In-silico to replace in-vivo in clinical trials?
When it comes to clinical trials, patient recruitment is laborious, ethically contentious, medically risky and can be expensive too. But what if there was a safer and more economical way to test drugs?
With the advancement of AI, machine learning and bioinformatics, it becomes possible to simulate real biological processes in virtual settings through the use of big data. In-silico is the term scientists are using to describe the modelling, simulation, and visualisation of biological and medical processes in computers.
The main advantage of in-silico trials is the ability to trial the effects of new drugs or treatment options in a virtual setting without real consequences for either animals or humans. It’s also an enhancement for personalised medicine where it can be used by doctors to try out treatment plans, to get to know the behaviour of drugs or to identify the most appropriate drug dosage.
While completely simulated clinical trials are not yet feasible with the current technology, its development would be expected to have major benefits over current in vivo clinical trials. The FDA is already planning for a future in which more than half of all clinical trial data will come from computer simulations.
- 693 views
- August 29, 2019
- Ameera Hamid
HELINA 2019 paper submission deadline extended to 31 July 2019
The deadline for submission of papers and poster abstracts for the Health Informatics Africa (HELINA) conference has been extended to 31 July 2019. They should be uploaded through this site.
The event will be in Gaborone, Botswana, 20 to 22 November. The conference theme is “From Evidence to Practice: The implementation of digital health interventions in Africa for achievement of Universal Health Coverage (UHC)”.
Image from here.
- 598 views
- July 24, 2019
- Ameera Hamid
South Africa uses 3D printing to cure deafness
3D printing technology is a rapidly expanding method to manufacturing across numerous industries, including health. Recently, a South African team of medical doctors took advantage of this disruptive technology to become the first to cure a patient’s deafness. This advancement in surgery will offer hope to many suffering from hearing loss.
The operation was performed by Professor Mashudu Tshifularo and his team from the University of Pretoria (UP) Faculty of Health at the Steve Biko Academic hospital on March 13, 2019. Using 3D technology, the team was able to recreate the bones of the middle ear to replace the damaged ones. The surgery was successfully completed in under 2 hours and immediately restored the patient’s hearing.
The best part about the surgery is that it will be available to patients of all ages, from newborns to the elderly. The use of 3D printing also offers a cost advantage over conventional ENT surgeries addressing hearing loss, thus making it accessible for all patients.
This has become the next prestigious medical achievement for South Africa after having performed the first heart transplant in 1967 and demonstrates the innovations health care workers are undertaking to achieve universal healthcare coverage in Africa.
- 834 views
- June 12, 2019
- Ameera Hamid
What's preventing eHealth adoption in Africa?
African countries are converging under a common desire: to transform African healthcare through technology. But they also share a common frustration: African healthcare's slow and unsteady embrace of new technology.
Why do so many seemingly great technologies fail to penetrate the health care system?
This was a question I asked myself while undertaking my master’s research. I hope the following answers shed some light on the realities of technology adoption in healthcare.
1. Many eHealth innovations don’t address the real problem
eHealth innovators start by discovering a useful technology. Later, they figure out how people can use it. eHealth should not only address a problem, but needs to be goal directed. Meaning, innovators should start with the goals of the end-user. The solutions come next. When the order is reversed, the results usually disappoint.
As an example, the introduction of wearable health tech has excited innovators in the industry. These wristbands, watches, sensors and headsets can obtain and transmit large amounts of data on heart rhythms and blood pressure. However, there’s little evidence those wearing them overcome abnormal heart rhythms or elevated blood pressures better than those who don't.
2. No one wants to pay for new technologies
Creating an innovative technology to help doctors and patients isn't enough. Patients, doctors, healthcare facilities and insurance companies long for the benefits and value that these technologies provide, however, each thinks someone else should pay for it.
Furthermore, new technologies that lowers costs and reduce patient visits discourage doctors and healthcare facilities from embracing these technologies because they work on a fee-for-service model instead of a fee-for-value model.
3. The infrastructure to share information is underdeveloped
The introduction of the electronic health record (EHR) allows healthcare providers to share patient information and collaborate across different specialties to provide holistic treatment plans for the patients. However, in Africa the supporting infrastructure, policies and standards for data sharing across multiple platforms and geographies are lagging. Several African countries have started investing in strategic working groups to address this challenge.
4. Technology slows down users
For many healthcare providers, entering data into an EHR takes longer than keeping a paper record. The structured format of the EHR also frustrates healthcare provider when the application prevents them from skipping steps or leaving out clinical details.
Frustrating as it may be, the added information reduces the risks of medical error, avoids redundant testing, and facilitates easier access to test results. The benefits to the patient are clear, but less so for the healthcare provider. Getting healthcare providers to embrace these more effective approaches is the next big challenge for innovators to overcome.
- 610 views
- June 03, 2019
- Ameera Hamid
Join leaders and innovators at the Digital Health Conference in Johannesburg on the 29th of May
As digital health progresses across Africa in innovative and exciting ways, it becomes important to share ideas and leverage on each others knowledge to harness the full benefits of ICT-for-health.
Leaders, innovators and experts will be gathering at the Gallagher Convention Centre in Johannesburg to do just that on the 29th of May. The conference agenda boasts an exciting line-up themed around “Digital Health Maturity: Fulfilling the Potential Towards Better Patient Care”. Featured topics for discussion include;
- Digital health collaboration: Changing the way the department of health manages information
- E-health tools for hospital equipment management: From guidelines to reality
- Leveraging IoT in healthcare
- e-Patients role in a sustainable digital health system
- Opportunities and challenges in leveraging digital health for planning and policy implementation and monitoring
- Using design thinking and community engagement to create improved human-centred health solutions
- Digital health: the past, present and future
- The change from conventional theatre design to full digital
- Beyond chat. Towards impact.
- Digitising the South African human hand
- 501 views
- May 23, 2019
- Ameera Hamid
Is a freemium model the way to go for eHealth apps?
The proliferation of medical apps for disease prevention and health promotion has made healthcare ever more accessible. It is further facilitated by the ubiquity of smart phones and demand for better healthcare.
The number of digital health apps available in the market has reached over 300,000 apps on the top app stores worldwide, almost double the number available in 2015. Over 200 apps are added daily.
Sadly, many of these apps aren’t sustainable for more than a year, fail due to a number of reasons, including poorly structured revenue models. A number of the businesses I evaluated during my master’s research relied on fragmented funding from various sources such as donor organisations to support development of their products. When this funding is depleted, other revenue models need to be put in place to ensure sustainability.
Freemium is a popular model in which the basic application is free for users to download and use for as long as they like, though enhanced functionality is available at a price. Eventually, some of these satisfied, non-paying users will want to upgrade to a better version of the app or make in-app purchases, and hence become paying customers.
In order to generate revenue from freemium apps, these three attributes need to be fulfilled;
- Capture high market share - the market strategy needs to revolve around capturing as much of the market share as possible because only a small percentage will become paying consumers and support the cost of non-paying users.
- Have a strong competitive advantage - the free offering must fulfil a need for the user in order to create a positive buzz, and the paid version has to create added value for customers to induce them to upgrade.
- Continued value creation - the freemium product should continue to add value as the user uses it over time in order to encourage non-paying users to switch over, and to maintain a consistent base of paying users.
This model works well for innovations that are highly adaptive and iterative. Motivation to become a paying consumer relies on the value that the product adds for the user. As soon as the value diminishes, interest in using the app wanes as well. The challenge for these companies becomes staying ahead of a rapidly evolving and innovative industry.
- 597 views
- May 21, 2019
- Ameera Hamid
Successful eHealth needs capacity building
Africa’s health-care system is undergoing an eHealth revolution. The technology is new, but it must be used by the existing health workforce.
A critical finding in my master’s research, is that eHealth needs better investment in educating and capacitating users of eHealth. Another report by the British National Health Service found that a lack of training for healthcare providers created barriers to eHealth care. In Africa, we face the same challenge.
Technology on its own, no matter how effective, cannot bring about healthcare revolution without acceptance and proper use by healthcare workforce. An implementation strategy which addresses the barriers to effective adoption of these technologies will be critical to their success.
Capacity development has multi-layer benefits;
- For staff it can increase overall job performance and satisfaction.
- For the healthcare organization or facility, it can improve effectiveness and profitability.
- Even at the societal level, training and development can increase the quality of the labour force, which in turn is a contributing factor to national economic growth.
By developing a workforce that is able to confidently use eHealth technologies and services, African countries could implement their national eHealth more successfully and move closer to achieving universal health coverage.
- 440 views
- May 06, 2019
- Ameera Hamid
Why eHealth needs business modelling
A substantial number of businesses and start-ups pursuing opportunities to bridge healthcare challenges with eHealth technologies are often confronted with “pilotitis” or failure to implement their technologies in a sustainable way. In my last article, I described some of the challenges eHealth businesses face.
Constructing a business model during the development of eHealth technologies can guide a value-driven evaluation of what is necessary and what is not, in order to overcome implementation failures. A review of the literature suggests that the business model canvas proposed by Osterwalder is a suitable business modelling tool for the eHealth industry.
The one-page canvas consists of nine building blocks that provides a conceptual framework to describe the business’ activities from four perspectives;
- Value offering – what need is being fulfilled by the business?
- Value communication and transfer – who are the customers and how does the business communicate with them?
- Value co-creation – what are the business inputs, including collaborating partnerships?
- Value capture – how does the business maintain profitability?
A key observation in my master’s study was that there is a strong focus on the value offering and value capturing activities of the business model, although little focus on value co-creation and value communication and transfer activities.
While eHealth businesses are aware of the importance of these activities, challenges of the environment create barriers to prioritising these activities. To overcome these challenges, transformation is required in both the micro and macro eHealth environment.
- 655 views
- April 24, 2019
- Ameera Hamid
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.
- 492 views
- April 11, 2019
- Ameera Hamid
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-ups
- High start-up costs and ongoing maintenance costs
- Regulatory legislation that lags behind technology development
- Resistance from end-users to adopt new innovations
- eHealth technologies lack user experience design
- Poor scalability of eHealth technologies after their pilot phase
- Poor ICT infrastructure in the environment
- Lack of leadership and political support
- Lack 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.
- 482 views
- April 08, 2019
- Ameera Hamid