• Articles (2,438)
  • Have your say on WHO’s draft Global Strategy on Digital Health
    April 2019 has been a busy month for global digital health, with two key announcements by the World Health Organization (WHO). One is the call for comments on the draft Global Strategy on Digital Health. It is the first strategy of its kind for digital health and an opportunity not to be missed. WHO invites consultation from all stakeholders in the digital health arena on a strategy aiming to help focus our efforts on digital health that achieves maximum impact. It identifies four strategic objectives: Work togetherHelp to accelerate the digital health agenda in countriesAddress global issuesSet the future direction for innovation and research.

    The period for commenting closes 30 April 2019, 00:00 CEST. Inputs can be provided via a web-based accessible here or you can email WHO for more information.

    A second pivotal event was last week’s publication of the WHO Guideline: Recommendations on Digital Interventions for Health Systems Strengthening, a much anticipated and important milestone in digital health’s journey to maturity and health systems impact. It has emerged out of a group that developed guidelines on digital health interventions for RMNCAH and health systems strengthening. 

    As we invest in our African National Digital Health Strategies and implementation plans, global publications like these are timely and helpful. eHNA will unpack the contents and their implications for our African digital health initiatives over the next few weeks.

  • WHO launches digital health guideline, Wednesday 17 April

    Figuring out how to use digital health for health systems strengthening is an important task. Now World Health Organization (WHO) has a guideline document to help, launching 14:00 CEST, Wednesday 17 April 2019. Join the live stream here to be part of the launch and gain access to the guideline.

    The title is WHO Guideline Recommendations on Digital Health Interventions for Health Systems Strengthening. This is the first WHO guideline on Digital Health Interventions. It provides evidence-based recommendations for ten ways that countries can use digital health to improve health services.

    eHNA will have more news on what the guideline contains and how we can use it productively for our African initiatives, after the launch.

  • Competitive telemedicine platform to help achieve UHC

    AfriDOKTA is passionate about transforming the delivery of healthcare in Africa through people, processes and technology. They have developed a telemedicine mHealth platform dedicated to Sustainable Development Goal 3, “Ensuring healthy lives and promoting well-being for all at all ages”. Anyone with a smart phone or internet access can easily download the AfriDOKTA app and would have immediate access to quality outpatient care.

    The Kenyan government is the first African country that has supported the roll-out of AfriDOKTA as part of a nationwide campaign towards universal healthcare. The roll out is supported at the community level by community health workers (CHWs) that train users on how to access health services using the AfriDOKTA app. Users can easily create a personal profile and an electronic medical record to store details of consultations received. The app also gives users referrals to vetted pharmacies and labs with certified medical professionals. 

    A unique design feature of the AfriDOKTA app is that it complies with international data security standards and adheres to the US-based Health Insurance Portability and Accountability Act (HIPAA). The architecture also applies Health Level 7 (HL7), SNOMED, and DICOM standards. These are international principles used for the transfer of clinical data between various software and electronic applications.

    AfriDOKTA's use of international standards for storing, accessing, and processing medical images and related information, their plans for strategic collaboration and relevant product benefits make it a strong competitive differentiator in the market. This solid technical foundation should position the platform to support our Universal Health Coverage (UHC) aspirations too.

  • IoT “in the wild” may help us manage stress better

    In his TEDx talk, Pablo Peredes makes a case for using the Internet of Things (IoT) to help humans manage stress. He points out that to be stress free, humans need more outdoor activity than our modern lives allow, and suggests that our “new” natural environment of homes, offices and cars can be more intuitive and responsive to support what we need. In his talk, he uses a book to explain our current stress-increasing predicament.

    Why Zebras don’t get ulcers is a book by biologist Robert M. Sapolsky. Sapolsky explains that for animals such as zebras, stress is typically episodic, such as when avoiding being eaten by a lion, and this stress is well managed by abundant opportunities for the free Zebra to engage in stress-relieving activities rambling around the savanna. In contrast, modern human stress is often chronic, such as worrying about losing a good job or how to survive a stressful one, and our natural environment is no longer the ubiquitous outdoors, but confined to homes, offices and cars, which offer too few opportunities for natural stress relief.

    Since we are unlikely to abandon our homes, offices and cars, Peredes suggests that IoT can help repurpose common household objects to make these devices able to help us manage our health better, transforming our homes, cars and workplaces into environments that identify and manage our stress. He suggests starting existing devices, avoiding the costs of adding new sensors. By collecting and analysing data from things we touch, such as a PC mouse, or a steering wheel in a car, Peredes says we can identify stress and do something about it.

    Peredes describes two reasons for people not managing stress: lack of willpower and lack of time. He suggests that we use the time available during our commute from home to office to diagnose stress levels and improve our stress management, such as making car seats talk us through breathing exercises, office chairs remind us to stand when we’ve been sitting too long, and adding imperceptible screen colour changes to adjust our breathing and heartrates.

    Peredes believes that the everyday devices around us should help us to manage stress. He calls it “stress management IOT in the wild” and invites us to share new design ideas via email.

    Many of our African homes are still connected to the natural environment, providing ample opportunities to blow off steam. Nevertheless, in Africa people are urbanising rapidly too, and it is reassuring to know that people like Peredes are thinking about how to make our modern environments more supportive. I look forward to writing more eHNA pieces about his IoT adventuring in the wild. 

  • Successful eHealth needs better business models

    eHealth is a complex business type, integrating many stakeholders acting across interwoven networks. Yet the characteristics of successful business models remain understudied.

    Despite the promise of eHealth to overcome healthcare access challenges, reduce costs and improve quality , successful implementation is low, especially in developing countries.  In fact, over 50% of eHealth businesses find it difficult to sustain their implementations sustainably beyond the pilot phase. I have been investigating these dynamics and will be sharing them over the next few weeks in a series of eHNA pieces.

    Recurring challenges of eHealth include;

    Financial institutions unwillingness to fund eHealth start-upsHigh start-up costs and ongoing maintenance costsRegulatory legislation that lags behind technology developmentResistance from end-users to adopt new innovationseHealth technologies lack user experience designPoor scalability of eHealth technologies after their pilot phasePoor ICT infrastructure in the environmentLack of leadership and political supportLack of research.

    To overcome these challenges, change is required in both the micro and macro eHealth environment. I’ll be sharing ideas on what changes are needed in my next piece.

  • A Whole-of-Government approach to investing in digital technologies to achieve the SDGs

    What do school children, farm animals and patients have in common? Well, rather a lot, according to the International Telecommunications Union (ITU) and some of its partners. Especially when it comes to investing in Information Communication Technology (ICT) to advance progress towards Sustainable Development Goals (SDGs).

    The SDG Digital Investment Framework calls for countries to take a whole-of-government approach to investing in digital technology. The paper shows how to “identify which technologies matter most to achieve the SDGs.” The approach was developed by teams from ITU and the Digital Impact Alliance (DIAL).

    Its theory of change is shown in the figure below, extracted from the ITU document. It is about a small set of common ICT building blocks helping countries to deliver many high-impact use cases that support progress towards SDGs.

     

    Figure: SDG Digital Investment Framework theory of change.

    The paper provides an approach for countries to identify reusable ICT building blocks across sectors, particularly education, health and agriculture, and calls on governments and the private sector to work together to fund these shared foundation elements. The list of candidate ICT building blocks is extensive, including:

    Analytics and Business Intelligence ServicesArtificial Intelligence ServicesClient Case Management ServicesCollaboration Management ServicesConsent Management ServicesContent Management ServicesData Collection ServicesDigital RegistrieseMarketplace Services Mobility Management Services Geographical Information Services Identification and Authentication Services Information Mediator Services Messaging Services Payment Services Reporting and Dashboard Services Scheduling ServicesSecurity Services Shared Data Repositories Terminology Services Workflow and Algorithm Services.

    It’s a bold approach that resonates with other initiatives underway in African countries, and across African regions. eHNA looks forward to reporting on further developments.

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    Image from the SDG Digital Investment Framework report.

  • An ITU/WHO “how to” guide for building interoperable digital health infrastructure

    As we strengthen African national eHealth strategies, interoperability is gathering momentum too. It's a critical component of our national eHealth programmes. We are looking for a common, comprehensive framework, incorporating all data sources and information flows, both electronic and paper-based, providing a clear development and consolidation path for all components, along a digital development maturity model.

    Fortunately, there’s a handbook about how to do it: Digital Health Platform: Building a Digital Information Infrastructure (Infostructure) for Health, published by the International Telecommunications Union (ITU) in collaboration with the World Health Organization.

    The figure below provides a high level overview of the Digital Health Platform (DHP) concept, its components, and how users interact with it. 

    Figure: How a DHP interacts with external applications and users

    The handbook suggests that a well-designed DHP will help countries to achieve the following priorities:

    Overall quality and continuity of careAdherence to clinical guidelines and best practicesEfficiency and affordability of services and health commodities, by reducing duplication of effort and ensuring effective use of time and resources Health-financing models and processesRegulation, oversight, and patient safety resulting from increased availability of performance data and reductions in errorsHealth policy-making and resource allocation based on better quality data.

    The DHP Handbook illustrates how DHP components are derived from the National eHealth Strategy. It is a detailed guide including illustrative case studies from Liberia, Estonia, Canada, India and Norway. It’s essential reading for African countries’ as we invest in our national eHealth programmes.

  • African countries setup Country Health Situation Rooms for better health monitoring

    Two weeks ago, I was fortunate to participate in a workshop in Ethiopia hosted by the African Union, Africa CDC and UNAIDS.  The workshop aimed at strengthening the Country Health Situation Room initiative and roll-out across African countries.  Its goal is to support better use of health data and help countries keep populations healthier by improving their response to infectious diseases and epidemics.  

    Kenya was the first African country to adopt the Situation Room in 2015.  A further six countries – Cote d’Ivore, Lesotho, Namibia, Zambia, Uganda and Zimbabwe – have launched their Situation Rooms and are currently at different stages of scale-up and roll-out. 

    The Situation Room software integrates health data from multiple sources such as the DHIS2 and logistics management information systems (LMIS) at a country level.  Data are presented visually to help countries track progress and identify gaps in key health indicators.  The customisable interface allows countries to design their Situation Room around their health areas of interest and user types. 

    Matthew Greenall’s case study on the Country Health Situation Rooms describes the progress so far. Achievements include; 

    Enhanced collaboration between different health programmesImprovements in health decision makingImprovements in data qualityIncreased data use for decision makingImproved data sharing between stakeholders at national and regional levels

    Important challenges are also identified, such as;

    High turnover of staff and leadership compromised progressOperational and budgeting constraints interrupted roll-out in some countriesPoor quality of data at sub-national levelsOwnership – a strong desire for countries to host the software themselvesMaintenance of the Situation Room software requires strong technical support

    The Health Situation Room is a bold step for the participating African countries. We look forward to reporting the progress of this important eHealth contribution to health systems strengthening.  

  • International SOS Foundation releases a teleconsultation guide

    The Medical Dictionary describes two types of teleconsultation. One is between doctors. The other’s between doctors and patients. It refers to networks and video links. Smartphone services such as Figure 1 is an example of a more modern version. It includes nurses too.

    Help in setting up and managing teleconsultation is available from the the International SOS Foundation. It’s launched a white paper on the topic, endorsed by the International Society for Telemedicine & eHealth (ISfTeH).

    Teleconsultation Services for the Mobile Workforce; Considerations & Guidelines for the Provision of Global Services in Compliance with Regulations & Best Practice Clinical Standards of Care provides insights into essential aspects needed to assess teleconsultation services. They include:

    Country level review of legal requirementsGuidelines on clinical best practices, including local healthcare environment, clinical expertise of disease threats at patients’ locations and integration into the local healthcare systemsCase studies for corporate and educational sectorsGlobal best practices for assessing teleconsultation services.

    It can help Africa’s health systems to develop their telemedicine services towards broader teleconsultation services. Modern mHealth technology offers considerable opportunities.

  • ISfTeH’s next annual meeting’s in Portugal

    On 19 to 20 March 2019, the International Society for Telemedicine & eHealth (ISfTeH) conference will be underway in Lisbon, Portugal. Partners include the annual Portugal eHealth Summit which’s co-organised by ISfTeH’s institutional member, Centro Nacional TeleSaúde, part of the Shared Services of the Portuguese Ministry of Health (SPMS). The Portugal eHealth Summit is the largest eHealth event in Europe, bringing together some 10,000 stakeholders from the Portuguese National Health Service.

    It’s ISfTeH’s 24th International Conference. The range of topics is huge. They include:

    Technology to:

    o   Monitor  vital signs for long term conditions

    o   Health management of service users with severe mental illness

    o   Facilitating integrated care in wider communities

    Global Digital Health Index’s state of global digital health Telemedicine’s potential for UHC in Portuguese-speaking CountriesInjecting the human side of telemedicine and eHealthEconomic evaluation of an new guideline of an online clinic in Japan Considerations and guidelines for global teleconsultationPhysicians' experiences, attitudes and challenges in a paediatric telemedicine serviceAlgorithms for predictive medicine AI for healthcare professionals Big Data and tele-ECG eHealth data protection with GDPREffective digital tools for everyday practicePortugal’s experience of telehomecare and telemonitoringPutting IoT to work for caregiversIs technology the solution for chronic disease management?Tele-ECG network in Southern BrazilAI and telemedicine for heart failure diagnostic supportPractice guidelines for primary and urgent careCan telemedicine reflect healthcare system investment Needs?

    Details of the event will be available soon.

  • AMA has a structure for choosing EHR providers

    Procurement sits between EHR strategy and implementation. It’s a challenging process and needs a rigorous structure to assess providers and choose a few to move on to a procurement short list, The American Medical Association (AMA) has a checklist that helps to find a vendor worthy of a long-term partnership. It’s step 4 in the Part 2, the Pre-Game section of the American Medical Association® Digital Health Implementation Playbook.

    Selecting and Vendor Guide aims to find a long-term partner, not just an organisation to execute a set of transactions. Speaking with similar organisations or practices can provide valuable information and insights needed to construct shortlists of quality vendors. eHealth conferences can be another source.

    Discussions are not enough. Structured market research and activity’s needed too. AMA suggests: 

    Build a Request for Proposal (RFP) that clearly outlines the goals that define successSend RFPs to vendors that most closely align to these goals Review RFP responses alongside key representatives from core and advisory teamsAsk for case studies and referrals Schedule live vendor demonstrations with members of the core, advisory and implementation teamsEvaluate vendors across six critical factors:

    o   Business

    o   ICT

    o   Security

    o   Usability

    o   Customer service

    o   Efficacy and clinical validation

    Narrow options to one or two preferred vendors in the pitch to leadership.

    Usability includes interoperability. Efficacy includes the vendors’ abilities to deliver organisational goals, metrics and Key Performance Indicators (KPI). For large-scale, strategic investment lick EHRs, three options may be more appropriate in revealing the differences between vendors’ technical services and cultures that are available. 

    AMA’s playbook can help Africa’s health systems to enhance the structure and sustainability of moving their EHR projects from investment decisions towards implementation. Procurement’s tough. Vendors are smart and used to the processes. AMA’s guidance helps to rebalance them.

  • An approach to regulating medical devices from the US FDA's now out

    Effective regulation’s a vital part of setting and maintaining high standards. In an article in Frontiers in Medicine, Tina Morrison and her colleagues describe an approach by the US Food and Drug Administration (FDA). Its Center for Devices and Radiological Health (CDRH) regulates medical devices, and emphases regulatory science with computational modelling for medical devices.

    Computational modelling is an increasingly powerful evaluation and regulatory tool for medical devices. Dealing with merging technologies resulting in novel products is one of the FDAs challenges. Using computational modelling can transform medical device design and evaluation. It can simulate treatment outcomes and clinical trials for imaging systems.

    The simplest and most common use of computational modelling for medical devices is simulating their performance under a variety of conditions that mimic aspects of clinical or use environments.  

    The primary use is for regulatory submissions is identifying appropriate bench testing configurations, such as worst-case or clinically challenging conditions, for cardiovascular, orthopaedic, and surgical implants. Its second common use is to provide evidence that supports safety assessments of patients with and without implanted devices when they’re exposed to radiofrequency (RF) fields of MR systems.

    Continuous development is underway too. A CDRH team is developing and validating a framework for streamlining the market entry of imaging systems relying solely on simulation instead of clinical trials.

    Using the approach to the increasing range of mHealth and wearables could close the knowledge gap. Directing users, especially clinical professionals to devices that do what the claim to do will be a huge step forward for Africa’s mHealth initiatives.

  • A playbook to help successful eHealth investment's 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 its 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.