GIS programmes.  In the United States, the Centre for Disease Control (CDC) launched its 500 Cities Project, which aims to provide geographic data on the distribution of chronic disease risk factors.  In South Africa, the South African National Aids Council (SANAC) launched the Focus for Impact Project, which aims to identify populations most at risk in areas most severely affected by HIV and TB. 

    The hope is that by better visualising and understanding the geographic distribution of health variables, health departments and planners will be able to plan public health interventions more effectively.  GIS software helps with this by answering 2 key questions; 

    Where are the high burden areas? – by overlaying routine health data on geographical regionsWhy is it a high burden area? – by profiling epidemiology and associated risks using secondary data and community dialogue 

    This in turn allows health departments and health planners to identify; 

    Who is at risk in this high burden area?What interventions can help reduce this burden? 

    To improve the overall health of our communities, access to these kinds of services is vital.  Further investment into GIS programmes could reveal other beneficial use cases for the healthcare industry, improve overall efficiency and better manage the cost burden of the healthcare system.

  • Malawi uses eCCM app to combat child mortality

    In Malawi, Health Surveillance Assistant’s (HSA’s) serve as a link between the the local community and the national healthcare system.  They make use of the WHO and UNICEF community case management (CCM) clinical decision tool to identify those requiring urgent referral to hospitals and those who can be treated at the local points-of-care before going back home.  The Supporting LIFE project has created an mhealth app that replicates this CCM tool to ease decision-making and workload for HSA’s.  

    The app supports a similar workflow to the paper-based CCM tool, allowing the HSA to enter patient information on an easy to use touch-screen interface.  It’s developed for the Android platform and is functional in an offline environment, making it ideal for countries like Malawi, where internet connectivity is a problem.  Power was also an issue during the Malawi pilot, so HSA’s were also provided with mini solar powered chargers for their devices. 

    During the pilot 3 indicators were measured to assess the potential impact of the app;

    Improvement in the number of children correctly referred to a health facility as a result of using the app.Increased attendance rates, as a result of correct referrals made by HAS’s using the app; andDecreased re-consultation rates through correct diagnosis and referral from the app

    The results of the pilot were presented at an mHealth strategy workshop and provided the health ministry and key policy makers with valuable data to improve the health systems in Malawi.  HSA’s using the app reported mostly positive responses.  

    While such projects offer great community benefits and health system improvements, further assessment is needed around the feasibility of scaling nationally, as well as integration with core systems like the DHIS2.

  • Low-cost video laryngoscope developed in South Africa

    “Innovation is change that unlocks new value” - Jamie Notter. This is what Cape Town Anaesthesiologist, Dr Caroline Corbett, is doing with her video laryngoscope invention.  SmartBlade, is a cost effective, novel and real-world solution to the management of a difficult airway. 

    It uses forward-thinking smartphone technology to link with video laryngoscopy, thus allowing clinicians to easily intubate difficult airways. The clinician can suction a soiled airway or perform apnoeic oxygenation, both without interrupting attempts to intubate. 

    The customised mobile application also facilitates video conferencing, image capture, recording and secure data storage.  SmartBlade aims to become a standard of care in advanced airway management. 

    This novel device won the WFSA-Fresenius Kabi Anaesthesia Innovation Award in 2017.  The South African Society of Anaesthesiologists (SASA) is proud of this accolade and looks forward to seeing it being used in South African hospitals in the future.

  • Zambia hosts ICT4D 10th annual conference

     Innovate. Connect. Transform. This is what executives, senior managers, program leaders, field officers, IT/data managers, and senior technical advisors will be doing in Lusaka, Zambia from the 8th-10th of May. 

    This year’s ICT4D’s conference will gather these cadres to discuss and debate solutions and answers to questions such as how and where ICT innovation helps sectors in aid and development achieve goals and accelerate their objectives. 

    Their exciting programme, with 6 parallel tracks including Agriculture, Health, Livelihoods & Education, Humanitarian Response, Digital Financial Inclusion, and Collaboration & Openness in ICT4D, is now available on the site.  Post conference activities offer participants interactive sessions to understand how to get more out of ICT4D tools such as CommCare or DHIS 2. 

    This is a great opportunity for Africa’s health care innovators to share their innovations, but more importantly learn from other industries to approach health care challenges more innovatively.  To secure your place, register via the conference website.

  • Bio-artificial kidney to become an alternate solution for renal dialysis

    Being on dialysis may give a patient with renal failure a chance to live a longer life. However, there are frequent inherent risks associated with it. The kidney project seeks to address this in an innovative way.

    According to the national kidney foundation, over 100 000 patients are currently waiting for a donor kidney and over 3000 are added to the list yearly. An average patient may spend 3-4 years waiting for a transplant and may be on dialysis whilst they wait. However, studies have found that only one in three patients may survive the 3-4 years without receiving the transplant.

    The kidney project’s goal is to implant a bio-artificial kidney to give hope beyond the short term solution of dialysis.  It can do this by simulating the removal of waste products, salt and water as a normal kidney would. Nanotechnology microchips are the key behind the the artificial kidney.

    While transplanted organs need to be thoroughly screened to prevent tissue rejection, the artificial solution bypasses such complications. The foundation hopes to begin human trials with the implanted kidney in 2018.

  • GE sells its healthcare Value-Based Care Division to Veritas for >$1b

    In a shake-up to the health ICT supply side, an announcement by GE says it’s selling its:

    Enterprise Financial Management, Revenue-Cycle, Centricity BusinessAmbulatory Care Management, Centricity Practice SolutionWorkforce Management, formerly API Healthcare.

    The buyer, Veritas Capital takes it on for $1.05b in a cash-will-do-nicely deal. It’s Veritas Capital is a leading, global private equity firm that invests in companies that provide essential products and services. Technology and technology-enabled solutions are its main service range. Governments and commercial organisations are its main customers.

    They extend across aerospace, defence, healthcare, national security, communications, energy, education and government services. It’s Veritas business model seeks to create value by strategically transforming companies that it invests in.

    GE says Veritas is ideal to provide the focus and investment needed to take GE’s former services to the next level of scale and performance. The former GE team  sees the switch as an opportunity to revitalise its product portfolio and pursue complementary acquisitions. The intended result’s better for patients, providers and payers services

    These big outfits seldom see Africa’s health systems as fruitful markets. Affordability’s a constraint. Will Veritas take a different view?

  • AI is also attractive for cyber-criminals

    As healthcare increases investment on eHealth projects and services, there should be synchronous investment in security measures.  In 2017, 25% of all data breaches were related to the healthcare industry.  This is because cyber-criminals have been working to make their attacks more advanced to easily target connected devices, cloud, and multi-cloud environments.  These advanced cyber-attacks are even able to evade detection by most legacy security solutions in place. 

    Advancements are aided by adopting AI and machine learning to carry out complex attacks at a rapid pace. Botnets such as Reaper have been made more sophisticated, enabling them to target multiple vulnerabilities at once.  Others, such as polymorphic malware allows for hundreds of variations of a threat to be created for different purposes in a matter of hours. 

    To address these challenges, Fortinet has recently released a few product enhancements that will tip the scales back in the favour of the healthcare industry;

    Fort iOS 6.0 – provides an integrated security architecture that spans the distributed networkFortiGuard AI – is an AI solution that is able to address automated attacksThreat Intelligence Services (TIS) - provides visibility into network activity and metrics to give healthcare security teams an understanding of their threat landscape 

    It has become inexpensive for criminals to mount attacks on healthcare data, but increasingly expensive for their targets. One key to the healthcare security transformation is flipping this paradigm.

  • Computer aided detection for TB (CAD4TB) installed across Ghana

    A target of sustainable development goals (SDGs) is to end tuberculosis (TB) globally by 2030.  Effective prevention, detection and treatment is necessary to achieve this goal.  Ghana is in the global high burden list for TB, but is tackling this burden using eHealth innovations. 

    In collaboration with Delft Imaging Systems, they have successfully installed 51 X-ray systems in facilities, containers and TB screening mobile clinics across the country.  These mobile X-ray systems are self sustainable, employing solar technology to power them, even in the remotest of locations.  All X-ray systems have been equipped with computer aided detection (CAD4TB) software that makes use of machine learning to detect TB in X-rays.  Additionally, tele-radiology technology is used to interlink all images to a central platform that allows healthcare providers across connected facilities and units to access images.

    The innovation allows healthcare providers to screen up to 200 images per day.  When the images reveal a high CAD4TB score, patients are referred for the standard and more expensive GeneExpert tests.  This makes detecting TB in poorer communities very effective. 

    It is eHealth innovations like this that will strengthen health systems in Ghana and other African countries, while still being conservative of the constrained health budgets in Africa.

  • Future health data systems need more of these

    On March 14th I spoke at the ANOVA data summit in Johannesburg. I was asked to talk about the future of health data and its systems. Earlier that morning Stephen Hawking had passed away leaving the scientific community weighing the enormity of one man’s extraordinary contribution. Some of his famous words repeated in my mind, including his terse challenge, “The greatest enemy of knowledge is not ignorance, it is the illusion of knowledge”, an apt warning for those of us in the information space.

    As health systems decisions become more data driven, demands for enough, quality data, and ways to make sense of it, increase too. Expectations are high.

    “It has become increasingly clear that Universal Health Coverage cannot be achieved without the support of eHealth” WHO suggested in the third global survey on eHealth and AMIA proposes that “access to broadband is, or soon will become, a social determinant of health”.

    In African countries, competition for resources is fuelled by smaller budgets trying to address substantial service gaps. Decisions to invest in eHealth and data need to be taken with considerable care, and must be economically sound, affordable, and evidence-based.

    Data systems should be built in steps that are sustainable and yield information that can be trusted. Emphasis should be on integration and consolidation and embracing emerging opportunities. It needs sound strategic planning too, with emphasis on:

    More substantive partnering among stakeholders Better agreement on architectural frameworks and evolving standardsMore opportunities for data collection from individuals, through mobile phones and other devices that become ubiquitousExploring new approaches to unique identifiers, including understanding the potential role of a medical blockchainIncorporating AI and machine learning to augment progress.

    Alongside these, cyber-security requires constant vigilance.

    Acfee is building a toolkit of good practice for help knowledge workers navigate these issues and make good choices.

    Talking about the future is fun but too often gratuitous. Hawking pointed out that “Intelligence is the ability to adapt to change”. The ability of our health data to provide value is also about our ability to adapt to health’s changing needs, to ensure that our efforts remain relevant and support impact.

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    Sean is CTO at HISP-SA and Chairperson of Acfee. HISP-SA supports the South African Department of Health in its efforts to build information systems that support health transformation.

    Acfee advances eHealth’s health strengthening and transformation role for Africa through the eHealth Network for Africa blog and eHealthAFRO stakeholder platforms, engagement with African Ministries of Health and other regional eHealth leadership groups, and the collection and sharing of knowledge and tools.