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  • A playbook for a successful digital health from AMA

    Good practice is always a good idea. The American Medical Association (AMA) has combined a wide range of good practices for eHealth. American Medical Association® Digital Health Implementation Playbook is built from an assessment that:

    Digital tools that enable new methods and modalities to improve health care, enable lifestyle change, and create efficiencies are proliferating quicklyClinical integration of these tools is lacking, so needs changing.

    It’s a valuable guide for Africa’s health systems. The four parts:

    Warm upPre-gameGame-time: remote patient monitoringPost-game resources.

    The playbook addresses four key requirements as questions for doctors adopting eHealth:

    Does it work?Will I receive payment?Will I be liable?Will it work in practice?

    These underpin several eHealth perspectives:

    1. WARMUP

    Introduction to eHealth implementation playbook Introduction to eHealth solutionsWhat’s remote patient monitoring? Remote patient monitoring in practice for hypertension The implementation path

    2. Pre-game

    Identifying needsForming teamsDefining successEvaluating vendorsMaking the case for eHealthContracting

    3. Game time for remote patient monitoring

    Designing workflowsPreparing care teamsPartnering with patientsImplementationEvaluating successScaling

    4. Post-game resources

    Idea intake form as an idea prioritisation worksheetTeam structure frameworkTeam structure worksheetWhen to engage teamsUsing the quadruple aim to establish eHealth valueSMART goals overviewSelecting a vendor guideVendor information intake formCyber-security knowledge neededNavigating digital medicine coding and paymentKey financial and legal documentsKey considerations for designing implementation workflowsClinical roles and responsibilitiesWhat if plans for patientsLessons learned worksheet.

    All four parts contain an eHealth investment process for healthcare organisations. In defining the steps, their next job is to assemble the information to support each decision.

  • AXA Health Tech & You Awards wants bids for consumer-driven health innovation and excellence

    Driving proactive consumer engagement in health and supporting innovation are to success of the AXA Health Tech & You Programme. The current award has two categories, innovation and excellence. Applications close on 15 February 2019.

    AXA, an international health insurer, has focused the 2019 awards on celebrating entrepreneurs who provide the most valuable, trusted innovations for consumers in the market. The innovation and excellence categories will be underpinned by core values embracing diversity, health equality, and social inclusion.

    It’s seeking two types of solutions. One’s standalone solutions that help citizens take charge of their health and wellbeing. The other’s smart applications that enrich relationships between people and their careers, whether health professionals, friends or family. 

    The results could offer Africa’s health systems transformation models for some of their health promotion and community services. It’s worth looking out for the results.

  • Servicio Extremeño de Salud and the MEDEA Project seeking bids to reduce adverse events

    Bids are needed for a precision medicine project. It’s part of Extremadura’s MEDEA project that combines genomics, scientific literature and patient data to optimise prescriptions, patient outcomes and clinical trial recruitment.

    Supported by Servicio Extremeño de Salud, applications should aims to build a clinical support decision system with three main objectives:

    Predict any drug adverse reactionsRecommend the most effective treatmentsIdentify the most suitable candidates for clinical trials.

    Five second-level objectives are:

    Predict drug efficacyRecommend dosagesIncorporate lifestyle choices and behavioursInclude genetic testing capabilities or a partnership with a genetic testing partnerTarget adverse events in psychiatry, cardiovascular diseases and cancer treatments.

    The brief specifies digital solutions with a Technology Readiness Level (TRL) < 6 are appropriate. They’re from conception to early development stages.

    The intention is to implement the project and solutions at regional level first. It’ll be extended to other healthcare systems at the national level later.

    Available finance for the project’s €5.4m. The Spanish government will allocate 70% to SMEs. Applications are needed by 31 December 2018.

    The resulting impact and solutions could provide a benchmark for Africa’s health systems. Encouraging local SMEs to contribute can be part of it.

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    Images from https://saludextremadura.ses.es

  • Research2Guidance publishes eHealth connectivity report

    Working within ecosystems is increasingly important for eHealth. Research2Guidance third report of its mHealth Economics 2017/2018 program deals with connectivity. It sees mobile apps as the core of eHealth connectivity hubs. These extend connectivity to wearables, tracking sensors, medical devices, tools, access to third party aggregated health data and EHRs.

    The report is an introduction to mHealth connectivity in mobile health. It discusses the connectivity landscape too. Contents are: 

    Tool usageConnecting to health data via APIsConnecting to sensors and wearablesConnecting to API aggregatorsConnecting to electronic health recordsOutlook on the future of connected devices. 

    These provide answers questions of:

    What eHealth connectivity options exist?To what extent are eHealth publishers connecting to sensors and wearables?Which tools are mHealth app developers using?Are mHealth app developers offering Application Programming Interfaces (API) for their apps?To what extent do they use aggregated health data through APIs?Which roles do EHRs play in eHealth?How will connectivity to sensors change in the near future?

    It’ll provide a wide range of stakeholders with insights needed for mHealth strategies, plans and initiatives. As Africa’s health systems keep building on their mHealth investments, the report is helpful in moving them on.

  • A roadmap for AI in healthcare can help set its trajectory

    It seems that AI’s popping up in lots of healthcare settings. It’s trajectory becoming a bit random? If it is, does it need a roadmap? An article available from xtelligence Healthcare Media says it does and describes several AI initiatives. It seems more a scan of AI’s horizon that how to reach it.

    Eduardo Galeano, the Uruguayan journalist and  writer, identified horizon’s dynamic that fits AI and eHealth. “Utopia is on the horizon. I move two steps closer; it moves two steps further away. I walk another ten steps and the horizon runs ten steps further away.” 

    AI in Healthcare’s perspectives and initiatives include: 

    Tapping the value of data at the right place, in real time; top questions for healthcare leadersWelcome to the age of intelligence: matching mind and machineHealthcare researchers using AI: don’t let data access derail clinical breakthroughsAn inside-out look at AI in outpatient radiologyChallenges in AI for radiologyWhen will AI be added to radiology training?Enterprise imaging infrastructureGreenlighting medical AI appsInside healthcare’s research revolution. 

    Two important roles for AI are seen as: 

    Personalised, precision medicineClinical research.

    These are already transforming healthcare. The potential and opportunities need health systems to implement effective strategies for 

    AI and eHealthHealth and healthcare transformation.

    AI reinforces the need for tight integration of eHealth strategies and health and healthcare strategies. It’s widely recognised as important. AI needs it strengthening. It’s a challenge for Africa’s health systems.

  • Using drones in healthcare supply chains is now proven

    Healthcare for Africa’s rural and remote communities is demanding. Supply chains can be long and time-consuming. Drones can help, and while they may have been a bit fanciful as an idea, they’re now proven. Two companies are doing it.

    Zipline, a global drone company, has a regular service in Rwanda. It delivers drugs and vaccines to remote communities. The steps to delivery are:

    Health workers use text message to the Zipline distribution centre to order the medical products they needItems are pack and prepared for flight in a few minutes, maintaining cold-chain and product integrityConfirmation to health workers that their order launchesDirect delivery at over 100 kmh, faster than other transport modes, delivered gently by parachute into a designated area the size of a few parking spaces, obviously with no pilot Health workers receive a text message notifying them that a delivery is completed.

    In April 2018, the UPS Foundation announced it was expanding its work with Gavi, the Vaccine Alliance and Ziplineto to use drones to deliver blood and medicines to Rwandas’ remote communities. Since October 2016, the partnership has made over 4,000 drone deliveries of over 7,000 units of blood to remote hospitals across the country. UPS says it’s the world’s first national medical drone delivery network, and is being developed throughout Rwanda.

    In Tanzania, an article in UAS Vision says DHL, a global delivery services, has completed a trial using Wingcopter to deliver medicines over 60 km in 40 minutes from Mwanza to Nansio district hospital on the island of Ukerewe in Lake Victoria. Over 160 proving flights were completed. It takes about six hours to deliver by road.

    Now, 400,000 people living in Ukerewe District now have healthcare access in hours, not days. Three other districts are served too, totalling over 10 million people. It follows the success of DHL’s test to ensure reliability of deliveries beyond line-of-sight and the return of the drone.

    These services show that drones should be a routine component of Africa’s healthcare supply chains. While remote services are current priorities, urban areas will benefit too as drone technology develops.

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    Image from dronebelow.com

  • WHO can help you keep up to date on global eHealth trends

    Awareness of eHealth achievements and dynamics from other users is crucial in framing eHealth strategies, investment decisions, benefits realisation and mitigating risk exposure. Finding the information’s often a challenge. A new publication from Johns Hopkins University Bloomberg School of Public Heath in collaboration with WHO can help.

    The first issue of Global Health: Science and Practice was supported by an Aetna Foundation grant. It deals with five themes:

    Establishing standards to evaluate eHealth’s impact on health systemsGovernanceFinancing UHC in low and middle income countriesWorkforceHealth service supply side and demand generation.

    These themes fit into WHO’s eHealth themes of information and research, governance, financing, workforce and health services. Africa’s health systems can use the findings to support the sustainability and direction of their eHealth trajectories.

    Within these, it’s important to avoid strategic mistakes identified by Rosabeth Kanter:

    Rejecting opportunities that initially seem too smallAssuming that new services and improved processes aren’t strategic goalsLaunching too many minor service changes the confuse stakeholders and increase internal complexity.

    These are some of her innovation traps. Africa’s health systems don’t need them.

  • Five strategies for your eHealth success in 2019

    Closing off 2018, I am struck by how much eHealth has grown up. It’s entering 2019 as a confident, enthusiastic adolescent, emerging almost abruptly from a precocious childhood. With eHealth’s latest pseudonym “digital health” gaining traction, it’s a timely herald of a viable, lucrative and sustainable digital health industry.

    If you are reading this, then securing a substantial piece of the expanding digital health pie is likely part of your organisation’s 2019 agenda. I’ve assembled five New Year’s resolutions to help:

    1.     There’s plenty to go around, and the spectrum of options is wide and growing, so find your niche and claim it

    2.     Take more time to identify and understand the needs and aspirations of your clients and stakeholders, then work with them closely to realise more health benefits

    3.     Use what you learn to develop a robust eHealth Impact Strategy that will provide a rudder for all your efforts through 2019 and beyond, locking onto core health benefits

    4.     Hire people who believe what you believe, then trust them and invest in them in line with your strategy

    5.    Find like-minded partners, growing your business through collaboration and cooperation, fulfilling your role as a unique member of the emerging global digital health community.

    Choosing one or more of these, and succeeding, will be enough to make a big difference.

    At African Centre for eHealth Excellence (Acfee) we have been monitoring the maturing eHealth landscape for more than a decade, examining the health-strengthening benefits, frustrated by the slowness of its arrival, and mindful that many critical foundation elements remained absent. Establishing the foundation more quickly has been a key focus of our work at Acfee, particularly:

    Developing eHealth leadershipBuilding eHealth capacityConstructing eHealth Strategies that create sustainable health impact.

    Now that progress is tangible, plenty of work remains to nurture and guide the fervent eHealth teenager, so Acfee’s focus on leadership, capacity and strategies will continue, expanding our efforts to meet demands. Priorities for 2019 include to:

    1.     Establish the eHealth Investment Model for Africa (eHIMA) and disseminate its use across African countries to assist Ministries of Health to take good decisions about their digital health investments.

    eHIMA is Acfee’s adaptation of the Digital Health Impact Framework (DHIF).  The DHIF is driven by the Asia eHealth Information Network (AeHIN) with support from the Asian Development Bank (ADB). Development of DHIF and eHIMA have been led by  Acfee’s Director of Strategy and Impact Tom Jones, providing a valuable bridge between Asian and African eHealth initiatives and challenges.

    2.     Expand eHealthAFRO, Acfee’s stakeholder engagement platform.

    We will build on the successes of eHealthAFRO 2017 in Johannesburg and the 2018 2nd EAC Regional eHealth and Telemedicine Ministerial Conference in Kigali, both covered in eHNA. eHA2019 will be in South Africa again. Keep an eye on eHNA for details to be confirmed later this month.

    3.     Grow Acfee’s existing capacity building initiatives:

    More support for academic programmes, such as:

    Rome Business School short courses on eHealth, including a DHIF short courseNew York University global public health master’s degree, which includes a collaboration with Acfee around a scholarship program to increase African participation Bespoke eHealth curriculum development for partnersAcfee’s eLearning and software development collaborations.

    More support for regional capacity building, such as the role I played alongside Acfee Director Ousmane Ly, and others, on the faculty of the first ITU/WHO AFRO Digital Health Workshop in Lesotho in November 2018.

    Re-launch of Acfee’s popular Future eHealth Leaders summer camps, to cultivate and advance the unique leadership skills and approaches needed for successful digital health.

    “Growing old is mandatory; growing up is optional” says 1960's Jamaican-American baseball player, Chili Davis. As eHealth moves into its teens, ensuring that we get it right will certainly be a collective effort. I look forward to working with each one of you, and all my African colleagues, to succeed in 2019. 

  • AeHIN says good eHealth governance methodology can transform health systems

    Information from eHealth investment’s reaches into many health and healthcare activities. Successful utilisation and benefits realisation needs effective governance.

    Asia eHealth Information Network (AeHIN), with support from the Asian Development Bank (ADB) and CC and C Solutions, an ICT training firm, has crafted a set of governance and architecture methodologies.  It aims to help health systems start the work needed to guide their eHealth projects at national scale.

    In a blog on Standards and Interoperability Lab Asia (SIL-Asia), Alvin Marcello says nine countries agreed to create the Health Information Governance and Architecture Framework (HIGAF). It’s based on a simplified Control Objectives for Information and Related Technologies 5 (COBIT 5) framework. 

    HIGAF helps developing countries address their health sector needs. It complements the Convergence Workshop for Ministry of Health national eHealth strategies. Many developing countries are accelerating their eHealth investment, but have yet to work out their governance approaches. 

    The governance initiative is part of a long-standing series of AeHIN initiatives that include: 

     WHO-ITU National eHealth Strategy Toolkit, introduced in 2012Training six countries in national eHealth strategy development in 2013Myanmar’s first Convergence Workshop to convene international NGOs, development partners, and the private sector in 2015 Guidance for Investing in Digital Health, 2018 Digital Health Impact Framework User Manual, 2018.

    AeHIN’s sustained focus and support is a collaborative model for Africa’s health systems. A challenge is the raising the finance to achieve.

  • SIL-Asia reports on the Digital Health Impact Framework (DHIF)

    Economic and financial evaluations of eHealth investment options rely on modelling. The Digital Health Impact Framework (DHIF) User Manual and Illustrative Models, help health systems to set up and develop them. The DHIF is a ten-step methodology developed by Tom Jones, Peter Drury, Philip Zuniga and Susann Roth, for the Asian Development Bank (ADB).

    A blog form the Standards and Interoperability Lab Asia (SIL-Asia) emphasises the value of using examples to help users. These appear in the manual and online models. The combination of techniques and examples are from six illustrative models:

    SMS for maternal and child healthmHealth for telemedicine for a current patient catchment areamHealth for telemedicine with an expanded catchment areasMalaria surveillance and interventionCapital and leasing finance for an EHRStrategic mix and choices.

    The six models are not templates. DHIF is a generic methodology, with every DHIF model being bespoke. 

    The approach is practical and rigorous and provides a valuable foundation for our efforts at Acfee to develop an eHealth Impact Model for Africa (eHIMA). Acfee colleagues like Tom Jones, who has been involved in many related international initiatives, provide a critical overarching perspective that will help to ensure that the various frameworks emerging are both appropriate to their regions of development, while following a sound, common conceptual methodology.

    Creating options is a DHIF core skill. The first four are single options for the initial stages of digital health projects. In practice, several options for each project are analysed in these early stages. The EHR example has two options and in practice would have more.

    The blog shows two dimensions for options. They’re vertical and horizontal:

     

     

    The vertical dimension is mainly incremental and thus, relatively easy to compile. Meanwhile, the horizontal dimension is more challenging. They have significant differences to options on the vertical dimension, and not incremental.

    An illustrative model on strategic mix and choices shows positive socio-economic returns but have considerable risk exposure and affordability challenges. The comparison can support agreements on decision criteria for eHealth investment. Examples are:

    Maximum patient impactLowest riskHighest socioeconomic benefitLowest cost.

    At the ADB workshop on 31 January 2018 in Bangkok, participants identified decision criteria they would use to select which of the six illustrative DHIF models they would retain in an affordable digital health strategy and why. Their ideas are set out in the DHIF User Manual.

    Modellers new to DHIF should start small. Rome Business School has a short online DHIF course. It’s in English, and coaches modellers using their own digital health projects.

  • Web sites need cyber-security too

    Malevolent hackers are smart. They know that many organisations’ websites are vulnerable to attacks. Akamai, a cloud security outfit, estimates that it costs attackers about US$40 to mount an attack, smaller than a peanut compared to the gains.

    Its infographic, Does my Enterprise Need  Web Application Security? is available from Health IT Security. It describes the threats and preventive measures. Most alarming’s its estimate that productivity losses of 98% arose from websites compromised in the last 12 months. About 86% have serious vulnerabilities. Most of the attacks are random, with robots searching for vulnerabilities.

    Akamai’s data shows the estimated range of attacks from Distributed Denial of Service (DDoS) activities were: 

    Human - 8%Servers - 30%IoT - 62%

     A solution’s a Web Application Firewall (WAF). About 40% of websites have between none and two. The 6% have more than three. Agamai’s estimate is that a WAF needs three Full Time Equivalent (FTE) staff. 

    Africa’s health systems need these types of cyber-security measures in place for their website plans. Without them, the disruption will degrade their benefits.

  • An eBook sets out six steps for clinical mHealth

    Clinical teams have increasing mHealth opportunities. mHealth strategies should provide the bases for decisions to use them. An eBook by Spectralink, a communications provider, available from Health IT Security, sets out six steps. The goal’s to invest in clinical smartphones for healthcare professionals to communicate, collaborate and co-ordinate patient care across wide arrays of teams and team members. 

    Six Steps to Developing a Successful Clinical Smartphone Strategy combines generic strategic concets, such as vision, with technical components. The six steps are:

    Define an overall vision for mHealth technology initiativesUnderstand information flows, application and technology requirementsEvaluate enterprise-class smartphone solutionsAssess ICT infrastructure and requirements, including Wi-FiImplement a proof of concept and pilot programmeAddress operational issues, including training and support requirements. 

    Creating successful clinical mHealth strategies need measured, forward-thinking. Improving patient care and outcomes, and accounting for future technology advancements  must be the focus. It should include people, processes and technology to maximise organisation’s benefits.

    The eBook extends from strategy to mHealth investment. Acfee would include a step for business cases to generate and compare options to identify and estimate:

    Strategic fitSocio- economic impact, including optionsManagement capacity to deliver and realise net benefitsFinance and affordabilityCommercial themes, such as contractual options.

    Completing this would be before and after step 5. Step 6 should also address benefits realisation issues. These lay foundations for M&E as step 7. 

    Africa’s health systems assign a high priority to mHealth. The eBook provides a process that they can adopt and ehance.

  • ADB eHealth guidance says look at the forest and the trees

    Managing and investing in eHealth’s seen as similar to forest management. Both are complex ecosystems. A Peter Drury blog from the Standards and Interoperability Lab – Asia (SIL-Asia) emphasises the large number of dynamically, interacting elements that where. Each element in the system may not know about the behaviour of the whole system. 

    Five-year strategic visions and plans help. The WHO/ITU National eHealth Strategy Toolkit provides guidance for these, but they’re not enough. Managing a complex sets of real-time elements is a greater challenge. It’s the core of Guidance for Investing in Digital Health, an Asian Development Bank initiative. 

     It’s based on how stakeholders engage, or don’t engage, with current systems, and how well, or not, they’re supported by management, technical, and workforce foundations. Investment appraisals and decisions spring from these,

    Instead of a five-year cycle, eHealth policy-makers should:

    Monitor progressAdapt to emerging challenges and opportunitiesManage expectations and investment. 

    The ADB’s Digital Health Impact Framework User Manual, linked to the Guidance, provides a methodology for these activities. It too is iterative, and addresses short and long-term requirements. 

    Pressure for quick wins doesn’t help. To counter this, the Asia eHealth Information Network (AeHIN) and SIL-Asia support work on Digital Health Governance Architecture and the Mind the GAPS programme covering governance, architecture, programme management, standards and Interoperability.

    While these are Asian initiatives, Africa can begin to adopt them. Using components that fit each countrys’ health systems is the way to start. It’ll set them on a trajectory of proven good practices.

  • Medical imaging’s the big gainer from AI and ML

    AI’s not new. It emerged in the 1960s. A blog from PLOS Speaking of Medicine says advertising hyperbole has led to scepticism and misunderstanding of what’s possible with machine learning (ML) and what’s not with. The blog sets about providing an accessible, scientifically and technologically accurate portrayal of ML’s current state in clinical translation.

    Medical imaging workflows are seen as benefiting most in the short-term. ML algorithms automatically processing two or three-dimensional scans to identify clinical signs of conditions, such as tumours and lesions, and determining likely diagnoses have been published. Some are progressing through regulatory steps toward the market. 

    Many use deep learning. It’s a form of ML based on layered representations of variables, ML’s neural networks. It’s benefited ophthalmology. A major UK eye hospital has used deep learning to deal with a clinically-heterogeneous set of three dimensional optical Coherence Tomography (CT) scans. Referral recommendations reached or exceeded experts’ decisions.

    Radiologic diagnoses are another ML beneficiary. An algorithm detected 14 clinically important pathologies from frontal-view chest radiographs. They included:

    PneumoniaPleural effusionPulmonary masses and nodules.

    ML’s performance matched practicing radiologists. Another 

    There’s several other clinical activities where ML can benefit healthcare. They include: 

    Triage and preventionClustering for discovery of disease sub-typesAnomaly detection to reduce medication errorsAugmented doctors.

    The blog’s an advance report. Its final version’ll be in PLOS Medicine at the end of December. It’s a valuable guide for Africa’s health systems’ eHealth strategies. An initial step’s to lay down data foundations.

  • Medopad aims for doctors’ and patients’ information to reach beyond healthcare

    Based in London, the Medopad mission’s to build solutions that provide the right information to patients and doctors when patients are beyond healthcare settings. It says this’s 95% of the time. 

    Activities that its data support includes:

    Better medical diagnosesEnhanced treatmentsExpanded professional knowledgeEmpowered publicFaster and better collaboration of medical teams.

    It claims its services are used by the “world’s leading healthcare providers.” 

    Medopad’s examples include four major London Hospitals: 

    Royal Free LondonGuy’s and St Thomas’Bart’s Chelsea and WestminsterHospital Corporation of America (HCA) a private healthcare provider.

    Its data range includes: 

    Medication trackingBlood glucose monitoringSP O2 logsWalk testsWeight measurementSymptom logsAfter care videosSupport groups.

    These are for four main conditions:

    Rare diseasesMetabolic diseasesCardiovascularCancers.

    Health insurers use Medopad to reward policyholders for healthy behaviour. Benefits include increased retention, lower risk and bespoke policies.

    Pharma’s a development project. Three goal are to use Medopad’s real-time data to develop more effective drugs, accelerate medication trials and to close the gap between suppliers and hospital.

    How long will it be for Medopad to be used across Africa? Does its emphasis on tertiary hospitals and rich countries’ health insurance mean that Africa’ll be towards the bottom of its priorities?

  • A study designs a model to manage eHealth evaluation

    eHealth evaluation isn’t a common activity. A study in the Journal of Medical Internet Research, says the importance of evidence hasn’t been discussed as rigorously as the diverse research approaches and evaluation frameworks have been discussed.

    From this position, the team’s objective was to elucidate how evidence of eHealth effectiveness and efficiency can be generated through evaluation. It developed a model to help. Evidence in eHealth Evaluation comprises:

     

    It aims to show how evidence can be generated by evaluating certain aspects at each intervention phase. Assessing distinct aspects during distinct phases is a novel concept discussed in this study and requires further analysis.

    It’s consistent with Digital Health Impact Framework (DHIF) designed for the Asian Development Bank (ADB) and Standards and Interoperability Lab Asia (SIL-Asia). It also has some differences. DHIF. For example, DHIF includes optimism bias and risk exposure, and emphasises the different impacts, especially benefits, across a range of stakeholder types.

    The study implies an inconsistency between literary eHealth evaluation concepts and practices. It

    found that eHealth evaluation isn’t common in design and pretesting phases. Acfee’s view’s that it isn’t common before these, at the strategic and business case decisions stages that seek preferred options that commissions designs. It’s also rarely used at eHealth procurement stages. 

    It seems feasible to stretch Evidence in eHealth Evaluation model to include eHealth components on a wider timescale. Adding extra components within its timeline seems possible too. It is a conceptual model in its preliminary stages, so still being developed. It’s not a prescription, but a way to show a reliable progression of evidence in eHealth intervention. Africa’s health systems could build from it too.

  • Babylon’s AI is embedded in Rwanda’s primary care, and other countries

    Succeeding with UHC depends on extra healthcare resources. It depends on efficient and effective use of resources too. eHealth’s part of the solution. 

    Babylon Health uses AI to improve access to primary care. It’s planning to expand into chronic care. In England, it’s restricted geographically to London.  Regulations seem to prevent Babylon’s AI from providing diagnoses. Instead, it provides health information.  This could change as hard evidence becomes available.

    A review, reported in Digital Health, says Babylon’s AI claims lack convincing evidence. Babylon Health doesn’t agree. A report claims its AI beat human doctors’ average score of 72% in a range of 64% to 94%. Babylon scored 81% in a Royal College of General Practitioners (RCGP) exam using a representative sample of questions from the final assessment for GPs in training. The results have not been peer-reviewed.

    In Rwanda, it’s called Babyl. It uses AI to provide:

    Consultations with doctors and nursesLab testsPrescriptionsReferrals.

    It’s a core UHC component for the country. Where access isn’t feasible with conventional healthcare, Babyl seems crucial in meeting health and healthcare needs.

    Babylon’s AI uses machine learning created by a team of research scientists, engineers, doctors and epidemiologists. They have access to large data volumes from the medical community. Learning’s continuous through feedback from Babylon’s experts.

    It comprises: 

    A knowledge graphA user graphAn inference engineNatural Language Processing (NLP). 

    It seems like a solution for all Africa. On its own, it may not be enough. Increasing referrals may need investment in extra healthcare capacity.

  • Nigeria uses mHealth to improve blood donations

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

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

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

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

    LifeBank’s resources include: 

    AIBlockchainCold chainmHealthMotorbikes.

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

     Supporters include:

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

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

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

  • AeHIN sets up its Community of Interoperable Labs (COIL)

    Six countries’ health systems have formed the Asia eHealth Information Network (AeHIN) Community of Interoperable Labs (COIL). The Standards and Interoperability Lab-Asia (SIL-Asia) is guiding the initiative. Viet Nam, Malaysia, Thailand, Philippines, Indonesia, and Taiwan commitment to interoperable health systems at the 6th Asia eHealth Information Network (AeHIN) General Meeting and Conference on Interoperability for Universal Healthcare Coverage (UHC).

     

    A blog by SIL-Asia says the Regional Interoperability Workshop organised by the AeHIN at the the Global Health Research Forum in August 2015 was the genesis. SIL-Asia was set up as a regional health interoperability lab to meet the needs of Asian countries for a facility to benchmark emerging digital health technologies in the market. The benchmarking criteria are common international standards for interoperability or systems to exchange usable data and information.

     

    COIL is a community of Asian countries committed to establishing their own interoperability labs (IOL). These will focus on digital health interoperability and facilitate national health data and information exchange to support evidence-based healthcare.

     

    It’s a knowledge sharing community too. Each country is expected to share their lab technologies, artifacts and documents with one another to promote inter-country co-operation on standards and interoperability.

     

    Other countries can join COIL too. Teaming with SIL-Asia is the way in.

     

    SIL-Asia and COIL are models that can benefit Africa’s health systems and their eHealth initiatives. Which entities will provide the sustainable finance needed.  

  • Zanzibar’s eHealth aims to connect its 24 hospitals

    Zanzibar, a semi-autonomous Tanzian region in the Indian Ocean, has successfully installed a national ICT programme. It’s the backbone of social services digitisation. A report in IPP Media says it’ll provide broadband to its citizens across the archipelago and connect all 24 hospitals in region. 

    The government has set up a data centre to house medical information. It supports the eHealth objective of improving delivery of a range of social services.

    It also provides a platform to develop eHealth programmes to:

    Share patient informationRemote interpretation of test resultsRemote diagnosis.

    The plan’s to use the expanded connectivity to improve healthcare and social services quality. There’s a more sophisticated objective too. It’s to stimulate economic growth by unlocking entrepreneurial potential. This can create exponential eHealth investment trajectory that all Africa’s health systems could replicate.