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  • eHealthAFRO sets the pace

    Interest in Acfee's eHealthAFRO conference is extending across Africa. The enthusiasm is reflected in its new name eHealthAFRO 2017 Southern Africa that matches the pan-African relevance. Its new name reflects the expanding programme and its difference to other events.

    eHealthAFRO 2017 has three parts:

    1. A week of pre-conference seminars from 26 September to 1 October
    2. The main event programme from 2 to 4 October’s that includes presentations, debates, several breakaway workshops and SAHIAs HISA academic programme.
    3. The post-conference African eHealth Forum where Acfee’s Advisory Board meets on 5 and 6 October.

    eHealthAFRO 2017 includes:

    • National eHealth strategies for Universal Access to Care, with a panel of Ministers and representatives from across Africa
    • A demonstration of eHealth robotics by eHealth Group
    • Updates on Cyber-security
    • Information about South Africa’s National Health Insurance programme and National eHealth Strategy
    • Updates on eHealth Strategy, governance, regulation and impact
    • The District Health Information System (DHIS)DHIS Free and Open Source Software (FOSS) global success
    • Breakaway workshops on OpenMRS, OpenHIE, OpenSRP, Vula and Bahmni, and open source EMR, and other topics
    • A perspective on India’s eHealth and lessons for Africa
    • Updates on Public health and surveillance.

    Discussions are underway with other eHealth organisations about their participation. Updates on progress will be on eHNA and eHealthAFRO 2017.

    Themes in the pre-conference seminars include:

    • Building blocks for eHealth strategies
    • Future eHealth leadership
    • WebDHIS for data managers
    • Hosting DHIS2
    • South Africa’s Health Normative Health Standards Framework (HNSF)
    • Managing an NGO in challenging times.

    It is vital that people in eHealth share and learn from each other’s ideas and progress. Join us at eHealthAFRO 2017 Southern Africa because eHealth’s transforming health and healthcare, and everyone’s ideas, experiences and challenges are valuable.

    eHealthAFRO is where healthcare professionals, government leaders eHealth enthusiasts and industry stakeholders explore tangible eHealth opportunities and eHealth excellence in Southern Africa and across the content. We look forward to welcoming you.

  • eHealth Group offers a telehealth paradigm shift

    About a third of African countries invest in telehealth, identified by the WHO and Global Observatory for eHealth in their 2015 survey. Since then, eHealth Group, based in South Africa, has leapfrogged telehealth’s technology and its supply side. 

    Its lineage goes back to the Da Vinci Robotic Surgery. This enabled eHealth Group to incorporate the ideas, principles and techniques into its robotic telehealth services. Instead of a link between a patient and a healthcare professional, eHealth Group’s robots and products enable healthcare professionals to deal directly and easily with several patients in wards, ICUs and communities.

    At its core are:

    • Direct access to a wide range of clinical data about patients
    • Explicit, precise and clear images of patients
    • Its own excellent, global telecommunication network. An example is where doctors can have two screens.

    The picture shows a doctor accessing a patient’s view and PACS side by side. It’s an efficient and effective use of his time and benefits patients directly.


    South Africa’s eHealth Group provides services across Africa. It’s part of a global network, operating in over 30 countries, across 20 specialties in over a thousand hospitals and over 4,000 medical specialists available online. About 70% of US telestroke hospitals in the USA use eHealth Group’s services, up from 30% four years ago. 

    There’s a wide product range extending from tablets to sophisticated robots that provide high quality telehealth. Alongside the products, eHealth Group provides a service range including access to advice from a network of medical specialists, specialists who can provide direct patient care, and training. 

    Elliot Sack and some of his robots from eHealth Group will be at eHealthAfro 2017 on 2 to 4 October in Johannesburg. His presentation’ll reveal the paradigm shift that can make a difference to Africa’s health and healthcare. eHNA has more to report on it.

     

  • Call for Papers - six days to go

    Sharing eHealth experiences and research finding’s essential to progress. These are the main goals of the Health Informatics South Africa (HISA) Call for Papers (CfP) for its conference at eHealthAFRO 2017 on 2 to 4 October 2017 in Johannesburg. It’s hosted by the South African Health Informatics Association (SAHIA). The CfP has four topics. They’re:

    • eHealth Strategy, governance and regulation
    • eHealth impact through routine health information
    • Cyber-security related to eHealth applications
    • eHealth systems related to public health and surveillance. 

    Papers on other relevant eHealth topics may be considered. Will extra papers include health informatics developments and research on eHealth futures, such as AI and health analytics?

    The timetable’s: 

    • Full papers submitted to South African Computer Journal (SACJ), complying with SACJ’s submission guidelines, by Monday 28 August 2017    
    • Notification of paper acceptance on Friday, 15 September 2017
    • Final author registration by Friday, 22 September 2017
    • Final paper due Friday, 29 September.

    A special SACJ edition will published presented papers. They’ll comply with SACJ’s editorial process, so at the end of the submission form, comments to the editor should include “HISA Conference paper.”

    eHealthAFRO 2017 brings together researchers and practitioners active in health informatics. At least one author should register for eHealthAFRO and present the paper at the HISA Conference for the paper to be eligible for SACJ publication. SACJ charges ZAR6,000 for publication costs for accepted papers, but authors with no funding can apply for this to be waived.

    Prof Nicky Mostert-Phipps is the contact for submissions. She is a software development lecturer at the Nelson Mandela Metropolitan University Faculty of Engineering’s Built Environment and Information Technology, and can provide more information about HISA’s conference and preparing and submitting papers.

  • Informatics and EHRs can prevent strokes and improve monitoring

    Increasing responses to strokes and their after effects are important health priorities. A report in the US National Library of Medicine has estimated that in 2015, strokes were the second-leading cause of death worldwide after ischaemic heart disease. In 2010, strokes caused 5.3 million deaths globally, 10% of all deaths. Trends include increasing stroke mortality and lost Disability Adjusted Life Years (DALYs) in low- and middle-income countries and a dire estimate of the global economic impact unless effective preventive measures are implemented.

    Another study identified the aged-standardised incidence of stroke in Africa as 316 per 100,000, 0.3% population, and age-standardised prevalence rates of up to 981 per 100,000, almost 1%. Stroke incidence’s increasing, but the study said the “peculiar factors responsible for the substantial disparities in incidence velocity, ischaemic stroke proportion, mean age and case fatality compared to high-income countries remain unknown.” This is despite the incidence being lower than higher-income countries. A study in Sage Journals estimated the incidence of stroke, adjusted to the WHO World standard population, in 51 countries. It ranges from 76 to 199 per 100,000 population.

    Atrial fibrillation (AF) an irregular and often very fast heart rate may cause symptoms like heart palpitations, fatigue and shortness of breath. Treating it’s important because it may cause a stroke, with resulting adverse DALYs. After a stroke, AF needs monitoring. A study in Cardiology, published by Karger, aimed to identify the characteristics of atrial fibrillation (AF) in post-cryptogenic stroke. It’s a stroke with an unknown origin.

    The US Stroke Association has an estimate that cryptogenic strokes (CS) may be between 25% and 45% of ischemic strokes, so about 30%. They are where blood supply to part of the brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die. Ischemic strokes are about 87% of all types.

    The team’s project included Transient Ischemic Attacks (TIA). Mayo Clinic has a simple description of a TIA. It produces similar symptoms to a stroke, but usually lasting only a few minutes and causing no permanent damage. Often called a mini-stroke, a TIA may be a warning of worse to come.

    The team of cardiologists and informatics researchers from the Department of Medicine and Division of Cardiology at Santa Clara Valley Medical Center, the Biomedical Informatics Training Program, Stanford University, the Center for Biomedical Informatics Research, Stanford University School of Medicine and the University of California San Francisco, stratified a cohort of stroke patients by risk factors. It used data from EHRs.

    These included obesity, congestive heart failure, hypertension, coronary artery disease, peripheral vascular disease and valve disease. A risk-scoring model applied seven clinical variables that assigned patients into three groups. The risk-score’s measures of AF risk and may be used to select patients who need extended AF monitoring, especially home monitoring.

    The study’s an example of the value of doctors, informaticians and analysts working together to exploit the value of data in EHRs. It’s a model for Africa’s health systems and universities to work towards.

  • HDC’s first year shows good progress

    Health Data Collaborative (HDC) is a global collaborative aiming to improve health data quality. Its 2017 progress report sets out achievements in its first year: 

    HDC’s future priorities are set around a core theme. It’s giving careful consideration to activities needed to scale up successes that support a broader range of countries aiming to strengthen scaled, credible and sustainable national health information systems. This’s a vital objective. HDC says Recording and reporting for specific diseases and programmes can take up to 33% of the time available for providing services. Liberating and redeploying these resources are extremely valuable in countries with tightly constrained healthcare resources.

  • Kenya’s mHealth standards are strong on IOp

    Kenya’s Ministry of Health has set a solid foundation for its next step in eHealth regulation and good practices. The second main section in Kenya Standards and Guidelines for mHealth Systems deals with information exchange and Interoperability (IOp). It has a seven stage model of IOp maturity, including level 0 for no maturity and three conventional IOp classifications of technical, syntactic and semantic. They’re:

    • Conceptual, enabling other engineers to understand documentation and evaluation
    • Dynamic, to recognise and comprehend data changes in systems over time
    • Pragmatic, including modest AI
    • Semantic
    • Syntactic and workflow integration
    • Technical and integrated
    • None, so can be ignored.

    They combine into three categories, integration, IOp and composability for maximum interoperation. It’s a requirement that all Kenya’s mHealth complies with its IOp standards. These include Health Level (HL)7 version 3 for clinical messaging and International Classification of Diseases (ICD) 10, Systematized Nomenclature of Medicine (SNOMED) for coding, Logical Observation Identifiers Names and Codes (LOINC) and Rx Norm for pharmacies.

    Developers have to provide Standards for Applications Programming Interfaces (API) to define how their mHealth interacts with other systems. It fits into a Fast Health Interoperability Resources (FHIR) architecture. It complies with Integrating the Healthcare Enterprise (IHE) and HL7 standards

    While these apply to health and healthcare data, Kenya’s standards apply to social health determinants too. It’s an indicator of the breadth of its approach.

  • IBM’s cyber-threat index shows it’s increasing

    eHNA’s covered many cyber-threats reports. The IBM X-Force Threat Intelligence Index 2017 puts them into perspective. It’s not good. It sees 2016 as a defining year for cyber-security.

    Three themes are Distributed Denial of Service (DDoS) attacks, loads of records leaked through data breaches and a step up by organised cyber-crime on businesses. Over four billion records were leaked, more than the combined total 2014 and 2015. 

    Mega breach was redefined, with one source leaking over 1.5 billion records. The average cyber-security events of IBM® X-Force®’s clients exceeded 54 million, 3% up on 2015. An event’s illicit activity on a system or network detected by a security device or application. 

    Attacks are security events classified by correlation and analytics tools as malicious activity attempting to collect, disrupt, deny, degrade or destroy information system resources or its Information. X-Force found an average of 1,019 attacks, a 12% decrease compared to 1,157 attacks in 2015.

    Incidents are security events worthy of further investigation by IBM security analysts. It’s better news. Average incidents were down to 94 in 2016, a 48% drop from 2015’s 178. This doesn’t automatically mean cyber-security’s safer. It may be that cyber-attackers rely more on proven attacks that need fewer attempts. It’s also inconsistent with the combination of huge record leaks and a record year of vulnerability disclosures.

    There were many notable leaks in 2016 involving hundreds of gigabytes of email archives, documents, intellectual property and source code. They exposed organisations’ digital footprints. Previous data breaches were often fixed sets of structured information. Examples are credit card data, passwords, national ID numbers and Personal Health Information (PHI) data. This’s a paradigm shift.

    X-Force’s report profiles a range of cyber-attack methods. They’re:

    • Cross-Site Scripting (XSS)
    • Physical access
    • Brute force
    • Misconfiguration
    • Malvertising
    • Watering hole
    • Phishing
    • Structured Query Language Injection (SQLi)
    • DDoS
    • Malware
    • Heartbleed.

    The analysis and overview are extremely valuable for Africa’s heath executive and ICT teams. Web application vulnerability disclosures made up 22% of all vulnerability disclosures in 2016. Injecting unexpected items manipulating data structures comprised 74% of all cyber-attacks. These are a few of the priorities.

  • EMGuidance scales its eHealth platform across Africa

    After its success at Seedstar SA, EMGuidance next step’s to scale its clinical facilitation platform across Africa. It’s ready to release of a slim-line version in eleven countries.  

    An article in Disrupt Africa says its centralised, interactive digital access point equips local doctors with the latest information. It reduces inaccurate decisions when they deliver care and administer medicines. A team of in-house doctors, pharmacists and national network specialists developed the app. It’s Africa´s first free, interactive and consistently updated mHealth medicines resource, with over 800 active ingredients listed. By August this year, there’ll be 1,200 listed. 

    The eleven countries are Botswana, Egypt, Ghana, Kenya, Namibia, Tanzania, Uganda, Cameroon, Rwanda, Sudan and Zambia.  Its platform’s available on Android and iOS. Over 5,000 doctors have registered since its launch. It’s gone viral, with over 80% of growth coming through word of mouth. 

    Over 20 medical institutions use EMGuidance to publish their clinical guidelines. It seems that EMGuidance’s set to roll out right across Africa.

  • Technology’s setting timescales for Africa’s eHealth strategies

    A few years ago, eHealth strategies were much simpler. They set and captured relatively straightforward information architectures and standards, and bounded decisions, such as which structured systems were needed, which vendor should provide them, which ones were affordable and how to realise their benefits. These all sat in a temporal setting, rarely more than five years. Relativity in this setting doesn’t mean easy, it’s compared to the immense range eHealth opportunities and decisions now.

    eHealth’s increased and continuing sophistication means that Africa’s health systems and eHealth strategies need to be explicit about how far into the future they want to look. Their settings now are determined more by eHealth’s technology than calendars. Two commentaries can help to set these.

    Machine, Platform, Crowd: Harnessing our Digital Future, a book by Andrew McAffee and Erik Brynjolfsson, both working at MIT Sloan School of Management and on the MIT Initiative on the Digital Economy, sets out changes led by new ICT. They identify three.

    • AI that moves more control from people to computers
    • A shift from products to platforms that can scale investment
    • A move away from centralised institutions to users, the core to the crowd.

    Alongside these, the Institute of Electrical and Electronics Engineers (IEEE) identified nine top 2016 ICT trends. Its performance was reviewed in Computing Now. Some came to fruition in 2016. Others may reach critical development points this year. They were:

    1.     5G, promising unimaginable speeds

    2.     Virtual Reality (VA) and Augmented Reality (AR), with VR now available and AR expanding

    3.     Nonvolatile memory that can store more data at less cost and power

    4.     Cyber Physical Systems (CPS), used as the Internet of Things (IoT), its deeply embedded hardware and software in smart medical technologies

    5.     Data science, processes and systems to extract knowledge or insights from data in various forms, either structured or unstructured, and a continuation of some data analysis fields such as statistics, data mining, and predictive analytics

    6.     Capability-based security to provide finer grain protection and defences

    7.     Advanced machine learning, used in medical diagnosis, and exploring the construction of algorithms that can learn from and make predictions using data

    8.     Network Function Virtualization (NFV), an emerging technology providing virtualised infrastructure for the next-generation of cloud services

    9.     Containers that can deliver app faster and more efficiently.

    As the year progresses, how will Africa’s health systems evaluate and take decisions on these combined twelve ICT and eHealth trends? Ignoring them means falling behind. Assessing and adopting some of them means highly complex eHealth strategies. Maybe AI, 5G and analytics will be enough for now.

  • HISA calls for papers for its conference at eHealthAFRO2017

    Sharing eHealth experiences and research finding’s essential to progress. These are the main goals of the Health Informatics South Africa (HISA) Call for Papers (CfP) for its conference at eHealthAFRO 2017 on 2 to 4 October 2017 in Johannesburg. It’s hosted by the South African Health Informatics Association (SAHIA). The CfP has four topics. They’re:

    • eHealth Strategy, governance and regulation
    • eHealth impact through routine health information
    • Cyber-security related to eHealth applications
    • eHealth systems related to public health and surveillance. 

    Papers on other relevant eHealth topics may be considered. Will extra papers include health informatics developments and research on eHealth futures, such as AI and health analytics?

    The timetable’s:

    • Full papers submitted to South African Computer Journal (SACJ), complying with SACJ’s submission guidelines, by Monday 28 August 2017    
    • Notification of paper acceptance on Friday, 15 September 2017
    • Final author registration by Friday, 22 September 2017
    • Final paper due Friday, 29 September.

    A special SACJ edition will published presented papers. They’ll comply with SACJ’s editorial process, so at the end of the submission form, comments to the editor should include “HISA Conference paper.

    eHealthAFRO 2017 brings together researchers and practitioners active in health informatics. At least one author should register for eHealthAFRO and present the paper at the HISA Conference for the paper to be eligible for SACJ publication. SACJ charges ZAR6,000 for publication costs for accepted papers, but authors with no funding can apply for this to be waived.

    Prof Nicky Mostert-Phipps is the contact for submissions. She is a software development lecturer at the Nelson Mandela Metropolitan University Faculty of Engineering’s Built Environment and Information Technology, and can provide more information about HISA’s conference and preparing and submitting papers.

      

  • Will China expand its role in Africa’s eHealth?

    China already has a longstanding role in Africa’s economy. A report in TechCrunch by Lux Capital, a venture capital firm for science and technology, suggests it’ll expand and diversify.

    Josh Wolfe, Lux Capital managing partner and co-founder, says China’s access and influence throughout the African continent keeps growing. Some trends he explores include:

    • In 35 years, Africans will be 25% of the global population
    • 50% of Africa’s population’s under 20
    • The working-age population will expand by 20 to 30 million a year over the next 20 years, up from 530 million in 2015 to 920 million in 2035, then 1.4 billion by 2055
    • By 2050, Africa will make up 25% the world’s workforce.
    • By 2055, most of the net growth on the world’s workforce will be in Africa
    • Trade between Africa and China has mushroomed over the last 20 years, up from US$10 billion in 2000 to US$220 in 2014
    • China’s loans to African countries totalled US$5 billion a year from 2006-2010, US$10 billion a year from 2011-2012, then US$15 billion a year from 2013-2014
    • China maybe accounting for one-sixth of all lending across Africa.

    China’s been investing in training across Africa. Huawei, its technology heavyweight, earns 15% of its global revenue in Africa. It also trains 12,000 students in telecommunications and technology in Kenya, Congo, Angola and Nigeria. 

    It’s popular too. Wolfe says in Senegal, 86% of people said China’s helped to improve their country. About 56% said America had. He sees a significant expanding market for software, services, telecommunications, data centres, technological infrastructure and application layers. China’s technology companies will play a big role. It’ll include US start-ups partnering with big Chinese companies instead of their US equivalents. 

    China’s expanded role in Africa’s an extension of a trend started some 15 years ago. It may offer an opportunity for Africa’s health leaders to attract Chinese investment in scaling-up and widening their eHealth strategies and plans. A healthier population can enhance Africa’s workforce.

  • AI helps to identify schizophrenia

    Artificial Intelligence (AI) is on the move. It’s becoming an integral part of healthcare. Research by IBM and the University of Alberta published in a report in the Nature Partner Journal Schizophrenia, a Nature publication, shows that machine learning algorithms can predict schizophrenia with 74% accuracy, says an article in IT-Online.

    It also shows that the technology can predict the severity of patients’ specific schizophrenic symptoms based on correlations observed across different brain regions. This predication of symptom severity could help clinicians identify customised treatment plans for each patient.

    Schizophrenia’s a chronic neurological disorder affecting up to eight out of every 1,000 people. Patients experience hallucinations, delusions and cognitive and physical impairment.

    Dr Serdar Dursun, professor of Psychiatry and Neuroscienece at Alberata University’s optimistic that the new technology’s. “Innovative multidisciplinary approach opens new insights and advances our understanding of the neurobiology of schizophrenia, which may help to improve the treatment and management of the disease.”

    The study can also extend these techniques to other psychiatric disorders such as depression or post–traumatic stress disorder, both of which are often tricky to diagnose and harder to treat. 

    Using AI is one way that Africa’s stretched mental health services can expand their impacts. The research provides a justification for it as part of eHealth strategies.

  • Kenya’s mHealth standards for documentation add clarity

    Covering a wide range of mHealth standards, Kenya’s Ministry of Health has set a firm foundation to step up its wide eHealth regulation and good practices. The first main section in Kenya Standards and Guidelines for mHealth Systems deals with development and functions. It’s comprehensive.

    Software development has to comply with a set of phases: 

    • Requirement gathering
    • Systems analysis
    • Systems design
    • Development and implementation
    • Systems testing
    • Operations and maintenance
    • Support
    • Post-implementation M&E.

    Documentation needed for these includes:

    ·       Systems Requirement Specification (SRS)

    ·       Software design documents, depending on the mHealth software design methodology, will include some of:

    o   Unified Modelling Language (UML) diagrams

    o   Data Flow Diagrams (DFD)

    o   Flow charts

    o   Entity relationship diagrams

    ·       Implementation plan, including:

    o   Implementation manual

    o   Training and capacity building manual

    ·       Test plans

    ·       Deployment procedures

    ·       M&E criteria.

    Three other required documents are:

    • Technical manual
    • Developer’s guide
    • User manual.

    Four requirements for data validation are included:

    • First order, ensure valid data formats and values and prevent obvious data entry errors
    • Second order, historical data comparisons for alerts for changes
    • Third order assess data for consistency in specific forms and indicator sets
    • Fourth order, assess statistical outliers for validity. 

    These examples show the range and rigour of Kenya’s mHealth standards. They fit all types of eHealth too. It’s a considerable benchmark for all Africa’s health systems.

  • Indian Ministry of Health pilots mHealth services

    Indian Health Ministry has stepped up its mHealth and eHealth services. The programme currently focuses on two districts. Baglung and Ilam. mHealth uses mobile apps and text messaging services to track pregnant mother´s ante-natal visits.

    An article in the Kathmandu Post says Medic Mobile, an organisation operating in 23 countries, signed a Memorandum of Understanding (MoU) to scale up the programme in several districts. The MoU will strengthen health systems by promoting mHealth access, especially in isolated communities. Medic Mobile will also provide technical advice and support so eHealth and mHealth solutions are implemented and leveraged more effectively.

    So far, it’s been implemented by 83 Village Development Committees (VDC) in Gorkha and Dhading districts. Other districts will be able to build from the initial scale.  

    In Baglung, the Female Community Health Volunteers (FCHV) use mHealth to remind expecting mothers of their health facility schedules and visits. The service has been successful. The Family Health Division director, Dr Naresh Pratp KC, said the mHealth and SMS services “Have been effective to increase ante-natal visits.” 

    The service includes:

    • Details of pregnant mothers are  entered onto an app
    • Reminders are forwarded periodically to FCHVs
    • FCHVs are kept up to date of any complicated cases.

    Ante-natal care ensures a reduced risk of complications in pregnancy. However, irregular attendance by pregnant mothers on their mandatory four visits to health facilities’s an issue. Only 69% of women visited health facilities four times. It drops to 62% in rural areas. In urban areas, the figure’s 75%. 

    Bhogendra Dotel, the ministry spokesperson, said the mHealth services will soon be extended to track immunisation and disease surveillance. The initiative has important lessons for Africa’s health systems. Their maternity services share equivalent challenges and priorities.

  • EHRs aren’t enough, they need communications

    Communicating isn’t easy. In “Is Anybody Listening?” a 1950s article in Fortune Magazine, William H Whyte, a journalist and author, suggested that “The single biggest problem in communication is the illusion that it has taken place.” Across health systems and within healthcare organisations, it can be at the demanding end of the spectrum.

    An eBrief from Spok says EHRs don’t do enough for clinical communication and collaboration. It’s particularly prevalent for information needing acknowledgements and prompt action. Spok’s proposal’s a complementary system for messaging and collaboration among all healthcare team members and across whole healthcare organisations. In Picking Up Where EHRs Leave Off: 6 Ways to Bolster the Benefits of Your EHR by Improving Communications in Your Hospital, six requirements are:

    • Support all clinical and other healthcare team members
    • Provide an enterprise-wide directory to serve  as the source of truth
    • On-call schedule integration and clinician status
    • Integration with third-party systems
    • Capability to support many devices
    • Deliver emergency notification rapidly.

    These will combine to enhance EHRs’ benefits. It reflects the changing nature of EHRs since the 1990s when they were seen as a database for healthcare professionals. Now, they’re a vital data source for health analytics, and Spok’s communicating needs.

    The perspective offers Africa’s health systems a broader approach to moving towards their goals for EHRs. Anton Chekov, the Russian story-teller, had an illuminating view of the wider world when he wrote in his Note Book “Don’t tell me the moon is shining; show me the glint of light on broken glass.”

  • Kenya launches app to protect health workers from HIV

    HIV’s still a big public health challenge for Africa’s health systems and their health workers. Many health workers see HIV+ patients every day, so exposed to cross-contamination risks, such as accidental pricks from contaminated needles and surgical blades and blood and other body fluid splashes that can result in contracting the HIV virus. Kenya's Ministry of Health (MoH) has partnered with Care for Carers (C4C), a carers’ platform, to provide an app to help healthcare workers have prompt medical care for accidental exposure to infections.

    It’ll provide a tool for health workers to ask for immediate attention says an article in Kenya Tech News. Post-Exposure Prophylaxis (PEP) drugs can reduce infection risk by over 80%, but have to be taken within three days of exposure. The dose’s needed for 28 days. They work by attacking and killing viruses before they cause HIV after they’ve multiplied. After the 28days, patients have to have two HIV done, each taking place after three months. Dr Martian Sirengo, head of the National Aids and STI Control Programme (Nascop), said “The time PEP is initiated, and the completion of the recommended dose is of great importance. And this new platform will help us with that.”

    Health workers have to log into the C4C platform and register. It then records information such as personal, employment, demographic data and any treatments. It then provides users with detailed procedural advice the MOH guidelines. The app also sends follow-up messages to encourage and advise practitioners to adhere to the requirements and provide information on PEP drug side effects.

    C4C enables county and national governments to monitor real time data on HIV exposure incidents in healthcare facilities. It also provides data on causes and risk exposure rates for locations. This can help to frame policies on safety in hospitals, creating safer working environments.

    M-health and Nascop helped developed the app. It’s currently used in Kisumu, Turkana, Meru, Embu and Murang'a counties.

    Kenya’ s not the only country struggling with these challenges. Other African countries need similar mHealth solutions to protect their healthcare workers. 

  • US eHealth IOp should focus on big impacts

    Interoperability (IOp) in eHealth isn’t an absolute state. Measuring it isn’t either. Sir William Osler, a Canadian doctor and one of four founding professors of Johns Hopkins Hospital, didn’t need to bother with eHealth IOp, but hinted at it in strategy when he said “In seeking absolute truth we aim at the unattainable and must be content with broken portions.”

    Challenges are how much, and which IOp measurement will achieve contentment without breaking it. An article in Fierce Health provide some indication. It sets out responses from five US organisations to the Office of the National Coordinator (ONC) report in the Proposed Interoperability Standards Measurement Framework, reported by eHNA in May.

    It has two main themes.  One’s measuring standards implementation. The other’s how end users can refine and customise standards to meet their needs. Most groups expressed some trepidation that new standards would result in an undue burden for providers. They want the ONC to focus on measurement areas with the biggest impact. Their advice is directly relevant for Africa’s IOp plans.

    The American Medical Informatics Association (AIMIA) supported the ONC’s framework in its response. It also asked the ONC to target “high-value standards” that offer the biggest impact. Specific requirements are functionalities for accessing drug databases and transmitting laboratory data. It wants the measurement framework to be automated too, so easier reporting mechanisms translate to higher participation.

    A combination of support and caution was part of the Health Information Management and Systems Society (HIMSS) contribution. It offers three main themes: 

    A sub group of HIMSS, the Electronic Health Record Association (EHRA) suggested a combination of standardised approaches with non-standard methods. It’s a focus on use cases with the biggest impact. It emphasised the potential burdens too.

    The College for Health Information Management Executives (CHIME) highlighted patient matching as one of the biggest IOp barriers. It says measurement standards are premature, and wants the ONC to:

    • Develop standards for seamless communication between ICT systems
    • Ensure that data exchange identifies patients with 100% certainty
    • Make data exchange usable for clinicians before tackling IOp standards.

    CHIME proposed that if the measurement framework’s implemented, the ONC should work with stakeholders to prioritise cases and develop a granular set of standards.

    Health IT Now, a coalition of patient groups, healthcare organisations, employers and payers, recognises that measuring IOP’s necessary, and said a narrow focus on successful data transmissions devalue improvements in using data to improve care and defer the capability of health systems to exchange information. It wants collaboration with patients and patient advocates and private sector organisations that can contribute to identifying, developing, and deploying IOp standards for better information systems.

    These perspectives can inform Africa’s eHealth development. IOp and its choices are seldom off the eHealth agenda.

  • Healthcare innovations claim top spots at this year’s Innovation Prize for Africa

    The sixth edition of the Innovation Prize for Africa (IPA) culminated with the African Innovation Foundation (AIF) awarding three African innovators for their innovations that tackle unique African challenges. Over 2,500 applications were submitted. Only ten nominees were selected.

    From these, Egypt’s Aly El-Shafei, a Professor of Vibration Engineering at Cairo University was the US$100,00 Grand Prize winner. Ugandan Philippa Ngaju Makobore, an electric engineer won the second prize of US$25,000, and Dougbeh-Chris Nyan of Liberia, a research scientist won the US$25,000 Special Prize for Social Impact, says an article in BIZTECH Africa. Two of the three African innovation wines focused on healthcare.  

    Inadequate medical solutions to administer drugs efficiently or diagnose diseases adversely affect healthcare quality in many parts of Africa. Makobore’s invention, Electronically Controlled Gravity Feed Infusion Set (ECGF) and Dr Nyan’s multiple disease rapid detection test both offer solutions that can improve Africa’s healthcare quality.

    AIF collaborated with the Government of Ghana, represented by the Ministry of Environment, Science, Technology and Innovation (MESTI), Ghana Investment Promotion Centre (GIPC) and Ghana@60 Planning Committee to host IPA 2017. The theme was African Innovation: Investing in Prosperity.

    AIF Founder, Jean-Claude Bastos de Morais was enthusiastic about the event. He said “AIF has rewarded IPA 2017 for developing solutions that can truly add value to the lives of Africans, and I believe that these innovations have incredible commercial potential and will succeed in attracting the right investments to go to the next stage.”

    Makabore’s ECFG’s  designed to administer Intravenous (IV) fluids and drugs accurately by controlling the rate of fluid flow using feedback from a drop sensor. IV infusions are critical for administering the right flows and volumes that patients need. Over 10% of children admitted to East African hospitals need immediate infusion therapy. Findings from the Fluid Expansion As Supportive Therapy FEAST trial indicate that over-infusion in children increases the risk of death by 3.3% at 48 hours. By increasing accuracy and safety, ECGF can save lives.

    Dr. Dougbeh developed a test to detect and simultaneously differentiate seven infections.  with similar symptoms, such as yellow fever, malaria, and Ebola. Most common testing methods take between three to seven days. His device provides results in ten to 40 minutes. He’s currently working on the second prototype. It’s a valuable step up  in detecting and managing infectious diseases.

    IPA has seen a large growth in applications and increasing interest from innovators and enablers. It’s attracted more than 7,500 innovators from 52 African countries. Hopefully next year’s winners will incorporate eHealth and mHealth in their innovations. 

  • Microsoft's joined the AI race

    The Artificial Intelligence (AI) supply side’s heating up. An article on the BBC says Microsoft is promoting its AI credibility and visibility. It brought its top scientists from across the world to London demonstrate their ideas, vision, research, initiatives and AI’s direction that over the next few years.

    One project’s Seeing AI. It does several clever things. It helps people with visual impairment access information using a smartphone’s camera. Pointing a phone at documents enables it to read them aloud. A set of bleeps guide people to barcoded on drinks cans to tell users what it is. 

    Creating Seeing AI took several years. Microsoft’s AI research programme’s been underway for 25 years. It has three main parts, speech, language and vision. Some of it’s now coming to fruition and seeing, recognising and understanding our world in a similar way we do. 

    Microsoft’s AI progress adds extra opportunities for Africa’s consumers and health systems. When will they become part of Africa’s eHealth strategies?

  • eHealth’s wide data range can benefit from embedded analytics

    Assembling data from eHealth’s increasing range is a considerable challenge. Business Intelligence (BI) and its analytics can help. It’s also moving on. An article in Business Intelligence Best Practices  by Wayne Eckerson describes how. It’s a trend that Africa’s health systems need to follow.

    He’s a BI thought leader, author and founder of Eckerson Group, a research and consulting company specialising in BI, analytics and Big Data. Two of his books are Performance Dashboards: Measuring, Monitoring, and Managing Your Business, published by Wiley, and The Secrets of Analytical Leaders: Insights from Information Insiders, published by Technics Publications.

    His view of BI’s next wave’s the enhancement towards embedded analytics. It’s part of a requirement that BI tools must be easier to use if they’re to fulfil their potential and provide real time, constructive insights into organisations’ activities business events. Embedding analytics into the operational applications and processess’ the best way to simplify and operationalise it. So far, most embedded analytics have barely scratched the surface its possibilities.

    The concept’s not new. Java and .NET developers sometimes create new reporting capabilities when they build custom applications. Portals can display charts and tables generated by reporting tools inside portal windows. Microsoft Office maintains live links to reports on BI servers. Online applications embed predictive models to score customer transactions in real time to detect fraud, cross-sell products, evaluate risk and assess credit worthiness.

    These analytics aren’t sophisticated. They display canned views of existing reports with limited ability to drill down, publish views in other formats or compare outputs with other data. Compelling analytically-driven applications are used by rich leading-edge companies that have big teams of skilled developers who can code, debug, and test monolithic applications that are time-consuming and expensive to build and more costly to modify.

    BI’s future’s leading to a blurred distinction between analytical and operational applications. Embedding analytics’ techniques will make it as easy as dragging and dropping objects onto a workbench. Instead of stand-alone BI toolsets, users will leverage embedded BI functionality as an integral part of applications. It’ll also be used in reverse, to launch operational processes and tasks. 

    Two types of workbenches available for the analytically minded developer are:

    • Traditional Interactive Development Environments (IDEs), such as IBM Rational, Microsoft Visual Studio.NET and SAP Visual Composer
    • Advanced Development Environments (ADEs) are similar to IDEs, but often enhance development so users and developers, can rapidly prototype and build applications. 

    Africa’s eHealth strategies need to find a place for these trends. It’ll include a combination of tools, skills, recruitment and retention.