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  • Articles (2,063)
  • mHealth lessons may not be easy to transfer

    As the volume of the mHealth initiatives across the world expand, transferring the successes offers an effective way to make use of scarce mHealth development skills. It’s a valuable concept, but “may as readily translated to a country like India as proponents of mHealth might assume.” It’s a conclusion of a study from Durham University in the UK. If it’s a challenge for India, it may prevail across Africa too.

    “MHealth and the management of chronic conditions in rural areas : (sic) a note of caution from Southern India” draws from fieldwork to explored challenges facing mHealth implementation in Andhra Pradesh. It reviewed mHealth in chronic medical conditions, type 2 diabetes and depression. The research:

    • Identified ways people in a rural area access medical treatment
    • Assessed how adults use mobile phones in daily life to gauge the realistic chances of mHealth uptake
    • Identifies different pathways to care for the two medical conditions
    • Emphasised the importance to the rural population of healthcare outside the formal health system, and provided by Registered Medical Practitioners (RMP) who are neither registered nor trained
    • Demonstrate the limited use of basic mobiles by most of the older adult population
    • Examine how promoting self-management by patients may not be as readily translated to a country like India as mHealth proponents of might assume. 

    These combine into significant mHealth inhibitors. An important finding’s that it can be difficult to identify a clinical partner for patients or their carers for mHealth designed to help manage chronic ill-health in rural India.  

    While mHealth offers an effective potential response for better public health surveillance and healthcare, a more appropriate perspective’s is its probability of success. Invariably, probability has a lower socio-economic return on investment. The study raises a note of caution for India’s rural communities, suggesting that some more ambitious hopes for mHealth may be hard to realise. Factors at play include:

    • Tendency diabetics to avoid the government or formal health sector as a whole
    • The role of RMPs are central to such choices
    • Difficulties in seeking and sustaining treatment for depression
    • The viability of patients managing their own healthcare to realise benefits of self-management.

    Health workers often acknowledged communication problems between clinics and patients, but tend to assume it’s more straightforward to identify appropriate clinical end of the communication. The study challenges this assumption. The hypothetical self-managing individual fits well with popular western notions of self-actualisation, but may not transfer to India’s remote rural communities. Does this description fit Africa’s remoted rural communities too? The study’s cautious about generalisation across India, but does emphasise social and systemic challenges in addition to the technical features. So, while mHealth may not readily transfer across rural communities, the challenge to maximise mHealth’s health and healthcare benefits might.

  • CDC says four actions are needed to combat AMR

    Bacteria’s resistance to antibiotics, Antimicrobial Resistance (AMR), is a continuing struggle. WHO has estimated that globally, about 480,000 people develop multi-drug resistant TB each year. AMR’s starting to complicate HIV and malaria treatments too.

    Afro Health Observatory (AHO) says the position in the region’s no known accurately. Understanding  AMR issues and its magnitude are hampered by surveillance of drug resistance being limited to only a few countries. Consequently, data on the true extent of the problem’s incomplete and inadequate data. Despite limited laboratory capacity to monitor AMR, what is available suggests that Africa shares the global trend increasing drug resistance.

    A report from the Center for Disease Control and Prevention (CDC) says health professionals across all healthcare’s activities should identify opportunities to improve antibiotic prescribing practices. These include identifying high-priority conditions and barriers to improving antibiotic prescribing, and establishing standards for antibiotic prescribing. Core Elements of Outpatient Antibiotic Stewardship proposes that:

    • High-priority conditions, where clinicians commonly deviate from best practices for antibiotic prescribing, including conditions for which antibiotics are over-prescribed, under-prescribed, or incorrectly prescribed with the wrong antibiotic agent, dose or duration.
    • Barriers leading to deviation from best practices are identified and addressed
    • Standards for antibiotic prescribing are set and adhered to.

    CDC’s framework has four actions:

    • Healthcare professional’s commitment to good standards and practices
    • Data tracking and reporting antibiotic prescribing practices and set baselines to provide regular feedback to clinicians and evaluate and compare stewardship, compliance and quality, or enable clinicians assess their own antibiotic prescribing practices
    • Increased education for patients and clinicians to manage expectations better
    • Implement policies and practices.

    Better data tracking and reporting requires Africa’s health systems to invest in eHealth to support AMR surveillance. It’s an opportunity for eHealth to help with prevention.

  • Ebola rears its head in the DRC

    After West Africa’s Ebola outbreak stretching across some four years, it’s emerged again. This time, it’s in the Democratic Republic of Congo (DRC). On 11 May 2017, DRC’s Ministry of Health (MoH) informed the WHO of a confirmed case of Ebola virus subtype Zaire at the Institut National de Recherche Biomédicale (INRB) in Kinshasa. The investigation’s ongoing.

    WHO released a press statement saying five samples were collected from suspected cases, but information’s only available for three. One’s a 39-year-old man who presented with the onset of symptoms on 22 April, but died on arrival at the health facility. He had haematuria, epistaxis, bloody diarrhoea, and haematemesis.

    Two other people in contact with the deceased are being investigated. One took care of him during transport to the health care facility, and has since developed similar symptoms. The other’s a taxi driver, now deceased, who transported the patient to the health care facility. 

    Protective medical gear for healthcare workers has been shipped to Kisangani.  Additional kits are being prepared and will be shipped as soon as available. 

    Public health response measures have since been implemented. They’re

    • Reactivating the national committee against viral haemorrhagic fever, which will meet every day to coordinate the response
    • Strengthening surveillance and investigation, including contact tracing
    • WHO will provide help and technical support, including possible deployment to DRC of an additional WHO multi-disciplinary team to support the response of national authorities
    • Activating the Global Outbreak Alert and Response Network (GOARN) to provide additional support if required.

     

    The need and feasibility of potential Ebola ring vaccination supplies is being discussed. eHealth’s role in the response can learn from West Africa’s experiences.

    So far, the outbreak’s contained in a remote area and appears geographically limited. Continuing investigations will help to assess the full extent of the outbreak. WHO has not recommended any restriction on travel to DRC based on the available information. For everyone in DRC, let’s hope it’s contained.

  • A checklist can help combat ransomware

    As ransomware ratchets up as a cyber-security threat, extra and effective vigilance’s essential. WannaCry, reported on eHNA shows how it’s a bigger risk and priority. A ransomware checklist and kit as part of a seven file download from Sophos, a cyber-security firm provides timely advice. It has two main parts, essential technologies and best cyber-security practices. These are valuable for Africa’s eHealth. 

    There are two main types of ransomware attacks. One’s a plausible-looking email that’s booby-trapped email with a malicious attachment. The other’s from a compromised website. Both download ransomware when users click on links that work their way endpoints and servers. It seems that WannaCry stepped this up. It scans and hunts for vulnerabilities and includes a worm that extends across networks.

    If ransomware reaches endpoints and servers it’s essential it’s blocked and removed promptly, This may need tools. An example’s CryptoGuard Technology. Solutions must:

    • Complements existing cyber-security
    • Block processes trying unauthorised changes to data
    • Work against local and remote encryption
    • Automatically undo changes to avoid data loss
    • Exploit prevention by stopping ransomware exploiting weaknesses in other software products.

    Host Intrusion Prevention System (HIPS) with behaviour and file analytics are important too.  Tech Support Alert has a description of HIPS as a program that alerts users to malware programs such as a virus trying to run on users’ computers or that an unauthorised users such as a hacker may have accessed them. It achieve this by examining files’ components and structures of files for malicious elements and seeking code trying to modify registries.

    Other cyber-security technologies include: 

    • Web security scans checking web content for ransomware code
    •  Malicious Traffic Detection (MTD) looking for traffic to ransomware command and control servers, then blocking it when it’s found
    • Application control that restricts applications allowed to run
    • Blocking Wscript often used by ransomware
    • Application whitelisting to establishes a default deny policy on servers so only trusted applications can run, so preventing ransomware gaining a foothold
    • Stopping email threats using defences blocks ransomware emails
    • Time-of-click protection stops users clicking on links to websites hosting ransomware, even if they’re safe when they entered inboxes
    • Cloud-sandboxing to find zero-day threats that exploit unknown vulnerabilities by rigorously testing files in safe environments before users run them
    • Web gateways block web-borne ransomware before they reach users’ endpoints, such as:

    o   URL filtering that blocks websites hosting ransomware and stops ransomware communicating with its command and control servers

    o   Web filtering enforcing strict controls on ransomware file types, stopping them downloading

     Sophos’s nine best cyber-security practices are:

    • Backup regularly and keep recent backup copies off-line and off-site to minimise data loss
    • Enable file extensions to help identify unusual file type, such as JavaScript
    • Open JavaScript files in Notepad because it blocks them from running malicious scripts
    • Don’t enable macros in document attachments in emails because many infections rely on turning macros on
    • Always be cautious about unsolicited attachments, and check with senders
    • Don’t have more login power than needed because admin rights may expand a local infection across networks
    • Consider installing the Microsoft Office viewers to see what documents look like without opening them in Word or Excel
    • Patch early and often so there are fewer holes for ransomware to exploit
    • Keep up to date with new security features in business applications.

    These activities reveal the considerable range of activities needed for effective cyber-security. As threats become more sophisticated and effective, Africa’s eHealth needs to keep up with modern cyber-security.

  • Cyber-criminals like Ransomware

    Ransomware’s a favourite with many cyber-criminals. It’s cheap to produce and can provide big, illegal returns by encrypting users’ data. Decryption comes with a fee, but experts say users should never pay, but fix it by relying on up to date offline back-ups. It offers good returns because it mainly relies on unsuspecting users clicking on illicit links in emails and webpages so malicious ransomware’s downloaded. Acfee’s cyber-security overview eBook reports that  ransomware restricts access to computers, which is reinstated after paying a ransom often in Bitcoin to remove the restriction.. Cyber-criminals know this phishing approach that kidnaps information is  significantly more profitable than stealing  it. WannaCry made headlines  when cybercriminals launched a global cyber-attack. It’s a step up on lucrative conventional ransomware, being extremely predatory, scanning and hunting for networks’ vulnerabilities. It’s not clear if it used phishing, or was more sophisticated and sought vulnerabilities.

     

    An article in the NewYorkTimes says the cyber-attack affected more than 150 countries and inflicted 200,000 Windows computers.  Hackers mainly targeted hospitals, academic institutions and high profile global companies. Perpetrators used a digital code previously leaked as part of a document dump. A report by News 24 says it explains the virus’s rapid spread

    Healthcare news has an alarming estimate that  72% of malware attacks on healthcare used ransomware. Healthcare is particularly targeted by hackers as they know how crucial data is to daily hospital operations, and the gravely result it might have when leaked or placed in the wrong hands.   Verizon researched this. Its 2017 Data Breach Investigation Report    found  that 602 of 2,000 breaches stemmed from phishing emails. Symantec identified ransomware’s growth. Its report said  the number of ransomware detections increased by 36% during 2016, up from 340,000 in 2015 to 463,000 in 2016.

    Any organisation can fall victim to these attack, so they must impose strict measures to increase cyber-security  and ensure that all employees remain vigilant and alert.

  • Africa’s eHealth isn’t far behind South America and Mexico

    Africa’s eHealth has a different profile to the average for South America and Mexico, but it’s not trailing significantly. Comparing findings from the WHO and GEO’s Global eHealth Survey 2015 shows similar simple coverage rates of just over a third. A global average’s near 50%.

    Perhaps the most important difference’s the emphasis on Big Data. South America and Mexico are at about 12%. Africa’s at about 2%. The survey didn’t ask for data about Artificial Intelligence (AI) or coverage of cyber-security. It doesn’t provide data about the quality, sophistication or maturity of the coverage. It’s not easy data to assemble, quantify or analyse. 

    Suffice to say, it highlights the need for Africa’s health systems to catch up on AI. A first step may be using their existing data more extensively. A second may be supporting public health specialists and clinical teams in local AI initiatives. The comparison seems to indicate no need for a sudden rush. A steady, imaginative plod along the AI road should be sufficient.

  • More mHealth strategies are in place

    As mHealth expands across Africa, a report from Spok identifies an expansion of mHealth strategies. It’s improving, but there’s still plenty to do. From 2012 to 2017, healthcare organisations with mHealth strategies have increased from 34% to 65%. The Evolution of Mobile Strategies in Healthcare also identifies areas for improvement. 

    While many healthcare organisations have explicit healthcare development goals for clinical and working practices, it seems that mHealth’s contribution’s lagging behind. Spok’s findings are:

     

    Stated goal

    In mHealth strategy

    Physician-to-physician communications                 

    53%

    19%

    Nurse-to-physician communications    

    53%

    18%

    Nurse-to-nurse communications

    43%

    13%

    Code team or rapid response team communication

    43%

    16%

    Communication with health professionals networks

    40%       

    18%

     

    Critical test results management

    38%

    10%

    Nurse call and patient monitoring alerts to mobile devices

    37%

    13%

    Patient satisfaction scores

    36%

    9%

    Patient throughput        

    35%

    7%

    ER and bed turnover

    33%

    5%

    Alarm fatigue    

    31%

    9%


    The findings provide a lesson for Africa’s health systems to ensure their mHealth plans and initiatives aren’t left outside conventional healthcare improvement projects. It seems it’s easy to overlook mHealth’s potential.

  • Patients in EDs have faster treatments when lab results use mHealth

    Being in ED isn’t a preferred way to spend quality time. Waiting longer than necessary makes it worse. Using mHealth can make shorter times feasible. A Canadian study in Annals of Emergency Medicine found that ER patients with chest pain spent 26 minutes less waiting to be discharged when doctors received the lab results on their smartphone. It took longer when doctors waited for results to show in EHRs. The approach, a push-alert system, sends all laboratory results simultaneously to both EHRs and an ED server. The server continuously searches for test results in the push-alert programme, such as troponin levels. When it finds them, it sends an email with patients names and test results to the most responsible doctors’ smartphones. An audible alert enables doctors to access the results as soon as they can. Only push-alert emails are sent to these phones.

    A 26 minute shorter wait’s significant for patients. The time savings the difference between 68.5 minutes for doctors decisions using mHealth alerts compared to 94.3 minutes for doctors who didn’t, but used EHRs. It also means EDs can be less crowded. The study dealt only with troponin tests, but it seems a reasonable assumption that other test results send to mHealth services under the right circumstances may yield equivalent results. 

    These results offer significant mHealth investment opportunities for Africa’s very busy EDs. The productivity and patient gains are attractive.

  • Magee and CMU’s app can combat pre-term birth

    Pre-term births are before babies have completed their 37 weeks of gestation. WHO has estimated that 15 million babies are pre-term each year, and it’s rising. Complications associated with pre-term births are the leading cause of the high mortality rates of children under five. Three-quarters of these deaths could be prevented with current, cost-effective interventions.

    An article in Medicalxpress says that maternal-fetal specialists at Magee-Women’s Hospital has collaborated with scientists at Carnegie Mellon University (CMU) to develop and test a personalised smartphone app to combat pre-term birth. It engages pregnant women living in remote locations.

    Research in the Journal of Medical Internet Research mHealth and uHealth, found that the app was successful in providing accessible and personalised obstetric care designed specifically to target risks of pre-term births. Tamar Krishnamurti explained that

    "Mobile phone apps are a great way to engage a vulnerable population in their health care because approximately 86 percent of American adults own a mobile phone, regardless of racial and ethnic groups."

    Users voluntarily logged into the app every one and a half days to complete daily risk assessments. Algorithms then provided specific, personalised risk feedback, with bespoke recommendations. If the app detects a decrease in self-reported cigarette use, it provides encouraging messages and resources about quitting resources. It  also provides basic pregnancy education, reminders about appointments and fetal health monitoring aids like a kick counter.

    When the app detects high-risk events, such as intimate partner violence or thoughts of suicide, it sends real-time alerts to medical staff. Women are then contacted directly and linked to appropriate medical and social service resources.

    While there are several apps to support pregnancies, few are developed through a  patient-centred scientific process and grounded in behavioural decision research. The next step in this technology is to conduct randomised controlled trials over entire pregnancy cycles to evaluate  the app’s benefits for behavioural and clinical outcomes, including adverse birth outcomes. It seems to offer Africa’s health systems and pregnant women effective opportunities to reduce substantially the number of pre-term births.  

  • Telemedicine’s as big a US priority as EHRs

    Telemedicine’s up with inpatient and outpatient EHRs for US eHealth investment priorities. A survey by Reaction Data found 33% of healthcare executive have it as their top priority, alongside 32 % who have EHRS for inpatients and outpatients as top. Nearly half the respondents work in standalone hospitals. About a third are ion Integrated Delivery Networks (IDN).

    About 20% have investment to support a payment initiative. The Medicare Access and CHIP Reauthorization Act 2015 (MACRA) is a new way to pay doctors who treat Medicare patients. CHIP’s the Children's Health Insurance Program.

    These eHealth priorities don’t convert directly into spending priorities across all types of healthcare organisations for the next twelve months. The top two are:

    IDNs      

    Inpatient EHRs 

    41%

     

    Outpatient EHRs               

    24%

    Standalone hospitals

    Inpatient and outpatient EHRs

    31%

     

    Population health management

    24%

    Hospital’s physician groups

    Information security

    50%

     

    Telehealth

    38%

    Independent physician groups

    Telehealth

    52%

     

    Information security

    33%


    With Africa’s different health and healthcare priorities and eHealth development stage, will mHealth feature in the top two or three short term priorities and spending plans? Will cyber-security be moving up the eHealth priority ladder?

  • eHealth can benefit healthcare’s operational activities

     Realising benefits from eHealth’s the essential goal. These can be for patients, communities, health workers, healthcare providers and health systems. AI in eHealth’s changing the opportunities. 

    A report from Tableau Software, based in Seattle, sets out four ways that AI benefits healthcare. Four ways data is improving healthcare operations says, under the over-arching goals of lower cost and better care, they’re:

    • Enabling population health management
    • Increasing productivity
    • Aggregating and blending data to reveal supply chain inefficiencies
    • Automating visual analysis for better revenue cycle management.

    Achieving these depends on an appropriate eHealth approach. Tableau says the biggest problem’s not acquiring more, data, it’s how healthcare organisations simplify their data to a point at where it’s not a technical construct. This leads to decision takers easily understanding where their organisations are, then identifying and moving in a common, appropriate direction.

    This may be true for US healthcare, but Africa doesn’t have comparable data volumes yet. An important lesson for Africa’s health systems seems to be to pursue parallel investment tracks of simultaneously making better use of its data and implementing more eHealth solutions.

  • Bouy determines a person’s medical condition

    Doctors and computer scientists in Boston and New York have developed Buoy, a free AI platform. It helps people to use their symptoms to determine their medical conditions and make better decisions. The eHealth tool began in 2014 at the Innovation Laboratory at Harvard. Buoy’s co- founder and CEO, Andrew Le says currently, medical information provided by simplistic web symptom checkers are often risky and unreliable. To overcome these limitations, Buoy leverages advanced machine learning algorithms to provide personalised and accurate analyses and diagnoses to users so they can quickly and easily have more control of their healthcare.

    Bouy asks users to enter their ages, genders, and symptoms. It then asks a few questions, such as the severity of their symptoms and their durations. It uses this information to analyse against millions of medical records to generate other important, more specific questions. After two to three minutes of analysis, Buoy has an accurate and detailed understanding of users’ conditions. It will then recommend appropriate healthcare alternatives. If immediate treatment’s needed, it provides directions on how to connect with a nearby healthcare providers.

    An article in eHealth news says Bouy’s been through a battery of quality control tests. The result’s that it can accurately analyse a wide range of symptoms, such as common colds, abdominal pains and how a change of running shoes has created muscular or skeletal issues.

    The study tried to determine how Buoy interprets a cough compared the top five web-based symptom checkers. It examined 100 standardised cases involving 33 different diagnoses with severity ranging from life-threatening pulmonary embolisma to benign, normal cough. Prevalence was assessed too, ranging from rare histoplasmosis to common cold. Results were that Buoy’s analyses were 92% accurate as compared to WebMD at 56%, Healthline at 53%, Mayo Clinic at 38% and Isabel at 28%. Buoy has over 5,000 users and is available as an app on Apple store and directly from Buoy.

  • High eHealth leadership event set for Geneva

    Africa’s health ministers have set up an event alongside the World Health Assembly (WHA) to discuss the government leaders’ critical role developing, costing, and implementing national eHealth strategies. Topics include co-ordination and relation shipbuilding between ministries of health and information and communications technologies (ICT).



    Arranged for Monday 22 May 2017 from 1800 to 2100 in Geneva, African Ministerial Dialogue on Digital Health Leadership organisers extend an invitation to a wide audience to participate. Developing and expanding eHealth leadership’s vital for realising eHealth’s benefits.

    Acfee see eHealth leadership as a triumvirate of clinical, political and executive leadership, and extending across eHealth’s wide range and depth. This dialogue, jointly hosted by African health ministers, is a huge step forward in developing Africa’s eHealth leadership.

  • WannaCry hack hits Africa

    As big scale hacks go, WannaCry’s malicious spread’s approaching an unprecedented pandemic. Data Protection Report from Norton Rose Fulbright, a global law firm, says the ransomware attack started infecting companies and healthcare organisations across the US, Europe and Asia early Friday morning, 12 May. Then it was 70 countries affected. On Sunday, the head of Europol told the BBC there’s more than 200,000 victims in 150 countries. Hacker News has posted that WannaCry v2.0 can by-pass the kill switch that stops v1 from spreading. This global cyber-attack may keep expanding. 

    Hackatrick has an article saying it’s believed to be the biggest ransomware attack ever seen. Over 75,000 PCs in 99 countries were infected, including US, Russia, Germany, Turkey, Italy, Philippines, Vietnam, India and UK in less than 24 hours. It has a map showing organisations in Angola, Egypt, Kenya, Nigeria, Tunisia and South Africa are affected. Affected systems have six hours to pay up. Delayed responses lead to an increased ransom.

    WannaCry’s spread by using a Windows vulnerability. On 14 March, Microsoft released a security patch, MS17-010, to close it. Some large organisations with far-reaching ICT networks can take up to four months to install it and update their systems, so can still be vulnerable. The attack’s huge scale means there are equivalent large-scale lessons to be learnt. 

    Initial ransom payments for the decryption key are about US$300, usually paid in Bitcoin within six hours. Delaying payment can result in increased ransoms. It seems the cyber-criminals haven’t raised much relative to the extent of the infections, maybe some US$20,000 in Bitcoins so far from under 200 payments, says the Guardian.

    Basic advice from Hackatrick’s:

    • Patch you operating system and reboot, especially MS17-010 for Windows machines and servers against EternalBlue exploit (MS17-010)
    • Beware of bogus emails
    • Backup your files remote from operational systems
    • Always have an up to date anti-virus software.

    A report from the BBC says WannaCry seems to have spread like a worm. It can move around network unaided. It’s more sophisticated that basic ransomware that relies on phishing emails to tricking users into clicking on attachments that download malicious code. When WannaCry’s inside a network, it scans and hunts for vulnerable machines to infect.

    WannaCry seems to stem from a bug found by the US National Security Agency (NSA). When its details were leaked, many security researchers predicted it would trigger the production of self-starting ransomware worms. 

    Africa’s health systems must learn and act on the lessons from WannaCry. Its wrecking effect on parts of the UK’s NHS is salutary, and partly attributed to using obsolete software, such as Windows XP.

  • An mHealth app increases smoking cessation chances

    Globally, over 1.1 billion people smoked tobacco. That’s an estimate for 2015 from the WHO. Many more men smoke than women. Tobacco is the only legal drug that kills many of its users when it is used exactly as its manufacturers intended. WHO has estimated  that tobacco use, both smoking and smokeless, causes about six million deaths a year across the world. Many of these are premature. It includes approximately 600,000 people estimated to die from the effects of second-hand smoke.

    Clickotine, is an mHealth app that aims to help reduce the number of smokers. It emphasises the chances of successful rehabilitation from tobacco use. Research in the Journal of Medical Internet Research  (JMIR) shows that a personalised app for smoking cessation can help smokers who wish to quit, but who prefer using less intensive clinical intervention.

    An article in mHealth Intelligence says Clickotine offers a user-friendly way for patients to engage with their needs. It is developed with effective personalisation and engagement features of a smartphone app but includes components to support personal intervention complying with US clinical practice guidelines (USCPG). A questionnaire starts up when Clickotine is opened. It probes users to record their smoking behaviours and quitting goals. They also create a user profile with their unique smoking behaviours and input for personalised updates and messages.

    A log tool allows users to record smoking behaviours like cravings, sentiments, and number of cigarettes smoked. It is one of the app’s most popular features.  An article published in PubMed.gov says people between 18 and 65 used the app to start quitting on their own. About 45% abstained for seven days. Almost 27% abstained for 30 days. It seems that mHealth apps could provide a good step towards smoking  cessation across Africa. However, they need more testing.  Will this app have the same effect in All Low and Middle Income (LMIC) countries?

     
  • Phishing attacks are a challenge for South Africa

    Phishing is one of the most common, dangerous and frequent cyber-attacks that poses serious threats. Phishingbox has an estimate saying that at least one in 1,846 emails is a phishing attack. Emails are not the only source. Cyber-criminals use fake websites and adverts to trap people too.

    In Acfee’s cyber-security overview eBook phishing is when cyber-criminals send apparently legitimate emails or website adverts to entice recipients to respond either by clicking on malicious links that can download ransomware, or by providing sensitive information like passwords, usernames and personal data, that can be used mainly for email fraud. Cyber-criminals are increasingly using invitations to connect to bogus websites to entrap unsuspecting users too.

     

    This form of cyber-attack is successful because some users are easily fooled by the emails or adverts which appear legitimate. These hoaxes convey a sense of urgency which prompt a respone for security reasons by clicking on a link in the email that directs them to the spoofed website. This type of bogus website is designed  to acquire information and identity theft and encrypt users for a ransom payment.

     

    An article in ITNewsAfrica says South Africa’s the second most targeted for phishing attacks. In 2013, phishing cost South Africa about US$320 million, about  ZAR4,256,340,017 billion. Since then, spear phishing has become aa common form of phishing. It bypasses most security defences by sending emails that  are significant to users. Anyone can fall victim to this scam. Banking has some tips to avoid phishing:      

    • Keep online IDs, passwords and PINs private and never write them down or share them with anyone
    •  Always log off or sign out at the end of a sessions
    • Never respond to emails that request personal details. Never use links in emails or adverts to access websites,  always use web address provided by their organisations
    • Type web addresses in browsers and ensure sites are secure by looking for the lock icon on browsers before logging on
    • Don’t open emails from unknown sources, even if the email addresses, titles and sender details look legitimate, and delete them immediately
    • Create longer passwords that combine letters, both lowercase and capitals, numbers and symbols that cannot be attributed to you
    • Avoid passwords that are too personal, too simple such as 1234 and don’t duplicate one password for several accounts
    • Ensure up-to-date anti-virus software  and frequently update security patches your operating systems.

    While these are generic, they’re essential for all Africa’s eHealth users. They fit personal use too. They require constant vigilance.

  • Philips helps to accelerate healthcare in Kenya

    Transforming Africa’s healthcare’s a generic goal. Philips is partnering with Kenya’s government and the United Nations to transform the country’s primary healthcare. The initiative focuses on gaps in human resources, healthcare financing, essential medicines, medical supplies, health information, and using technology, says an article in IT News Africa.

    Philips is the first private sector company to collaborate on this type of initiative and establish a Sustainable Development Goals (SDG) Partnership Platform. The company will support the platform to establish a common knowledge base on primary healthcare by assessing current and future healthcare needs. It’ll enables platform members to work together to identify, design and implement initiatives.

    This project brings together executive leadership from government, development partners, private sector organisations and civil society. They'll investigate opportunities to accelerate universal access to Kenya's primary healthcare.The country’s constitution “Guarantees the rights to health as contained under article 43. The Council of Governors of Kenya is looking forward to closely collaborating with the SDG Partnership Platform to help accelerate universal access to primary healthcare in Kenya’s 47 counties through unlocking transformative public-private partnership investments,” said Mrs. Jacqueline Mogeni, CEO, Council of Governors, Kenya.

    Kenya’s been implementing healthcare technologies for some years. This partnership aims to accelerate its impact by making better use of healthcare information. It should help healthcare providers and policy makers make more informed, so better decisions.

  • USA’s ONC updates its eHealth IOp plans

    eHealth’s Interoperability (IOp) just doesn’t stand still. The USA’s Office of the National Coordinator for Health Information Technology (ONC) has released a new IOp framework. Proposed Interoperability Standards Measurement Framework aims to identify the USA’s progress in implementing IOp standards in healthcare. It builds from the ONC’s IOp roadmap Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap, and deals with:

    •  The current state of measurement
    • Standards implementation and use
    • An overview of the Proposed Measurement Framework
    • Implementing IOp standards health ICT products
    • End users use of standards to meet specific Imp needs
    • Data collection sources and mechanisms.

    The report identifies significant variability across the health ICT ecosystem in capabilities to measure IOp standards vary significantly. It constitutes significant eHealth challenges. Most significantly, health ICT developers and exchange services exhibit variability in tracking the use of standards in Health Information Exchange (HIE). The main causes are attributed to differences in:

    •  Architecture
    • Development decisions
    • Access to the data
    • Variability in standard implementation.

    Two vital proposals to enhance progress towards uniform implementation and use measures set out in the framework are:

    ·       Capturing progress on implementing standards in health ICT products by annual reporting on:

    o    Standards in development plans

    o   Standards implemented in health ICT products and services

    o   Product versions with standard implemented deployed to end users

    ·       End users using standards, including customisation, to meet their specific IOp needs

    o   Standards used by end users

    o   Volumes of transactions by standard

    o   Level of IOp standards conformance and customisation 

    There are three valuable lessons for Africa’s eHealth IOp. An IOp roadmap’s essential. It’s also essential to have a grip on the distance travelled and what’s needed to reach the destination.

  • Senegal’s eHealth strategy has valuable lessons

    All African countries have valuable lessons to impart as they pursue their eHealth initiatives. Senegal’s have been complied into a case study with support from USAID and Knowledge for Health (K4H). Senegal’s Journey Toward an eHealth Strategy: Highlights from the Development Process sets out approaches to:

    • Senegal’s methods
    • Its process to develop its eHealth strategic plan
    • Engaging stakeholders
    • Desk reviews
    • Situational analysis
    • The Drafting Committee activities
    • Financial resources
    • Critical Success Factors (CSF)
    • Challenges and barriers
    • Comparison to WHO/ITU eHealth Guideline
    • Recommendations to a useful eHealth Strategic Plan, successful implementation , monitoring implementation and for other countries’ eHealth strategies. 

    General lessons for other countries:

    • Leadership by the health ministries of health
    • Development of governance and co-ordination mechanisms
    • Harmonise health and ICT experts contributions
    • Integrate with existing initiatives, such as Rwanda’s electronic identity cards integrated with eHealth programmes
    • Engage with and co-ordination stakeholders
    • Identify  human and financial resources needed
    • Look for ICT impacts of ICT rather than the technology itself
    • Use actors and systems already in place
    • Protect personal health data confidentiality
    • Build in measurement and evaluation.

    People who participated in the Senegal eHealth Strategy have concrete recommendations based on their personal and collective experiences:

    • Allocate sufficient time to develop credible scientific documents
    • Anticipate the financial resources needed
    • Start with a baseline evaluation or situational analysis that includes reviews of existing eHealth projects and players
    • Apply a consultative, participatory approach where key players with diverse expertise are brought together for brainstorming
    • Refer to countries that have an operational strategic plan and learn from their model while taking into account socio-economic factors
    • Assess infrastructure
    • Ensure appropriate legal norms are in place
    • Establish realistic activity calendars
    • Seek high-level support for strategies
    • Refer to the WHO/ITU toolkit.

    Acfee has identified other essential features for Africa’s eHealth. Two are an eHealth leadership triumvirate of clinical, political and executive personnel that permeates across all eHealth activities, and a considerable emphasis on benefits realisations through health and healthcare transformation.

  • Microsoft fixes a dangerous email bug

    Where are all the bugs? All organisations or users are vulnerable. It seems they can’t be sure if their systems have vulnerability waiting to be exploited. Microsoft’s the latest.

    The Register has a report saying it’s released a security patch to fix a bug, MS14-068, in Windows Kerberos authentication system. It’s used by default in the operating system so users can ramp up their privileges and access rights to match those of domain administrators. With simple emails, hackers are exploiting it to compromise whole networks of computers by impersonating domain accounts, joining groups, installing programs, viewing, changing and deleting data, and creating new accounts. Cyber-criminals can use these to compromise computers in the domain.

    Microsoft has released an urgent update to stop hackers taking control of computers with a single email. The BBC has said Microsoft’s anti-malware software such as Windows Defender, could have been exploited without the recipient opening malicious emails. Windows 8, 8.1, 10 and Windows Server operating systems are all affected by the bug.

    The BBC said the bug was discovered by two Google Project Zero researchers, Tavis Ormandy and Natalie Silvanovich. The vulnerability enables remote code execution, malicious attackers golden goal. While the bug’s been there for some time, once Microsoft was alerted, it issued a patch rapidly. Windows users can check if they now have the latest Windows Defender version 1.1.13704.0. It should download automatically.