Ameera Hamid

eLearning Specialist and Disruptive Innovator in eHealth

  • Healthcare enters the blockchain ecosystem

    Over the last few years, healthcare has seen a record number of security breaches involving healthcare data.  This has prompted several start-ups to realise the work that needs to be done on the cyber-security front to make healthcare data secure.  Blockchain offers one potential solution to this challenge. Other solutions offered by blockchain include interoperability and the ability to connect data silos for more seamless systems and improved patient safety.


    SimplyVital Health is one of those start-ups experimenting with blockchain technology to give the healthcare industry a facelift. The company has developed a decentralised open-source protocol that will enable frictional-less sharing of healthcare data.  Their Health Nexus is a public-permissioned blockchain. It provides a platform to build advanced healthcare applications while maintaining the privacy and security required in the healthcare industry. 


    The developer tools on the Health Nexus are open source and available for free.  Members are able to build and deploy distributed apps utilising the blockchain protocol for transactions, identity and smart contracts, and a distributed hash table (DHT) for data storage, managed by a governance system. This will allow developers to create valuable solutions for pharmacies, healthcare providers, insurers, clinical researchers or patients.  


    Blockchain is certainly paving opportunities for new business models in healthcare.  The trajectory it will follow in the coming years, however, is an unmapped terrain waiting to be explored.  The road ahead for blockchain and healthcare will also require substantial intra-industry cooperation as well as dialogues between the public and private sectors regarding standards and regulatory frameworks.

     


  • EMGuidance web-platform to simplify medication look-up in South Africa

    Since the launch of their clinical support platform in 2016, EMGuidance has become one of the most popular medical apps in South Africa, even extending to other parts of the globe.  Its popularity is largely due to the comprehensive, up-to-date and locally relevant clinical guides and protocols made easily available to health professionals.


    In fact, the response from health professionals has been so great that EMGuidance is now available as a web-based platform.  The web-based platform essentially functions as a Google search engine with a twist.  This niche search engine only returns locally relevant information – fulfilling a great gap in clinical support tools in South Africa.  Health professionals will now be able to search for relevant South African therapies by trade name, active ingredient or registered indication. 


    Realising the potential for other African countries, EMGuidance has launched a slim-line version of their tool in Sierra Leone.  The positive response from the local community has spurred plans to expand to Kenya, Tanzania and other African countries.  It’s activities and initiatives like EMGuidance that will springboard eHealth in Africa to first-world healthcare delivery.


  • 3D printing makes a breakthrough in personalised healthcare

    3D printing may open up a whole new chapter of opportunities in the pharmaceutical industry.  There are a number of ways it could be used; drug dosage forms, supporting delivery, or helping to research cures.


    3D printing, also called stereolithography, creates objects by fusing different materials, layer by layer, to form a physical version of a digital 3D image. In the last 15 years, 3D printing has expanded into the healthcare industry, where it’s used to create custom prosthetics and dental implants. 


    Now, there may be an opportunity to use it for personalised healthcare as well.  This was achieved by Aprecia Pharmaceuticals who became the first pharmaceutical company to produce an FDA approved 3D printed pill for epilepsy in 2015.   The drug is made using their proprietary ZipDose Technology platform to produce a high-dose of leviteracetam in a rapidly disintegrating, easy-to-swallow form. 


    Personalised 3D-printed medications, deploying customised dosages, may serve particularly well for patients who respond to the same drugs in different ways.  It may also allow pills to be printed in a complex construct of layers, using a combination of drugs to treat multiple conditions at once.  This could help reduce adverse drug reactions and poor adherence to medications for patients on multiple medications. For Africa, this could be a solution for adherence to ARV and TB medication, especially amongst children and the elderly.


  • Why blockchain may be the future of healthcare

    The blockchain revolution has made its way to the healthcare industry.  If you haven’t heard about it yet, blockchain is a distributed system which records and stores transaction records.  Think of it as a database which stores information.  The main difference is that the data is located in a network of personal computers called nodes where there is no central administrator, such as a government or bank controlling the data.


    On permission-less blockchains, all parties can view all records. On permissioned blockchains, privacy can be maintained by agreement about which parties can view which transactions and where, masking the identity of the party. 



    Blockchain principles were first applied in the financial world as the technology that allowed Bitcoin to operate.  It has applications for many industries and more promisingly for healthcare. 


    This disruptive innovation would be able to solve many of the issues that plague healthcare today, while enjoying unprecedented security benefits because records are spread across a network of replicated databases that are always in sync.  


    A common database of health information can facilitate better sharing of research and evidence-based practices.  It would allow healthcare professionals to access patient records no matter what electronic record system they used and,  even improve supply chain management to prevent resource deficits.


    Blockchain won’t be a cure-all for the industry today, but it would certainly be a step in the right direction. 


  • Virtual reality better than pain killers?

    So we’ve heard how virtual reality (VR) can enhance our social lives. Now we’re going to discuss the medical benefits of the technology. Particularly in pain management.  VR has is being studied for its potential to ease pain by serving as a distracting force during medical procedures like wound care sessions for burn victims. Already, studies and papers on the subject have provided evidence that VR can lessen the sensation of pain, both chronic and acute. 


    While VR is a promising, drug-free option for pain treatment, existing VR systems are expensive and use unconvincing graphics. However, recent advances can allow the development of more realistic and more cost-effective applications. These include;

    • improved realism

    • immersion using 360-degree 3D technology

    • more affordable delivery systems


    Applied VR, a company in Los Angeles, is already capitalising on these advances. The company is working with hospitals and doctors to get patients using the technology on Samsung’s Gear VR headset and to study its effectiveness as well.   So far, the company has created three different virtual-reality pain applications, as well as one for reducing anxiety.



    Not so far in the future, your doctor might prescribe VR sessions to ease aches and pains, rather than popping a pill.  The greatest challenge it faces right now is finding software developers who want to make applications that target specific medical problems.  Perhaps this is an opportunity for African start-ups looking to innovate in the eHealth space this year.


  • South Africa’s mHealth has opportunities and bigger barriers

    Much has been made of the growth in mobile phones and their opportunities for Africans’ better health. A qualitative study in Science Direct found that there may not be a high positive correlation. It says while mobile phones have been evolving to fill South Africa’s primary care services gaps, there are barriers to access. Poor digital infrastructure and low digital literacy are two main longstanding inhibitors. 


    The study investigated mobile phone use by a wide range of people. It included patients with chronic diseases, pregnant women and health workers in Mpumalanga, South Africa. In 2014, semi-structured in-depth interviews were completed with 113 patients and 43 health workers from seven primary healthcare clinics and a district hospital.


    Some health workers and patients used their own mobile phones for healthcare, bearing the cost themselves, Bring Your Own Device (BYOD) initiatives. Patients used their mobile phones to remind themselves to take medication or attend clinic visits. They appreciated receiving voice call reminders.


    Some patients and health workers accessed websites and used social media to gather health information, but lacked web search strategies. Patients and health workers’ use of websites and social media was intermittent due to affordability constraints for airtime. Many didn’t know what to search for and where to search. 


    Doctors developed their own informal mobile health solutions for their work needs. It also overcomes resource constraints due to rurality. 


    Removing these seemingly unresponsive barriers needs investment in people and infrastructure. It’s a critical component of successful eHealth.

     


  • eHealth's 'good to great' formula offers success for 2018

    Amit Ahlawat in his book, “Seven Ways to Sustained Happiness”, says, “New doors open up; we stop looking back, enjoy the present and start planning and prioritising for the future in an optimal and optimistic manner." Similarly, as the doors of 2018 have swung open, eHealth must look forward, carrying with it the wins and lessons from 2017 to plan for an optimistic future. So, what does this future look like?  More importantly, what are Africa’s  eHealth priorities in 2018?


    2017 left us with a whirlwind of eHealth innovation, some big wins and some great lessons. Over the past few days, every noteworthy eHealth blogger, author and fund have written about their insights for 2018. As a young voice in this industry, I’d like to share my eHealth predictions for the year ahead. 


    My infatuation with analytics leads me to my first prediction; 2017’s curiosity with BDdata will result in greater investment in analysing data and making it more useful in 2018. eHNA’s published several articles over the last two years around the need for predictive analytics and the applications of Machine Learning (ML) in Africa’s healthcare. Micromarket Monitor predicts a Compound Annual Growth Rate (CAGR) of over 28% in predictive analytics investment in the Middle East and Africa by 2019.  Growth will be driven by the high penetration of new technologies in eHealth, rapidly increasing eHealth start-ups in Africa and the deluge of data they generate.


    Next, the rise in mHealth applications will swing more users towards Bring Your Own Devices (BYOD). While  it’s been a hot topic in 2017, Africa’s eHealth seems unconvinced by it. An eHNA article reported that over 90% of healthcare workers own a smart device. Barring security concerns, mHealth’s growing use in clinical decision support and healthcare delivery will propel government and organisations towards developing BYOD strategies. 


    Unsuspectingly, gamification may grab lots of attention this year. As healthcare moves away from a reactive to a proactive response, gamification may provide a large helping-hand in behaviour modification and awareness. It’s already created a sensation with Pokemon Go. Research suggests it improves physical and mental health.


    There’ll be many more predictions and events for Africa’s eHealth in 2018. The success of these will be underpinned by prioritising and investing in:


    • Developing eHealth leadership
    • Change management
    • Risk management
    • Cyber-security. 


    eHealth needs a unique type of leader with the right eHealth perspective, insight and skills to identify and maximise Africa’s eHealth opportunities. Without this, opportunities may not be seized. Acfee feels strongly about this and has put together a number of resources to develop eHealth leaders and champions.


    Change management’s vital for eHealth transformation. It helps stakeholders understand, commit to, accept and embrace the changes that eHealth brings with it. Prosci reports that projects with excellent change management are six times more likely to meet their objectives than projects with poor change management.


    Lastly, no endeavour is without risk. England’s WannaCry crisis and spambot Onliner are proof that eHealth and innovation will attract a fair amount of risk. 2017’s frenzy around cyber-security has taught us some valuable lessons. Lessons that need to carried into this year and strongly embedded into risk management protocols. For preparedness is no luxury, but a cost to eHealth’s progression and efforts.


    I look upon 2018 with great zeal and zest for the infinite opportunities that lie ahead. 2017 has shown that Africa has a promising eHealth future ahead of us, and the contributions you make as innovators, collaborators and visionaries can only strengthen it. I wish you all a prosperous new year and hope that you will remain in our readership as we unfold 2018’s innovations and breakthroughs.



  • AI’s on the move in healthcare

    Perhaps the biggest display so far of AI potential and enthusiasm was at the Neural Information Processing Systems (NIPS) conference. It’s role in healthcare was a core theme of applied research, as reported in The Economist. 


    Initiatives presented at NIPS 


    • Australia’s Maxwell MRI combines MRI and deep learning to improve prostate cancer diagnoses
    • Johannes Kepler University has an AI system to track cell proteins to identify underlying biology
    • North Carolina’s Duke University uses machine learning to use a pocket colposcope to find cervical cancer. 


    Mining EHRs and doctors’ notes to estimate unplanned readmissions is increasing too. Another application’s categorising and understanding children’s allergic reactions. AI algorithms identify the use and distribution of Naloxone, a drug to reverse effects of narcotic drug, treat pain and block the effects of opioids. 


    With AI marching on, it adds to Africa’s eHealth priority challenge. How can it invest simultaneously in mainstream eHealth and AI? There’s no easy answers.


  • Will AI improve cyber-security?

    AI is seen as a big step up in eHealth and healthcare. Will it help to improve cyber-security too? Forrester, a strategy firm, says it will. Its report Artificial Intelligence Will Revolutionize Cybersecurity But Security Leaders Must View All Vendor Claims With Skepticism also offers caution.


    While AI can help, pure AI, the sci-fi version won’t. It’s the building block technologies of pragmatic AI that can provide applications that can support cyber-security in dealing with about current and future threats. Like all solutions, AI’s not a silver bullet, but it’s part of the cyber-security armoury that can help analysts to keep up with new and emerging threats and the daily deluge of alerts and events they have to deal with every day. This emphasises an important AI theme. Human knowledge is paramount and can be enhanced by AI.


    AI for cyber-security’s a second joint priority. About 34% of organisations say it’s their objective, the same percentage as improving analytics and insights. Better ICT efficiency’s the top priority at about 40%.


    Some AI vendors are incorporating one of more components into their services. The range includes: 


    • Biometrics to authenticate users unique physical characteristics
    • Natural language processing (NLP) technology to reads and understand people’s text
    • Machine learning, composed of tools, techniques, and algorithms to analyse data
    • Deep learning, a branch of machine learning focusing on algorithms that construct artificial neural network
    • Security automation and orchestration (SAO) to help with cyber-threat investigations and responses.
    • Cyber-security analytics.


    Forrester sets out six ways to scale cyber-security with machine learning. It identifies and advantage and disadvantage of each one. The core role is automatically identifying suspicious, anomalous patterns and user behaviour that appear faster. The techniques are:


    1. Thresholds set on continuous metrics to detect anomalies. Advantage: thresholds are very simple to configure. Disadvantage: they may detect situations after the fact, not before





    2. Built-in rules using vendors’ years of expertise can automatically raise alerts based on this internal. Advantage: built-in rules require little setup and codify vendors’ expertise with other customers. Disadvantage: rules may not exist for all threat surfaces and may be based on outdated information



    3. Customisable rules to let cyber-security professionals apply their experience using their organisations’ own unique complex combinations of software and systems. Advantage: security professionals can codify their expertise in the solutions. Disadvantage: they may create rules based on theories instead of concrete data




    4. Built-in models, can go beyond rules created by people to address complex relationships from historical data faster and find complex, nuanced relationships than people can. Advantage: models are created by machine learning algorithms that analyse historical cyber-security data, yielding better predictions that improve over time. Disadvantage: models need more data science knowledge to tune and maintain.




    5. Built-in models can learn the peculiarities of organisations’ cyber-threat surface. Advantage: predictive models are based on actual data collected from infrastructure and analysed by machine learning algorithms. Disadvantage: false positives and false negatives are often problems with predictive models generated by machine learning




    6. External, importable models let organisations’ communities share knowledge. Advantage: organisations can share and reuse AI models used for cyber-security. Disadvantage: community models may vary widely in efficacy and applicability to specific organisations.





    The report provides Africa’s health systems sophisticated, balanced insights into AI’s wider user. It is essential to include its perspectives into their eHealth strategies with AI having more than one role in frontline healthcare. It adds a new, constructive dimension to eHealth’s essential cyber-security strategies and plans.


  • IBM Watson supports better care plans

    Horizons provoke considerable sentimentality and concepts.  Pankaj Patel, an Indian businessman and chairman of Cadila Healthcare urged people “Dwell on possibilities to open up your horizon.”

    It seems that IBM Watson aims to help too. Its Whitepaper. Population health management beyond the EHR:Part 2 unsurprisingly builds from Part 1 that EHRs are necessary but not sufficient. It proposes a care collaboration platform based on a data lake to which all care team members contribute.


    Cognitive computing ‘s the means to achieve it, combining parallel processing with augmented intelligence. It structures unstructured data, enabling fast searches of medical literature, finding connections and patterns among myriad data types and enables computers to learn. These can be used to:


    • Identify real outcomes from similar patients
    • Enable clinicians to make informed decisions about diagnosis and treatment
    • Utilise data on social determinants of health and genetic and environmental factors that influence health
    • Produce personalised clinical guidelines, so patients’ personalised care plans are more effective
    • Improve clinical decision support over time.


    Central data registries can be expanded to include many elements not typically available through clinical and claims data alone. Extra content be added from care managers and community health workers whose pertinent patient observations might not be able to be document in EHRs.


    This wider range of data can be used for better:


    • Performance management with retrospective concurrent, and predictive analytics applied to new payment and delivery models
    • Risk identification and mitigation of stratified populations into cohorts
    • Operational processes.


    Personalised care’s the core goals. Achieving it needs more than IBM Watson. Clinical eHealth leadership’s vital too. Warren Bennis, founding chairman of The Leadership Institute at the University of Southern California has a concept to achieve this. “The manager has his eye on the bottom line; the leader has his eye on the horizon.” Which eHealth horizon?