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.
- 469 views
- July 19, 2018
- Ameera Hamid
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.
- 439 views
- July 18, 2018
- Matt Jones
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.
- 501 views
- July 17, 2018
- Tom Jones
Wearable heart rate monitors don’t tick the box
A cynical insight from Napoleon Bonaparte was “If you wish to be a success in the world, promise everything, deliver nothing.” I doesn’t fit wearable mHealth, where reliable results are everything.
Research in the Journal of Medical Internet Research (JMIR) says some wearables have considerable promise, but have to do much better at delivery.
It sees an important role for wearable sensor technology in clinical research and healthcare. Before it can, it must undergo rigorous evaluation prior to market launch and its performance should be supported by evidences. The researchers found that match between three heart rate monitoring devices and an electrocardiography (ECG) reference was weak.
Many studies have tried to validate wrist-worn photoplethysmography (PPG) heart rate monitors, but contrasting results question their utility. A big problem’s inadequate methodologies.
Validation strategies should consider the nature of data provided by both the investigational and reference devices. There must be uniformity in the statistical approach to the analyses too. Investigators should test the technology in user populations and in appropriate settings for the planned uses. Developers, suppliers and scientific communities need robust standards to validate new wearable sensor technology.
There’s a lot more to do before wearables can become mainstream clinical devices. The findings and recommendations should be considered be Africa’s health systems as they advance their mHealth strategies and plans.
- 416 views
- July 11, 2018
- Ameera Hamid
AI in England’s NHS improves precision and saves time
The UK’s NHS is 70 years old this year. It was born on 5 July 1948, so happy birthday Since then, it’s seen a continuous surge in new technologies and techniques leading to transformation. eHealth’s been an increasing component over the last 30 years or so. Now, AI’s coming into the investment frame.
The Guardian has an article on AI at Addenbooke’s Hospital, Cambridge. It’s used to delineate tumours. AI completes the work in minutes. Doctors use InnerEye from Microsof to mark-up scans prostate cancer patients. Images from completed scans are anonymised, encrypted and sent to InnerEye to create 3D models. It’s learnt to do by training with previous patients
Brain tumours are next on the list. For some cancer patients, may have to review over 100 images doctors to plan their radiotherapy treatment. It’s obviously time-consuming, both for doctors, their colleagues and can defer the start of treatment for patients.
The other significant AI benefit’s greater precision, so improved effectiveness. By focusing more precisely on cancer cells, it helps doctors providing radiotherapy treatments to avoid healthy tissues.
Both benefits, precision and time-saving, are leading to more streamlined, more effective and more efficient healthcare. These are some of eHealth’s main goals.
The NHS has also Heart Flow, developed by Stanford University. It’s AI uses routine CT scans from patients with suspected heart disease AI to create personalised 3D models of their hearts and blood flow. It reveals how specific blockages disrupt blood flow in individual blood vessels, leading to better treatment decision, or none where appropriate. Over half the patients with HeartFlow data avoided angiograms.
London’s Royal Free Hospital has an AI development underway. It analyses and refines blood test results and to predict which patients are most likely to die, or have serious problems such as kidney failure. It’s trained from almost 1 billion blood test results from 20 hospitals, and identifies subtle changes in red and white blood cells and electrolytes such as sodium and potassium. It reveals which patients’ health may be deteriorating.
Other AI services include:Skin cancer diagnosesEye disorders from retinal scansHeart disease from echocardiogramsStrokes.
The results are encouraging. Africa’s eHealth strategies and plans need a place for AI the data it needs.
- 487 views
- July 05, 2018
- Tom Jones
Intermountain Healthcare integrates telehealth and mHealth in a connected care platform
Information silos are huge obstacles to integrated healthcare. And integrated care is the kind most of us want for ourselves and for our loved ones. It's a key eHealth challenge.
In a report in Research Information, research platform outfit Dimensions says they’re usually created unintentionally, and are a phenomenon to “escape” from.
Intermountain Healthcare, based on Salt Lake City, US, seems to be free of these troubles. A report in mHealth Intelligence says it’s integrated 35 different telehealth and mHealth services into Connect Care Pro, a single connected care platform. Objectives are to improve care coordination and keep care in communities, both of which could be good for patients and health systems. It took five years to plan.
The services it supports include:Virtual or tele-programmesTelestrokeTelehealth programmes for behavioural healthTelehealth programmes for newborn critical careTelepharmacy serviceseHealth services using connected health devices.
The legacy was a history of launches of several telehealth and mHealth programs and pilots that didn’t integrate easily. Intermountain sees their integration initiative as the next telehealth phase.
The initiative has valuable lessons for our African countries' mHealth and telehealth programmes. It makes sense to start constructing equivalent platforms without delay. It’ll be easier and cheaper than waiting until more silos need integrating. Even more important, it’ll bring extra patient and healthcare benefits, sooner, for our patients, our families and ourselves.
- 483 views
- July 05, 2018
- Sean Broomhead
What can eHealth have to do for radiology services?
Radiologists are in short supply. Radiology workloads and demand are rising. A report from Digital Health explores the opportunities to use AI and Radiology Information Systems (RIS) in the UK’s NHS to fill the gap. It identifies essential requirements for national eHealth too.
Two solutions are proposed, both needing RIS:
Sharing reporting workloads across healthcare organisations
Using AI to automate some of the clinical workload.
Current images and workflow sharing relies on an Image Exchange Portal run by Sectra. It’s fast, but seems it needs replacing to meet radiologists’ needs of:Knowing when an image is there for reviewA single system that displays their own images and other clinicians’ images for individual patientsAccess to each patient’s reporting history and images needed for full and useful reports.
This needs a specific organisational structure, a lesson for Africa’s health systems. In the days before England’s National Programme for IT (NPfIT) was abandoned, radiology information could be shared across each of England’s five NPfIT regions.
Since then, smaller geographic consortia have emerged to procure Picture Archiving and Communications Systems (PACS) and RIS from single vendors. It achieves lower costs, smoother, more efficient workflows and makes their sharing easier. Patients, radiologists and organisations outside these consortia don’t benefit.
Vendor-neutral standards are the solution. Two, Soliton and Wellbeing Software, provide solutions share radiology reporting across several sites with different RIS vendors. Their impacts are constrained because there isn’t a single or unified procurement organisation.
Is RIS becoming obsolete? EPRs and PACS may be able to deal with scheduling and remote reporting. Some radiologists see it differently. They may be increasingly dependent on RIS.
AI may be a solution too. It’s already dealing with some basic reporting. Wellbeing has a platform for an AI algorithm to report directly into its RIS.
Agfa uses the term Augmented Imaging (AI). It’s exploring the potential for its AI to automate some administrative tasks. Algorithms are already available to detect TB on chest X-rays. Partnering’s already in place with hospitals and research institutes that need Agfa’s workflow engine to develop their own algorithms.
Lessons for Africa’s eHealth are clear. Radiology needs its own eHealth engagement, strategy, plans and procurement.
- 375 views
- July 04, 2018
- Tom Jones
There’s a comprehensive cyber-security manual from KnowBe4
Cyber-security firms regularly release short cyber-security white papers dealing with a single theme. Now, there’s an updated, big-scale, 221-page manual, and it’s free.
Cyberheist 2018 fromKnowBe4 extends across cyber-security’s wide range. Written by Stu Sjouwerman, Sunbelt Software co-founder and anti-spyware specialist, and a supporting team, Cyberheist’s 19 chapters provides Africa’s eHealth programmes with a comprehensive view of their cyber-security requirements. While there’s an emphasis on commercial and business activities, such as banking, retailer and ePayment scams, cyber-security principles in these chapters are relevant for eHealth.
Cyberheist deals with:What drives cybercrime?How and why scams survive, thrive, and succeedTypes and methods of attacksPhishing explored and explained Phishing variations: smishing and vishingTargeted scams, including spear phishing, whalingUnderstanding cyber-crime losses and exposureScary cyber-crime reports and statisticsBank scamsCredit card and ePayment scamsMortgage rescue scamsAutomated clearing house scamsRetailer scamsSocial networking scams Safe computing fundamentalsSyncing security policies, user training and monitoringSecurity technology to protect people and assetsManaging online banking securityFostering cyber-security awareness.
It has two main goals. One is to help organisations recognise the increasing danger that they, and individuals, face when they use the Internet. The other’s to enable organisations to take proactive measures to protect them from cyber-threats. After reading Cyberheist, strategies and techniques are needed for protection. These should be core to Africa’s eHealth strategies.
- 407 views
- July 02, 2018
- Tom Jones
GPS tracking finds a role for dementia patients
Location, location, location’s not just a property agents’ mantra for house hunting and valuations. It’s essential for dementia patients and their health workers and family carers too. Knowing the whereabouts of the patients and loved ones can be supported by GPS. A NHS organisation in Dorset, UK’s testing a tracking device in shoe insoles to know patients’ locations and help to keep them safe.
It was reported in a BBC Radio 4 programme that alerts are sent to carers’ mobiles when users stray from designated areas. The can be a nursing home yard or garden. The GPS can pinpoint patients precisely to map. When they stray, they can be found, minimising the risk of harm and needing hospital care.
Alz Products makes trackers prices at £75 and a £26 monthly fee. They can be transferred to other footwear, so it’s a price per user.
A report from the South Central Region of the Dementia Action Alliance South Central Region says there are 670,000 people with dementia in England and 550,000 friends and family acting as their primary carers. Socio-economic costs across healthcare, social care and wider society are estimated at £19b in 2011. It’s more than cancer, heart disease or stroke costs.
These kinds of impacts from imaginative innovation offer Africa’s eHealth programmes direct patient and healthcare benefits. They need a significant place in their strategies and plans.
- 391 views
- June 29, 2018
- Ameera Hamid
QuantumMDx offers low cost DNA tests at points of care
As technology help DNA test costs and prices tumble, the range of opportunities expands. While conventional supply and demand economics hints that higher prices attract suppliers, lower prices reduces them, disruptive technology’s changing the DNA testing model.
QuantumMDx, a UK firm based in Newcastle UK,, offers DNA tests at point of care. They can cost as little as £5, about US$6.65, each. It takes a few minutes to extract DNA into a biosensor that can multiplex in thousands. Its Q-POC™ assays provide data for whole genome sequencing and creating gold pathogen surveillance networks. Global Good Intellectual Ventures aims to bring technology to solve global problems. QuantumMDx works with them.
Plans are in place to expand from the four main services currently supported. They’re:Tuberculosis has an in vitro diagnostic device for future multi-drug resistance Tuberculosis treatment regimensWarfarin has a pharmacogenomic assay to determine optimum dosage of the anti-coagulantSexually Transmitted Infections (STI) uses a panel test for quick and easy screening to help containment, including a test for Human Papilloma Virus (HPV) enabling health workers to use molecular diagnostics to screen and treat in a single visitMalaria has uses a drug susceptibility panel to support malaria eradication initiatives.
Africa’s an important market for QuantumMDx. It has the highest regional malaria burden and the lack of healthcare infrastructure in many communities hinders health workers’ ability to diagnose and treat the infection. Empiric diagnosis is a common technique.
Rapid Diagnostic Tests (RDTs) are simple to use and don’t need laboratory infrastructure. They’ve been crucial in dealing with malaria, but have an inherent lack of sensitivity to detect low-level asymptomatic infections, so cannot alone move a country from high burdens to eradication. QuanumMDx sees its role as essential. How will Africa’s health systems move to mobile diagnostics at points of care.
- 424 views
- June 28, 2018
- Tom Jones
Drones are good for your health
Stuck in in deep marshland in Norfolk, a very rural, flat part of England, or anywhere else, isn’t a good health initiative. Being rescued by a drone is. A report on the BBC website says a 75 year old man was separated from his friends while walking near Titchwell, a particularly wet and soggy part of the county. He was missing for 21 hours, and stuck in a marsh.
Police used a drone to find him, and it did. He was admitted to hospital and treated for hypothermia. It’s another example of good drone use.
Without the drone, the outcome could’ve been different. It’s another graphic illustration of the case for drones. Africa’s eHealth strategies for emergency services should have plenty of them.
- 339 views
- June 26, 2018
- Ameera Hamid
KnowBe4 updates its ransomware rescue manual
Cyber-security companies have to keep up with cyber-criminal’s expanding ingenuity. KnowBe4, a cyber-security firm, does it to keep users up to speed. It’s overhauled its Ransomware Hostage Manual What You Need to Know To Prepareand Recover from a Ransomware Attack, available from Health IT Security. It reflects the increasing professionalism of cyber-crime activity over the last five years or so. It deals with:
What’s ransomware?RansomwareBitcoin and cryptocurrencyCryptominingThe Onion Router (TOR)
Am I infected?SymptomsInfection vectors
I’m infected, now what?Disconnect!Determine the scopeWhat strain of ransomware?Evaluate your responses: restore, decrypt, do nothing
Negotiate or pay the ransomFirst response: restore from backup or shadow volumeSecond response: try to decryptThird response: do nothing and lose filesFourth response: negotiate or pay the ransomRansomware attack response checklist
Protecting yourself in the futureDefence in depthSecurity awareness trainingSimulated attacksAntivirus, antispam and firewallsBackups
ResourcesRansomware attack response checklistRansomware prevention Checklist.
KnowBe4’s checklist’s for dealing with a cyber-attack’s extensive. It’s in two parts, actions and resources. The main headings are:
STEP 1: disconnect everything
STEP 2: determine the infection’s scope and check the of encryption signs
STEP 3: determine the ransomware strain
STEP 4: determine the responseResponse 1: restore files from backupResponse 2: try to decryptResponse 3: do nothing and lose filesResponse 4: negotiate or pay the ransom
STEP 5: protecting yourself in the future
ResourcesUsers are the first line of defenceSoftware’s the second lineBackups are third
For cryptomining attacks:Train users to avoid downloading it or exploit kits in the first placeIdentify a baseline performance metric for computers and servers and monitor and alert excessive utilisationInstruct users to report significant system slowdowns or strange behaviourEnsure endpoint protection’s updated frequentlyConfigure web filtering to update frequently and block outgoing firewall traffic to suspicious IP addresses and Command and Control (C2) networks.
With users as the first line of defence, effective cyber-security training’s essential. It’s been said before, so sustained users awareness and training should already be in place. It is?
- 488 views
- June 25, 2018
- Tom Jones
Duplicate patient records keep turning up
Achieving accurate patients’ IDs’s a constant theme of managing EHRs. Duplicate records just won’t go away. University of Washington (UW) Medicine based in Seattle regularly reviews and improves the reliability and accuracy of its EHRs. Cleaning duplicate records is an important part of the task.
Its latest initiative, available from EHR Intelligence, is with Just Associates, a consultancy that identifies and resolves patient data integrity problems, reveals some critical lessons for Africa’s eHealth. It found that the duplicate rate was significantly higher than the 10% to 20% it usually finds. The main cause was inadequate information. Many records contained only four of six ID components. They’re last name, first name, middle name, gender, fate of birth and social security number.
The review identifies the source of ID issues and issues that create duplicates. This information has helped UW Medicine to develop its strategy and planning to control duplicate rates.
There’s a long-standing ID challenge. It’s an “uphill battle to dedicate the appropriate resources.”
Sustaining appropriate staffing levels for ID management’s a challenge. Part of the solution’s relying on ICT tools. An objective’s to using technology to improve efficiency and reduce staff time manually accessing and matching records. It means that staff can then deal directly, efficiently and successfully with awkward ID cases and records.
A valuable lesson for Africa’s eHealth’s that EHRs alone are not enough. Extra resources are needed to ensure the value of data in EHRs. With a typical duplicate rate of 10% to 20%, any drift in ID management seems to lead to higher rates, so greatly diminished value of EHRs’ data.
- 524 views
- June 22, 2018
- Tom Jones
A coffee case study has lessons for blockchain in healthcare
Coffee has loads of health benefits, though it’s not typically the go-to place for innovative approaches to health information systems. So I was intrigued by a coffee story that appeared in a June edition of Seattle Business magazine.
Scott Tupper is an anthropologist and founder of Onda Origins coffee, a company that combines ideas on improving wealth disparity in the world, with a passion for information technology, and coffee. He uses the unique characteristics of blockchain technology to improve information accuracy and accountability in the coffee trade, driven through Yave, a company he started for this purpose.
Blockchain structures are used to capture information at key steps along the coffee supply chain, from farmer to consumer. This creates a single source of truth about the coffee bean’s journey, encrypted and shared across a trusted, distributed network. And that sounds a lot like what we aim to achieve when building health records.
Yave constructs multiple registers for each coffee consignment journey. The first register records the coffee producer’s name and electronic ID, the shipment’s ID, the coffee’s place of origin, the amount of coffee and the coffee’s description and quality score. That is encrypted and becomes the first block in a new blockchain.
At key stages in the supply chain, an additional block is added to the chain, such as when the shipment is received at a mill, or passes through exporters and importers, or roasters. The mill register includes details about the milling process followed, initial roasting, and the results of taste test scores. At each stage new registers are created and existing data, such as taste scores, may be updated with new values. Since blockchain data is immutable, the old data is never overwritten. When new data is added, both new and old values remain in the chain and are auditable. At each stage, the new data is broadcast to the network, which can access all the information.
How these details change across the supply chain helps to set the final assessment of the quality of the coffee bean, which affects pricing, and helps to review the quality of the supply chain, which drives operational improvements. The coffee-folk believe that one of the most valuable aspects of this application of blockchain is the ability to verify coffee’s origin and other key details of steps along the way to our cups, thereby making it easier to make value judgements about the final product and what you and I should pay for it.
As we learn more about Blockchain technical attributes, we are beginning to recognise it as a tool for democratisation, sharing data ownership and access equally with all participants. This distributed architecture puts participants in control of their data in new ways that are technically extremely challenging with more conventional systems architectures.
While Blockchain protects our coffee supply chain, it has the potential to transform ownership of our health data too.
Image from the Yave site, https://www.yave.io/
- 535 views
- June 20, 2018
- Sean Broomhead
mHealth can help to reduce hospital readmissions
Using mHealth to improve hospital services’s a common theme in Africa’s eHealth strategies and plans. Reducing readmissions’s an important part of these initiatives. A report from MobileSmith says how three mHealth solutions can help.
How to Reduce Preventable Readmissions with Healthcare IT describes:Efficient mHealth strategies for reducing hospital readmissionsStrategic use cases for prompt implementationSix best practices for cost-effective apps for engaging patient and doctors.
Efficient mHealth should provide:Relevant discharge communicationFamily and carer engagementImproved medication adherenceChronic disease control.
The six best practices are:Research and know target patient groupsThink big, start small, act fast, so avoid mHealth that does everything for everybody, so unlikely to be user-friendlyPolish user interfaces and experiencesKeep mHealth freshEstablish secure data exchangesAdopt analytics.
Underpinning each of these’s the core goal to empower patients. mHealth’s the bridge that healthcare can leveraging now to empower patients. It can only work with easy-to-use mHealth so patients are encouraged to become more proactive towards their health. These themes need expanding in Africa’s next wave of mHealth strategies and plans. They also need setting alongside high priority patient groups and clinical conditions.
- 521 views
- June 19, 2018
- Tom Jones
Five main insights on the impact of EHRs can help investment plans
While EHRs provide the most comprehensive, up-to-date patient information, more details about their impact’s needed for investment decisions. eHealth investment challenges are:What benefits to they bringHow are they realisedHow long does it takeDoes their value exceed their costs.
Spectralink describes insights into some of these in its technical brief Five ways EHRs improve healthcare delivery. It’s available from EHR Intelligence. The five generic ways are:Access to critical data, anytime, anywhereImproved care coordinationMore accurate diagnosticsIncreased work flow efficiencies and cost savingsBetter patient participation.
Within these five, ten benefits are identified across two groups:
Physician workflowAccessed patient chart remotely - 74%Alerted to critical lab value - 50%Alerted to potential medication error - 41%Reminded to provide preventative care - 39%Reminded to provide care meeting clinical guidelines - 37%Identified needed lab tests - 28%Facilitated direct communication with patient - 25%
Patient-related outcomesEnhanced overall patient care - 74%Ordered more on-formulary medications - 41%Ordered fewer tests due to lab results availability - 29%
Three other activities show large impacts:Note practice functions more efficiently - 79% Receive lab results faster - 75%Report enhances in data confidentiality - 70%.
While these are large increases, there’s no information about how much more efficiently, fasters of enhancing these changes were. These estimated values are important in evaluating EHRs’ impacts.
None of the benefits refer to increased patient access as part of Universal Health Coverage (UHC). This needs resources liberated by efficiency gains to be redeployed to communities with no or limited UHCs. Acfee reviews reveal that these seldom happens on a large scale with EHRs. It has to be linked to specific UHC initiatives.
Uploading information with mHealth links are in place in about two-thirds of EHRs. This offers scope for further investment. It’s an essential feature for Africa’s eHealth
- 422 views
- June 18, 2018
- Tom Jones
AI and machine learning need data storage resources
Many things come in bundles. Amit Ray, author of Mindfulness Meditation for Corporate Leadership and Management says “As more and more artificial intelligence is entering into the world, more and more emotional intelligence must enter into leadership.” It’s not enough. A report by Source Media, sponsored by Pure Storage says powerful, advanced computing and storage capacity and capabilities are needed too.
It recognises AI’s “vast” potential. Currently, some radiology departments use it effectively to improve workloads. Progress across other clinical activities depends on extra computing and storage power for two activities, training and clinical use.
When researchers deliver AI and machine learning techniques to clinical practice and healthcare, solutions need huge amounts of data for training models, including labelling data. It’s especially important for neural networks. These are hardware and software patterned on the way neurons work in human brains. They’re deep learning technologies often focusing on solving complex signal processing or pattern recognition problems.
If storage’s inadequate, it can’t keep up with the workload. The result’s diminished AI. Healthcare’s typical eHealth investment model’s to buy enough computing storage infrastructure as a minimum requirement, then expand it a few years after it’s clogged up. Eventually, it’s replaced with modern solutions after a period of obsolescence.
This doesn’t fit AI and machine learning. It has to match the computer power and storage capacity needed as AI and machine learning expands. Developers and healthcare organisations can then move beyond exploring AI’s potential and bring into full use. The, patients benefit.While assembling the resources needed for AI and machine learning’s challenging for Africa’ health systems, the infrastructure requirements add to the constraints. Before venturing into the AI space, it’s essential to contemplate and deal with the whole resource requirements and their affordability.
- 746 views
- June 15, 2018
- Tom Jones
Robotic surgery is revolutionising prostate care
Robotic surgery is a remote-control operation. Movements of a surgeon are translated through the tiny robotic arms of a machine. The surgeon is often not in the same room and can even be on a different continent.
Surgeons and patients are thrilled with the results. Specifically, in prostate surgery, the Da Vinci robotic surgical machine has been used successfully in the UK and Africa countries to perform over 10,000 surgeries in men with prostate cancer, with marked improvements. Procedures are quicker, safer, and with fewer side effects than conventional open surgery or laparoscopic radical prostatectomy. A review of 104 studies covering 230,000 patients confirmed it.
Robotic surgery demonstrated superiority in:Operative timeLength of hospital staysBlood lossTransfusions requiredRate of post-operative erectile dysfunction and incontinenceLong term cost, due to the quick recovery timePositive surgical margin (PSM), which indicate whether the entire extent of the cancer was extracted during the operation.
The review is in line with other research on robotic surgery, which shows improved erectile function and reduced urinary continence compared to open surgery.
South Africa has seen an increasing uptake of the robotic procedure since it was first implemented at the Urology Hospital in Pretoria in 2013. It is now more widely available.
Doctors and patients benefit from these types of innovations. Long term net cost-benefits are likely too. The challenge for our health systems is how to find space for these, alongside other healthcare challenges, in ways that are affordable and sustainable.
Watch a You Tube video about it here.
- 471 views
- June 14, 2018
- Ameera Hamid
A Global Digital Health Index can help countries track their eHealth progress
The eHealth landscape is evolving rapidly. So is the range of national and local initiatives under development. It can be difficult for countries and organisations to measure their own efforts against others, to benchmark their progress. The Global Digital Health Index (GDHI) has been developed to help.
GDHI is an interactive digital resource that tracks, monitors, and evaluates the use of digital technology for health. It uses components of the WHO and ITU eHealth Strategy Toolkit. It was designed collaboratively with representatives from over 20 countries, and 50 international organisations. Online reports describe the consultations that took place in Cape Town November 2016 and Bellagio September 2017.
GDHI’s three objectives are to empower, evaluate and motivate. GDHI website describes each as follows:Empower: The GDHI provides visibility into the status and historical progression of key digital health performance indicators at a national and global level. It empowers health ministries, funders, policy makers, and industry players to make intelligent and informed strategic decisions about why and where to allocate resourcesEvaluate: The GDHI benchmarks countries against standardized digital health criteria. It assesses the presence and quality of national policies and strategies, investment risks, and coverage of key digital health platforms while providing countries with a roadmap for maturing over timeMotivate: The GDHI helps countries track progress and identify weaknesses within their digital health initiatives. It incentivizes improvements in national digital health systems and more targeted investments globally. The GDHI helps facilitate the strategic use of digital health to accelerate and monitor the achievements of Sustainable Development Goal 3: Ensure healthy lives and wellbeing for all at all ages, through enhanced data use and visibility into health systems.
As the tool develops, we hope to see more on health outputs.
These types of initiatives are invaluable, particularly when they include deep and meaningful stakeholder consultations. Congratulations to all involved.
The initiative is co-facilitated by HealthEnabled and Global Development Incubator, with partners ThoughtWorks to develop the web-based index and Dalberg Design for design aspects of the index.
Financial support is from Bill & Melinda Gates Foundation, Johnson&Johnson, Philips and HIMSS.
- 793 views
- June 13, 2018
- Sean Broomhead
Promising future for eHealth in Africa, despite lower than expected growthGrowth in the eHealth sector has failed to meet initial high expectations, but start ups are starting to gain traction as obstacles are removed.
Africa’s eHealth sector has always attracted investment, but o far failed to live up to the market’s high expectations. Is change in the air? Disrupt Africa’s latest Africa Tech StartUps Report shows that ten eHealth start ups raised close to USD$9.5 million in 2017, up from USD$8.3 million in 2016. A report from Disrupt Africa summarises the main themes.
This increase reflects Africa’s health market’s continuing potential for disruption. Nic Klopper, CEO of the hearX Group, a South African based company which develops smart phone hearing solutions, believes that clinical and traditional solutions aren’t meeting African market requirements because they’re prohibitively expensive and static. It means they can’t assist with decentralised healthcare programmes. By changing the way healthcare’s delivered, eHealth solutions are reaching people at the grassroots.
However, any eHealth project must first find solutions to Africa’s specific social and physical environment to stand a realistic chance of success. So far, the path to growth in the eHealth sector has not been without pitfalls.
Rob Heath, a South African investor at HAVAIC, says a main obstacles to growth was a of tech-savvy locals to carry projects over the finishing line. Quality’s good, but numbers aren’t. There’s a lack of professional investors who can add real value too.
Another major obstacle was difficulty in achieving scale. It makes investors hesitant. Yet there are signs that start ups are now beginning to overcome this.
The key is in the data. While African eHealth solutions meet local solutions, they provide data of global significance which can be sold on the world market. An example’s Zipline, a drone-based blood delivery service in Rwanda. It could supply data to organisations on other continents, so the US Federal Aviation Administration could obtain a drone delivery licence based on its data from Rwanda, or use its technology in a disaster relief zone.
This potential for international growth is a major factor for investors. It’s essential in enabling start ups to achieve scale, which in turn means they’re taken up by the market. This closes a virtuous cycle; scalability attracts investors which allows scalability.
Siraaj Adams, CEO of Digital Health Cape Town, a dedicated eHealth accelerator programme, says eHealth’s a sector that’s now attracting the much-needed attention it needs. He sees a bright future. Start ups in Africa find solutions for specific issues within their immediate environment. Scalability with the right backing can become a reality. Plummeting hardware and software costs means the cost of rolling out eHealth projects is becoming more affordable. It enables net benefits AI’s in the frame too plugins, web-hosted servers, and natural language processors can turn good ideas into products very quickly and affordably.
eHealth’s future looks promising. Africa needs mHealth and cost-effective solutions delivered in communities, but it’s their value to the international community that will provide funding streams to turn these visions into action.
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- June 05, 2018
- Matt Jones
Rome Business School eHealth Masters
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