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  • Will AI and Blockchain converge to enhance health analytics?

    While AI and Blockchain are seen by some to offer powerful tools, a view’s emerging that combining them offers significantly more potential for Big Data and health analytics. Or, is it just another dose of eHealth hype? An article in Health IT Analytics  says in the US, AI and Blockchain are now tools of choice for developers, providers and payers in improving their eHealth infrastructure.

    But, it acknowledges that both are near their hype curves peaks. Some providers and payers are reluctant to invest heavily at their maturity stages. Concerns over security, utility and Return on Investment (ROI) are justifications for some organisations to defer investment, leaving others to provide evidence that combining AI and Blockchain can succeed in secure the large data sets and exchanges that Big Data needs for innovative analytics.

    Access to data’s one obstacle. Most data resources are held securely and privately by several institutions. Opening them can create cybersecurity vulnerabilities. Despite this, ideas are fermenting of using Blockchain to produce metadata about the datasets available at several organisations. It can also provide secure, peer-to-peer data exchange. Blockchain can be a pointer to where full data sets are stored, allowing for discoverability without requiring data sets to move each time a transactions completed.

    This strategy enables organisations to keep sensitive data, such as Protected Health Information (PHI) and Personally Identifiable Information (PII) off Blockchain. It’ll reduce risks of breaches. Instead, minimal but sufficient data should be held in Blockchain.

    These comprise complex decisions and projects. It seems premature for Africa’s health systems to pursue combined AI and Blockchain strategies in the medium term. There are other eHealth priorities to address, such as using mHealth to support remote health workers with access to test results and improving their co-ordination with colleagues.

    If the AI and Blockchain are converging in healthcare, Africa’s health systems can watch trajectories and learn from them. If they deliver a significant proportion of their potential, a challenge for Africa’s health systems may be to avoid a sudden disruption to their eHealth strategies and plans. While this can be costly, missing new eHealth opportunities has a cost too, often of missed benefits. 

  • Patients rely on health information on the Internet

    Trusting doctors is a crucial requirement of successful healthcare. The Internet has added a variable into the relationship between patients and their doctors compared to the traditional set up. An empirical study by a team from China and the US in the Journal of Medical Internet Research (JMIR) investigated the effects of the quality and source of Internet health information on patient compliance. It relied on social information processing and social exchange theories.

    Relationship Between Internet Health Information and Patient Compliance Based on Trust: Empirical Study found that the quality and source of health information from the Internet affects patients’ compliance through the mediation of Cognition-based trust (CBT) and Affect-based Trust (ABT).

    Consequently, patients’ compliance can be improved by strengthening the quality of health information management on the Internet. It also suggested that doctors should obtain health information from health websites to expand their understanding of patients’ knowledge of their conditions and their compliance with their treatment regimes.

    More specifically, the mutual demonstration of care and respect in physicians’ and patients’ communication’s important in promoting patients’ ABT in their physicians. CBT doesn’t have any direct effect on patients’ compliance, but directly affects ABT, then indirectly impacts patient compliance.

    For Africa’s health systems, the study emphasises the need to invest in high quality, accurate, sustained Internet health information. Setting up the service with minimal operational resources may be unhelpful and disruptive.

  • Will a new tech-giant coalition on interoperability move Africa’s eHealth on?

    Coalitions mean co-operation and joint action towards a common cause. They’re usually for the each participants own self-interest. The latest initiative in eHealth’s sphere should offer considerable benefits to health and healthcare organisations.

    A report in Healthcare IT News says a broad coalition of technology giants emerged in an unscheduled session at the Blue Button 2.0 Developer Conference on 13 August at the White House.  Amazon, Google, IBM, Microsoft, Oracle and Salesforce joined forces to set about removing interoperability barriers.

    The US Information Technology Industry Council lead the session, Its CEO described the initiative as a commitment to eliminate friction in healthcare systems. The solutions will affect cloud computing and architecture, moving towards open standards through Fast Healthcare Interoperability Resources (FHIR) and the Argonaut Project.

    While details seem limited, an indication of the coalitions trajectory includes: 

    Supporting healthcare as it shifts to the cloudMaking AI more availableEnabling connected careBetter access for patients to their dataFlexibility to use products and services across different systems to work seamlessly for their care. 

    While it’s obviously aimed at the US healthcare market, the outcome of the coalition should have significant implications for Africa’s health systems’ eHealth strategies, investment options and procurement. As the coalition improves interoperability, it should open up expanded and new eHealth benefits, including opportunities to enhance and transform health and healthcare.

  • AI passes a stiff test at London’s Moorfields Eye Hospital

    England’s Grand National run at Aintree is gruelling. It has 30 fences, two with open ditches, in a distance of 2.25 miles that’s completed twice. AI has just moved up the field in the eHealth equivalent. 

    An AI project at London’s Moorfields Eye Hospital with Google’s DeepMind has accurately diagnosed eye conditions from scans. As ophthalmologists’ workloads and their complexities increase, diagnostic imaging is expanding faster than specialists can interpret the results. AI already has a constructive reputation in classifying two-dimensional photographs of some common diseases it’s reached the performance of expert clinicians in a real-world clinical pathway with three-dimensional diagnostic scans. 

    At Moorfields, a novel, deep learning architecture is now applied to a clinically heterogeneous set of three-dimensional optical coherence tomography scans from patients. The research found that after training on 14,884 scans, AI’s referral recommendations of sight-threatening retinal diseases reached, and sometimes exceeded that of experts. 

    Other benefits include:

    Tissue segmentations produced by the architecture are device-independent representationsReferral accuracy’s maintained when using tissue segmentations from a different devicePrevious barriers to wider clinical use without prohibitive training data requirements across several pathologies have been removed.

    After training, the algorithm assigned diagnoses to 1,000 patients’ scans whose clinical outcomes were already known. The same scans were shown to eight clinicians. Four were leading ophthalmologists, four were optometrists. They classified the diagnoses into four referral types,  urgent, semi-urgent, routine and observation. AI performed as well as two of the world's leading retina specialists. The error rate was 5.5%. More strikingly within this performance, the algorithm didn’t miss any urgent cases.

    The impact of the project’s global. For Africa’s health systems, the challenge’s entering the AI Grand National and making sure they don’t fall at any of the daunting fences. It offers an eHealth strategic scenario that extends what is now relatively conventional EHRs and mHealth. AI can extract more value from them than originally imagined.

  • Argentina’s health system aims to balance information needs and privacy

    Balancing competing claims in health systems never ends. Simon Sinek, an author, says “There’s no decision that we can make that doesn’t come with some sort of sacrifice or balance.”  So it is with eHealth. In an interview in eHealth Reporter Latin America, Dr Alejandro López Osornio, director of Information Systems in Argentina’s Ministry of Health says “The challenge is to balance the need to share information while respecting privacy and autonomy of people who generate it.” 

    There’s been progress, and more to do. The next steps are in the National Digital Health Strategy, The goal’s to consider both patients’ rights to share information only with their healthcare professionals and simultaneously respect provinces’ and private institutions’ autonomy to develop their information systems and share data with other authorised users and organisations when necessary.

    Argentina invested in a minimum national infrastructure that integrates and connects all the countries current projects. Anyone working with health information system in different jurisdictions can communicate centrally and automatically with all other authorized participants.

    There are several outcomes. Everyone speaks the same information language and shares the same type of information safely and privately. Healthcare quality’s improved. Patient empowerment’s the core component of strategy and planning.

    Patients can use smartphone apps to record dietary information and their exercise activities. It’s expected that app providers will soon help patients to understand their clinical and health data better. Examples are their cholesterol trends and comparing their weight. This information can help them make important health and life-style decisions.

    Argentina modelled its eHealth strategy on Canada’s It reflects its federal institutions and independent provinces. Local eHealth fine-tuning’s still needed. Human eHealth capacity’s a critical difference between the countries. One Hundred Leaders was Argentina’s strategic response. It plans to train one hundred computer scientists or doctors in this field, four for each province. The National Digital Health Strategy provides for scholarships for a postgraduate course of four to six months, mostly online, to provide local specialists and avoid medical staff having to the Ministry of Health in Buenos Aires for advice. This’s an initiative relevant for Africa’s eHealth strategies.

    The next strategic phase’s being developed. A scenario is to enhance eHealth regulation and integrate different strands, such as digital signatures, electronic documents and privacy and security of documents, into a single law. Existing personal data protection and digital signature laws can be extended to health and its EMR repositories. A general digital health law is an option.

    Argentina’s rapid progress and future strategy offers a constructive comparator for Africa’s health systems. Both technology and human eHealth capacity are moving ahead together. While it’s challenging, it’s essential to maximise eHealth’s benefits.

  • Can Africa’s eHealth avoid human burnout?

    As countries’ health systems move towards Universal Health Coverage (UHC), a challenge is to afford a new and optimum and sustained balance of resources to meet the increased demand. It includes a mix of extra health workers, more and better eHealth, and resultant gains in quality, access and efficiency. It’s an extremely demanding, integrated strategy.

    It’s also starting from a modest base. Africa’s eHealth investment needs boosting significantly and recruiting and retaining extra health workers is a long-term challenge. A report from Athena Insight shows its starting point may have even more constraints.

    In The business case for physician capability, US doctors’ burn out is identified as “48% of physicians think they’ll have trouble maintaining their workload over the long term.” The equivalent in Africa’s health systems for all health workers doesn’t offer an effective platform for the sustained engagement needed to expand eHealth for UHC. The time needed away from clinical activities will exacerbate burn out.

    On these findings, it’s important to include in eHealth programmes initiatives to fix burn out. Better capability reduces burn out from about to 51% to 27%. It includes skills and organisational changes. Jessica Sweeney-Platt, the report author, says “In an organization that emphasizes capability, team members have clearly defined roles and responsibilities. Leaders listen to the frontline and prioritize training, communication, and alignment. Innovation is prized and rewarded — especially innovation that results in fewer administrative tasks performed by physicians and other providers.”

    While the report doesn’t offer the business case one would expect from its title, it sets out some essential themes for organisational development that successful eHealth depends on. 

  • Japan extends healthcare to the home

    Welby My Karute is an innovative app developed by Welby Inc, a Tokyo based IT company to support the management of healthcare. The use of such apps for monitoring patient's lifestyles and chronic diseases is a growing trend in Japan.  Medical institutions using this app rely on the information provided to improve treatment and care and reduce the incidence of healthcare visits.  

    The aim of this app is to encourage patients to keep a record of their lifestyle at home, which is then shared with dieticians, doctors and other medical workers. This serves as a “watcher” as it keeps an eye on the patient without them seeing a doctor. Data such as meal choices, blood pressure, pulse, sleep patterns and whether they take drugs appropriately can be shared with computers at the hospital to inform patient management and disease monitoring. 

    Patients have stated that the app makes it convenient for them as they tend to miss hospital checkups due to having other commitments such as work.  This provides a useful use case for Africa, where patients struggle with similar challenges.  Coupling this app with suitable patient incentives can help patients and clinicians shift healthcare away from being reactive, but rather proactive and preventative.

  • mHealth can improve communication and teamwork

    Good football teams talk constantly during a game to ensure high levels of concentration and performance needed for success are sustained. Effective healthcare teams need to do the equivalent. Anmed Health Medical Center, a 461-bed acute care hospital in Anderson, South Carolina, uses mHealth to achieve effective communications and alerts for hospital teams.

    In 2015, it started to integrate its phone system, nurse call system, patient monitoring alerts, secure texting and EPIC into a unified mHealth service. Other providers, including Philips Healthcare, Voalte and Connexall, are included too. The goal was to bring stakeholders together to improve and streamline connectivity, coordination and clinical workflows. Choosing the right phone was essential for success.  PIVOT smartphones from Spectralink were selected.

    The company has described the initiative in a case study. It has several lessons for Africa’s mHealth strategies. A major benefit’s the capacity to connect quickly with the most appropriate available people as different needs arise. Direct and effective messaging has increased response times, helping to provide more effective and personalised patient care.

    While Africa’s mHealth has priorities for remote communities and healthcare workers, hospital teams need mHealth too. A challenge’s to find an appropriate investment balance within constrained resources.

     

  • Managing and mapping EHRs after implementation's essential

    While EHRs may be a solution, implementing them’s not enough. They need managing effectively to sustain their benefits. A white paper from ServiceNow describes a way to do it.

    Because EHRs are complicated, mission-critical and support high quality patient outcomes, visibility of their reach into all healthcare’s parts enables effective and efficient EHR management. Service visibility: A road map for IT Operations and managing your EHR system says healthcare ICT teams need an EHR  map that shows its infrastructure and the services that rely on it. A service-level view’s needed to. This should show how EHR modules, features and hospital and clinical services are routed over the ICT infrastructure. 

    It’s a considerable project. Automated mapping services can help. A solution should:

    Automatically map complete services within a few hoursDoesn’t need significant input from your domain expertsTraces hospital business services across entire ICT and clinical environments, not just a few technology domainsMaps custom-built business services, not just standard services such as email or Enterprise Resource Planning (ERP) systems. 

    Benefits of EHR mapping include:

    Pinpointing disruptions to EHRs that affect critical hospital and clinical servicesIdentifying root causes of hospital service issuesInstantly seeing the impact of planned changes to specific EHR environments, reducing the time needed for manual analysis Easily optimising architecture of EHR-related hospital and clinical services, saving time, reducing costs and improving reliabilitySecuring and simplifying major transformation initiatives, such as data centre consolidations, upgrades, new modules and migrations. 

    These combine into sustained support for benefits realisation and embedding them into daily clinical and working practices. It’s an essential part of EHR investment that Africa’s health systems should consider to ensure that EHR implementation isn’t the end, but the start of improved healthcare. 

  • Interoperability across all healthcare’s needed

    Unlike most organisations, healthcare’s an huge array of integrated services. Ensuring that its information in interoperable across the range’s a daunting task. A white paper from Verato, a patient matching service, says comprehensive and effective healthcare needs a new architecture for patient identity interoperability (IOp).

    Its thesis has four themes:

    Healthcare involves extensive co-ordination across the healthcare continuumAccessing patient information’s the cornerstone of co-ordinationResolving patient identities across disparate systems and enterprises is critical to accessing informationExisting Master Patient Index (MPI) technologies can’t resolve patient identities consistently enough or well enough to support emerging needs.

    The task’s easier is if each citizen or visitor has a unique national patient ID number (UPI). These should be assigned at birth or on entry into countries. Issuing and maintaining UPI’s is challenging and needs sustained resources.

    Where these aren’t in place, MPI technologies are used but may be obsolete. Verato says they may not cope successfully with routine factors such as maiden names, old addresses, second home addresses, misspellings, default entries such as 1/1/1900 for birthdates and hyphenated names. Probabilistic matching fills in the gaps.

    A national database that healthcare organisations can access is seen as a better option. It can be managed effectively and updated regularly more efficiently than each healthcare organisation can achieve.

    The model offers Africa’s health systems an option in improving their UPIs. While many of these may be in their infancy, it creates an opportunity to set up a reliable way ahead to set up IOp rather than switch at a later stage of maturity.

  • Saudi Arabia’s RAH@H aims to improve healthcare quality
      

    Connecting and integrating healthcare resources to improve quality’s a core eHealth goal. In Riyadh, the Remotely Accessible Healthcare at Home (RAH@H) initiative offers a daily, patient centric, connected health model to achieve it. Five themes are integrated: 

    EducatingEmpoweringInfluencingMonitoringTreating. 

    Achieving these depends on RAH@H operating at the centre of a technological hub.

    Available both on Android and IOS, RAH@H uses modern technologies for telemedicine, webinars, and observations from medical devices to serve patients. Healthcare needs of vulnerable communities that don’t have ready access to services. They include pregnant women, especially with complications such as hypertension, gestational diabetes and cardiac conditions.

    Interventions include:

    Improved nutritionPrevention and protection against diseases and illness.

    These aim for outcomes of:

    Better life qualityCreating satisfied and empowered patientsIncreased treatment compliance.

    Based in Riyadh, RAH@H’s project custodian’s the Director General of Prince Naif Bin AbdulAziz Health Research Center at King Saud University in Riyadh. It's concept and technology can have a role in African countries and their vulnerable, underserved communities.

  • eHealth start-up Redbird can expand access to rapid diagnoses across Ghana

    Africans suffer from diabetes at more than twice the global average. Resource constraints mean that millions lack proper access to healthcare to help them manage the disease. Launched this year, July has been a month of swift advances for Redbird Health Tech (Redbird HT) to try to bridge the gap.

    Chronic diseases, such as diabetes and hypertension, account for half of Ghana’s healthcare activity. Responses require treatment and long-term monitoring and management. Travelling to a hospital and waiting was the only the services for chronic disease patients. Risks of patients ignoring their conditions, either by necessity or willfulness, are very high. Consequences can be devastating.

    An interview  with Patrick Beattie, Redbird’s CEO, in Disrupt Africa, says his team could leverage existing, approved, under-utilised Rapid Diagnostic Test (RDT) technology to create convenient health monitoring points for routine health questions and, alleviating pressure on overburdened physician. Redbird secured funding from Gray Matters Capital an Atlanta-based impact investor. Redbird’s success with third place in the Ghanaian round of the DEMO Africa Innovation Tour seems to have helped its case.The solution develops a network of locations for primary care diagnoses and personal health monitoring to offer patients local access to healthcare at minimum disruption and cost. Existing national networks of pharmacies are part of the service. Redbird supplies them with verified RDTs, health monitoring software, and trained staff to interpret RDTs’ data.

    Having secured finance, Redbird’s plans to expand its pharmacy partnership from two to thirty in the next three months. The project’s scalable, and could become regional. Eventually, it could expand across all Africa’s health systems.

     CureAid pharmacy in Adenta advertising Redbird health monitoring services. Image from the Redbird website.

  • AI needs faster data access for researchers and analysts

    Maximising AI’s potential for clinical research and breakthroughs needs access to large data volumes to train then deploy AI models. A white paper by International Data Corporation (IDC), sponsored by: Pure Storage, says Hard Disk Drives (HDD) are too slow for the task. It says All-Flash Arrays (AFAs) are faster and more accurate. 

    An AFA’s a Solid State Disks (SSD) storage system with several flash memory drives. Instead of searching for data on spinning HDDs, SSDs have no moving parts, so are faster to access. The Tech Republic has an entry-level guide on AFAs. It says they’re disrupting traditional data storage resources. 

    IDC’s white paper emphasises AI as a learning process where researchers and analysts need prompt access to data for clinical projects. It has two main benefits:

    Shortens the clinical innovation time from desk to bedsideAttracting and retaining scarce clinical researchers and data scientists who look for leading-edge AI investment and infrastructure to succeed.

    Improved data response times with AFA benefits clinical teams that need access to clinical data for direct patient care too. Faster response times help to improve their productivity and efficiency. They also help to minimise eHealth frustrations and improve job satisfaction. 

    As eHealth foundations are vital parts of eHealth strategies, Africa’s health systems should consider SSDs along with expanding network capacity and connectivity capacity.  

  • Ada Lovelace’s 19th century computer book sold at auction

    The first female computer expert translated and expanded the Sketch of the Analytical Engine, published in 1843. She worked with Charles Babbage who invented the Analytical Engine, a mechanical calculator. It had four components that match modern computers. They were: 

    Mill, the calculating unit, the equivalent of the Central Processing Unit (CPU)Store, where data was held before processingReader, an input functionPrinter, an output function. 

    He unveiled his machine at a seminar at University of Turin in 1840. Italian military engineer and mathematician LF Menabrea, subsequently a prime minister, reported on the presentation. Babbage encouraged Lovelace to translate it into English. She added her own, substantial explanatory notes, which more than doubled the length of Menabrea's article and included an Analytic Engine’s algorithm.

    A report in the Antiques Trade Gazette say the book sold for auction in England for £95,000 (US$124,000). It’s one of seven known copies. It’s significant because she was the first person to recognise that the machine had applications beyond pure calculation, and published the first algorithm. She’s referred to as the Countess of Computing, reflecting her social standing and formal, title of Lady Lovelace, and the World’s First Computer Programmer, recognising her pioneering role in computer programming. When it was published, she was not credited as author. In 1848, she was, four years before her death, aged 36. 

    Her father was the poet Lord Byron. Her mother, Lady Byron, was educated in science and mathematics. It may be that inherited traits such as creativity and analysis combined in Ada Lovelace with a resultant impact on computer science and creation of the Ada Lovelace Institute.   

    How much will these abilities reflected in manuals of modern algorithms sell for in about 180 years from now? Presumably they’ll be in an eBook.

  • Villgro Kenya financing Uganda’s MamaOPe and clinicPesa

    East Africa’s startup ecosystem is growing. clinicPesa and MamaOpe, two innovative Ugandan enterprises, are set to take up capital from Villgro Kenya, an investment firm with its HG in India. The goals are to raise clinicPesa’s and MamaOpe’s  profiles, underpin the initial growth, and enhance the availability and accessibility of eHealth services in economically vulnerable areas.  

    clinicPesa’s support’s USD$40,000. MamaOpe’s USD$25,000

    An article in Wee Tracker says Villgro focuses on finance, mentoring and networking support for social enterprise startups. Its business model focuses on projects in agriculture, education, energy and health. Its partners are usually early-stage for-profit solutions for disadvantaged individuals and communities. The outfit’s recent extension into Kenya expands the reach of these broader.

    clinicPesa’s a digital micro-savings and loans platform. It provides users with convenient and affordable access to quality healthcare services by accessing their savings and loans for a range of registered health services providers. Many families slip further in to poverty after accidents or meeting unexpected medical emergencies. clinicPesa reduces out-of-pocket spending on medical bills, medicines or treatments so users to avoid excessive debt or property sales to cope.

    MamaOpe group’s a biomedical initiative. It aims to minimise pneumonia misdiagnoses and associated delayed treatments. These are primary reasons many deaths from the disease.   The MamaOpe team’s developed a biomedical smart jacket to help healthcare workers who are not doctors in low resource areas to gauge pneumonia’s primary symptoms and diagnose it accurately.

    Villgro’s been keen to add East African startups to its portfolio. Kenya’s Villgro Innovations Foundation offers a structured programme that includes finance, mentoring and connections to wider healthcare networks. These contribute to steps towards East Africa’s Universal Health Coverage (UHC). Will Villgro be offering these opportunities across all Africa soon?

    Watch this YouTube clip about clinicPesa.

  • Singapore health system hacked

    About 5.9m people live in Singapore. About 25% of their demographic and personal data has been stolen from SingHealth. A report in Channel News Asia says theft of 1.5m records by the cyber-attack was the “most serious breach of personal data.” Some 160,000 patients had their dispensed medicines’ records stolen too. 

    The Ministries of Health and Communications and Information revealed that Prime Minister Lee Hsien Loong’s records were “specifically and repeatedly” targeted. It included his outpatient dispensed medicines details. Several other ministers were also affected. 

    Data taken included names, National Registration Identity Card (NRIC) numbers, addresses, genders, dates of birth and racial origins. Hackers didn’t amend or delete records. Nor did they steal medical records, such as diagnoses, doctors’ notes and health scans

    Database administrators detected unusual activity on a SingHealth’s IT database on July 4. They immediately to stopped it.

    Cyber Security Agency of Singapore (CSA) and the Integrated Health Information System (IHIS) investigations found that the cyber-attack was “deliberate, targeted and well-planned.” They concluded that it was not the work of casual hackers or criminal gangs. They are not revealing more because of operational security reasons.

    Channel News Asia hints at a country’s behind it, with only a few that have the sophistication required. The motivation’s not known. 

    The incident’s another reminder for Africa’s health systems that cyber-security’s essential. Technical measures are not enough. SingHealth’s database managers’ rapid intervention shows that constant vigilance’s needed too. Without them, the breach could have affected more than 25% of the population.

  • Stethee reinvents the stethoscope with AI

    The worlds first Al enabled stethoscope system has been launched by M3DICINE Inc.

    The design itself is revolutionary and operates as easily as the traditional stethoscope. However, it allows users to listen to the lung and heart sounds with a more sophisticated amplification and filtering technology. Heart and respiratory sounds captured are sent via Bluetooth to the Stethee Android or iOS App which enables a wider range of diagnostic capabilities.

    The Stethee system comes in three core products:

    FDA cleared Stethee Pro for medical and healthcare professionalsStethee Vet for veterinarians and animal professionalsStethee Edu developed specifically as an education and research tool

    The technology platform behind the Stethee AI engine , named “Aida” can analyze the heart and lung sounds to build a unique personal biometric signature.  In addition to this, Aida automatically tags geo-location and environment data to each sample in real time.  This offers a completely new dimension of data analytics for public health planning by allowing one to understand what effects environmental factors such as pollution, temperature or humidity have on our heart and lungs.

    Aida also analyzes this encrypted and anonymised data in order to learn and report back quantitative clinically actionable data to vets, doctors and other healthcare professionals. Not only does it identify and analyze heart sounds and respiratory activity but also patterns that may indicate a disease condition. The data is represented in real time in the Stethee App, therefore making it easy to understand vital signs.

    The potential for the Stethee to be used in remote rural areas is quite vast because its relatively easy to use and results can be shared and analyzed promptly by a medical specialist anywhere in the world. This is invaluable to the improvement of patient care, more especially to remote rural areas where access to screening services or a cardiologist is very difficult.

  • Better eHealth can improve HIV monitoring and surveillance

    Ambitions to eliminate HIV are enthusiastically in place. Achieving them, such as the 90-90-90 goals can benefit from better eHealth. An article in the Journal of Medical Internet Research (JMIR) says questions remain about the sustainability of the programmes and the value of data initiatives. 

    Five principles identified in Sustainable Monitoring and Surveillance Systems to Improve HIV Programs: Review are:

    Better quality, local, granular, and disaggregated data to design and support a sustainable responses to ending the AIDS epidemicSupporting the health services cascade needs a cascade of linked dataUsing surveillance data is an intervention in itself, allowing programmes and communities to improve services’ responsesSurveillance needs systematic investment of at least 5 to 10% of programme budgets so that remaining resources address the epidemic and its impact can be assessedIncreased support for routine, integrated, district health data as part of health information systems, including sexually transmitted infections and hepatitis, linked to real-time health decisions.

    The study found that data’s been removed from healthcare settings and communities. It’s part of anonymous testing, national surveys, and modelling. It says that routine data’s part of implementation and an essential part of public health interventions,  packages of prevention and care. Without routine data availability, it’s difficult to achieve an effective public health or community responses. 

    This highlights the need for Africa’s health systems to review their HIV data components to test how they fit the service requirements identified by the study. It seems that some development or resetting may be needed.

  • Planning, stumbling blocks and learning: Argentina’s advancing health centre eHealth programme

    While considerable challenges remain, Argentina’s eHealth revolution’s gaining ground.

    A report in eHealth Reporter Latin America says it’s the view from the Argentine Association of Users of Information Technology and Telecommunications, (USAIRA) at its 8th Forum of IT Health Argentina  at the National Academy of Medicine in Buenos Aires 

    Dr Daniel Rizzato Lede, Director of Development of Healthcare Information Systems at the Ministry of Health, described how the Argentinian National Digital Health Strategy will promote connectivity between different health centres and develop a dialogue between information systems in provinces. It’s part of a digital strategy for Ministry of Universal Health Coverage (CUS) project that connects 14 provinces and a unique EMR for all patients, regardless of local government, medical institution or facility. 

    Defining national eHealth standards is planned before the end of 2019. It’ll enable implementation of a national eHealth infrastructure with scalable projects in provinces that operate within regulatory and legal frameworks. Before 2023, these services will be in all Argentinian provinces. 

    Guidelines for a strategy for a paper-free environment are underway at the Hospital de Alta Complejidad en Red “El Cruce”, Buenos Aires. Matías Said, functional analyst and project coordinator says it’ll be in place in the 180-bed hospital before 2022. 

    The In addition, , from Swiss Medical Group (SMG) has a long-term project for a unique health information system that integrates management of 30 health care units. It began in 2014. Daniel Castro said it involves 11,000 doctors and dentists, 1,500 nurses, 1,200 administrative employees, 300 telemarketers and 1,700 assistants.

    Gonzalo Rojo, a pediatrician, shared the step by step EMR implementation in the Hospital Britanico de Buenos Aires. The project started from scratch in August 2016. There are 80 project team members, and 200 direct collaborators. Doctors are on the hospital group leading the initiative. His crucial insight that’s a lesson for all eHealth project’s is that “Sometimes, we lose sight how easy it is for the doctor to use paper.” 

    Other contributors included the collaborations between RedHat and the Massachusetts Open Cloud (MOC). Its aim’s to increase processing imaging speeds and diagnostics precision. OMINT in Brazil, presented research into chatbots. They show that only 16% of 1,700 calls required the intervention by a human operator. Some 95% os users registered satisfactory responses.  Here come the robots.

  • England’s NHS tale of two technologies

    While some of England’s NHS is leading the way with AI, as previously reported in eHNA, other parts seem heavily reliant on FAX machines. This tale of two technologies, with apologies to Charles Dickens for modifying his book’s title, was revealed in a survey by the Royal College of Surgeons (RCS).

    The Independent, a newspaper, says the RCS finding’s that the NHS remains "stubbornly attached" to fax machines. It identified almost 9,000 FAX machines in about 75% of NHS trusts. Using this archaic technology for a significant proportion of their communications looks even more odd when at the other extreme, aspirations for AI are underway and being fulfilled.

    The BBC has highlighted that one NHS trust has 603 machines, over 6.5% of the total identified. Nest in line are 400 and 369 at England's biggest trust. Taken together, the three organisations have about 15% of the total. It’s a heavily skewed distribution.

    In its blog last year, Deep Mind had identified that the NHS was the world’s biggest buyer of FAX machines. The RCS findings are not a surprise. 

    Another dimension of the ICT legacy is that National Health Executive, a blog, highlighted that most NHS trusts had about 160 different computer systems. It seem that one end of the NHS’s two technology continuum’s a long way from the other, AI end. It reveals a legacy and investment challenge that all healthcare organisations face.