eHealth Articles (1,847)

Smart fire alarms and SMSs in informal dwellings save lives and homes

Informal settlements are part of Africa’ urban landscapes. Individual dwellings are fire hazards that can lead to injury, loss of life and homes. Neighbouring dwellings can ignite too. A start-up in South Africa, Lumkani, has developed an early-warning system to reduce the damage and destruction caused by the spread of shack fires. It’s having a big impact on people’s health and lives.

Lumkani’s low-cost detectors measure the rate of temperature rises. They’re not smoke detectors, which aren’t appropriate for heating, lighting and cooking methods used in low-income households. When they’re triggered, they alert the family, connect to neighbouring detectors in a 60 metre radius and send an SMS to the local fire services, achieving a faster response time and limiting the serious consequences of fires. It saves lives, reduces injury and reduces firefighting and rebuilding costs. It can also reduce the need for emergency healthcare to deal with burns and smoke inhalation.

A shack can be burnt to the ground in less than two minutes. It doesn’t stop there, and often set neighbouring dwellings ablaze. The potential to minimise the resulting health and healthcare impacts offer health ministries opportunities to look beyond eHealth to equivalent initiatives that help to prevent or limit the effects of shack fires. It applies to all types of accidents and can be a set of public health, eHealth plus and collaborative efforts.

Dec 08, 2016

Does mHealth make healthy behaviour better?

There’s a general drive to develop mHealth on the back of the huge and increasing number of people with mobile phones. A study by the School of Public Health University of Sydney  in the Journal of Medical Internet Research (JMIR) seeks evidence to answer the question, Can Mobile Phone Apps Influence People’s Health Behavior Change?

It’s explicit that “The widespread adoption of mobile phones highlights a significant opportunity to impact health behaviors globally, particularly in low- and middle-income countries.” But, it found bias and a lack of rigour in mHealth evaluations of mHealth’s effect on healthy behaviours.

The researchers say they think that no previous study has completed a comprehensive thematic mHealth literature review for health behaviour change, so it’s an important step forward in understanding this type of mHealth’s benefit. Despite most studies reporting statistically significant effects in targeted behaviour changes, they didn’t use longer duration Random Control Trials (RCT). These are needed to determine mHealth’s effectiveness.

Another limitation relevant for Africa’s the low number of mHealth evaluations in low and middle-income countries. Redressing all these drawbacks needs researchers, healthcare providers, app developers and policy makers to collaborate more.

The study included a wide range of 17 mHealth evaluations, but with differing numbers and types of apps in each group of a wide health range:

  1. Mental health or alcohol addiction
  2. Physical activity and weight and diet control
  3. Medication management
  4. Lifestyle improvement
  5. Diabetes management
  6. Sun protection
  7. Hypertension management
  8. Cardiac rehabilitation
  9. Smoking cessation
  10. Family planning.

An important finding’s that seven publicly available apps in the reviewed evaluations are popular, but haven’t been comprehensively evaluated. They’re used without an understanding of their risks and benefits.

The study offers an important proposition for Africa’s health systems. Before embarking on mHealth initiatives, rigorous business cases are needed to identify and assess the probable risks and benefits. Then, they need evaluating after going live to be sure that the risks are mitigated and the benefits realised. If they’re not, corrective actions needed.

Dec 08, 2016

Disappointing findings from a US EHR survey

The US may not be too good at EHRs. Peer 60 has released its survey results in Physicians' Take on EHRs. Its coverage includes:

  1. Ambulatory EHR adoption
  2. Main EHR suppliers for acute care participants
  3. Primary EHR suppliers for ambulatory care participants
  4. Damage control - the replacement market
  5. Top physician priorities.

The survey’s revealed some unsatisfactory findings. For 26% acute and 74% ambulatory healthcare, they include:

  1. Most physicians are highly dissatisfied with their EHR
  2. Frustrations are driven by poor usability and lack of desired functionality
  3. The EHR market for acute care facilities is consolidating quickly
  4. Fragmented Epic keeps making inroads in the ambulatory EHR market.

Most ambulatory organisations, 85%, have ERHs. Most of the other 15% are small clinics.  Measured by the number of doctors in the organisation, the vast majority of ambulatory organisations, between 75% to 100%, have EHRs. With fewer than eleven, 25% don’t have EHRs. The rest are between 95% and 1005, with 201 to 500 doctors the only one at 100%. Ambulatory organisations are more likely to have EHRs when they’ve links to larger hospitals.

About 89% of ambulatory organisations are not planning to replace their EHRs. For acute services, 91% are not planning to replace them. Acute healthcare doctors priorities for EHRs are:

  1. Patient satisfaction data: 30%
  2. Accountable care: 25%
  3. Alternative payment models: 22%
  4. Patient portal 15%
  5. No priorities: about 8%.

Cost’s the biggest inhibitor for adopting EHRs for 47% of ambulatory services. About 28% see them as inefficient. The report has a Net Promoter Score (NPS), % Promoters minus % Detractors.  Only one supplier out of nine had a positive NPS. It was 5%. The other NPS scores ranged from -24% to -73%. As a group, doctors are extremely unhappy with their EHRs.

For EHRs in acute healthcare, the range for four suppliers is 0% to -65%. The other two are -38% and -64%, so plenty of unimpressed doctors here too.

Peer 60’s overview’s that frontline user satisfaction is rare, but they have few expectations of anything better coming soon, hence the low replacement rate. The EHR supplier that cracks it will have unparalleled competitive advantage. It seems that Africa’s health systems may have three main choices: endure the dissatisfaction until a better replacement comes along, adopt a slow implementation rate that can fix some dissatisfaction before stepping on, or wait, which may be interminable and deny benefits that EHRs can offer. These are not easy decisions.

Dec 07, 2016

Technologies that will soon transform healthcare

Technology that drives healthcare transformation needs stakeholders to reset strategies. As healthcare continues its move towards the anytime, anyplace, continuous and personalised care model, technological advances are helping to unlock previously inaccessible segments, says an article in IT-ONLINE.

Vision 2025 – Future of Healthcare, part of Frost & Sullivan’s Advanced Medical Technologies, has identified 18 technologies that will impact healthcare by 2025. Some are set to create billion-dollar opportunities, such as:

  1. Wearables
  2. Enhanced prosthetics
  3. Nanorobotics
  4. Electroceuticals
  5. Advanced materials
  6. Population health analytics
  7. Quantum computing
  8. Wellness gamification
  9. Regenerative medicine
  10. Precision medicine.

African countries, don’t have the luxury of keeping up with technological advances in healthcare. Their questions are different. Buying the latest high-tech equipment isn’t the goal. With limited resources, it’s crucial that technology delivers value and benefits.

Africa’s healthcare organisations need to identify technologies that benefit healthcare delivery improve efficiency and enhance healthcare quality for patients. The biggest trends identified in the report include:

  • Artificial intelligence (AI) to speed up the analyses of large volumes of data to efficiency levels that exceed human capability
  • Brain to computer interfaces that connect a wired brain directly with an external device for neural bypass, so help paralysed patients move or blind patients see
  • Digital avatars offering holographic projections of doctors to answer health queries, similar to voice assistants like Cortana and Siri
  • Medical tricorders that record health vitals and parameters to diagnose a range of health conditions without needing doctors

Frost & Sullivan offers timeframes for commercialisation and indicates when significant healthcare impact will be seen for each technology. Frontrunners enabling healthcare technologies include:

  1. IBM Watson Health with its AI for healthcare
  2. Organovo for 3D bioprinting
  3. DeepStream VR for its virtual reality applications
  4. QualComm with its tricorderX inducement prize to develop medical tricorders.

African countries need to start planning for these changes and how to incorporate selected technologies into their healthcare strategies. Identifying which will deliver the biggest return on investment is key. It’s never to early to start planning.

Dec 07, 2016

CodeRED shortlisted for Africa Prize for Engineering Innovation

A logistics app significantly reduces emergency response time using a custom-made mapping system. CodeRED, has been shortlisted for the 2016/17 Africa Prize for Engineering Innovation. The inventor, Sesinam Dagadu, and his team were identified after the 2015 Ebola outbreak to help manage future disasters, says an article in BIZTECH Africa.

Using software originally written to help deliver parcels faster, the life-saving CodeRED software helps ambulances navigate dense urban areas to reach patients faster. CodeRED’s currently used in 14 ambulance stations serving 4.2 million Ghanaians in Accra. The team plans to grow CodeRED and extend its services beyond Ghana.

The Royal Academy of Engineering organizes the Africa Prize. It aims to recognise and reward innovative African engineers. Applications for the Africa Prize came from 15 countries in sub-Saharan Africa.

New technologies developed by the shortlisted 16 innovators span all areas of engineering. The shortlisted candidates from Cameroon, Ghana, Kenya, Nigeria, South Africa, Tanzania, Mozambique and Uganda, undergo an intensive six months training and mentorship in business and entrepreneurial skills before the winner’s selected to receive the £25,000 prize.

Now in its third year, the Africa Prize equips talented engineers with tools and expert advice to develop their innovations into sustainable businesses. “Over the years we’ve seen the Africa Prize alumni go on to develop commercially successful and socially disruptive businesses. These are the engineers who will shape Africa, solve development challenges for local communities, and inspire more innovation,” said Malcolm Brinded, Chair of the Africa Prize judging panel.

Dec 06, 2016

How’s mHealth moving on?

When it comes to wobbly dynamics, mHealth seems to doing well. Lots of different initiatives seem to pop up right across Africa. This can obscure the overall trend, so a US, France, Germany and UK benchmark can help.

Vanson Bourne, a market research firm dealing with technology, asked Red Hat, a survey firm, to find out more. Its results show that 82% of healthcare organisations have a fully implemented mHealth strategy. This’s much more mature compared to commercial enterprises rate of 52% a year ago.

About 78% of healthcare organisations say they’re achieving positive Returns on Investment (ROI) from their mHealth, but the report doesn’t say how much, how long it takes, how long it’s for, when diminishing returns set in. when major upgrades or replacement are needed, or the length of their life cycles. However, the ROI is seen as the driver for more mHealth investment over the next year, set to be 56% up on the average number for each US healthcare organisation. This means an increase from nine to 14 apps. The four EU countries developed an average of 13 apps and estimate 31% growth, so 17 apps each in the next 12 months.

A financing snag’s looming. Red Hat found the expected increase in budgets may not support the estimated growth. Planned budget increases average 15.5%, well below the forecast mHealth growth rates. The disparity between forecast budget growth and mHealth growth may constrain one-off projects. Instead, healthcare may move towards a modern platform-based model that supports agile development and modern architecture with Application Programming Interface (API) as its building blocks. This should help increase developer efficiency, reduce development costs, and support increasing mHealth demand. It’s a model for Africa’s health systems to adopt.

Why do the acclaimed mHealth ROIs not provide sufficient finance for the next mHealth investment wave? It is question that Africa’s health systems should ask. Part of the answer may be that the ROIs aren’t entirely financial returns. They may include productivity gains that enable resources to be redeployed but don’t generate extra cash. Another component may be financial and intangible benefits for patients, carers and communities, so more of a Socio-Economic return (SER) with no extra cash for health systems.

Red Hat found a wide range of mHealth users across business needs, between 60% and 63%, for better patient engagement and care between 57% and 60%, and patient demands at 56% in the US and 43% in the EU countries.

In the US mHealth is provided mainly for doctors:

  1. Doctors 59%
  2. Technicians 44%
  3. Patients 55%.

In the EU countries, it’s very different:

  1. Pharmaceutical research development staff 53%
  2. Patients 46%
  3. Doctors 43%

Over the next year, external, user and patient demands are expected to outpace demand for internal efficiencies slightly.

Almost every organisation, 98%, faces mHealth challenges. They include security as the most dominant, costs, regulatory and compliance issues, and adoption and utilisation. At 52%, the main back-end integration language’s Java. Further down the field are .Net at 15%, JavaScript at 13%, Ruby on Rails at10% and Node.js at 9%.

It may be that relying heavy on languages like Java and .Net for integration may limit organisations’ mHealth agility compared to using lightweight back-end languages like Node.js or Mobile Backend-as-a-Service (MBaaS). Switching needs a big swing towards these languages.

Africa’s health systems can tailgate these mHealth changes in other continents. It’ll help them to keep up and improve their momentum.

Dec 06, 2016

SMSing’s still effective in fighting HIV

Texting young women in Kenya with regular information about sex, contraception, and sexually transmitted diseases has encouraged them to seek HIV tests. This’s an achievement in a country where stigma surrounding the virus is widespread, says an article in allAfrica. Some 600 female college students in Kenya received monthly surveys as text messages about their sexual behavior. In addition, 300 were sent weekly messages about HIV prevention, for a study by mSurvey.

Two-thirds of the 300 group said they were tested for HIV within six months of the study. Only half of those who had monthly surveys reported testing for the virus. "Young women across Kenya lack knowledge about HIV, but many have mobile phones and love texting," said Njambi Njuguna, a doctor and researcher at Nairobi's Kenyatta National Hospital.

Over 80% of people in Kenya own a mobile phone, according to a 2015 study by the Pew Research Center, a US think tank. "Women like receiving health surveys by text message because it's anonymous and they can do it at their convenience," Njuguna told the Thomson Reuters Foundation ahead of World AIDS Day on 1 December.

Kenya has reduced its HIV prevalence rate among adults to 6% from 11% in 1996, according to the United Nations Programme on HIV/AIDS (UNAIDS). The World Bank tables show it was slightly less than 6% in 2014. Even so, it’s still the leading cause of death in Kenya, responsible for nearly 30% of deaths, with roughly 1.6 million Kenyan infected. An average for Africa’s 12% of all deaths.

Almost 75% of women in the study hadn’t had an HIV test. Stigma and a lack of awareness about the risk of contracting the virus may be to blame, Njuguna said. The study found that most of the young women who sought testing said they chose to visit health facilities far away from where they lived to avoid being recognised.

The SMS campaign’ll be expanded next year to reach up to 15,000 women in ten of Kenya’s counties, It builds on the effective surveys already completed says mSurvey. It’s also looking to expand beyond SMSs such as using social media, such as Facebook.

Dec 05, 2016

Is IOp max a cyber-security risk?

Exchanging health and healthcare information and Interoperability (IOp) is an important eHealth benefit. It needs extensive levels of IOp to make it work, but how much is enough and sensible to minimise cyber-security risks?                                                                                                                                

It’s a scenario described by the US Federal CIO Tony Scott at the College of Healthcare Information Management Executives (CHIME) 2016 CIO Fall Forum, and reported in Healthcare IT News.

One of his two special addresses identified the inherent threat posed by the technical paradigm of maximum IOp. The other dealt with the digitisation process.

Complacency may prevail in IOp max where specifications and manufacturing are so good, it's assumed that everything will work. The next step’s addressing a set of crucial missing questions from a cyber-security perspective. They include:

  1. Who should interoperate?
  2. Are connections reliable?
  3. Are all entities what they portend to be, or are some masquerading
  4. Is IOp working as it should?

Currently, investment’s in place to answer these questions and configure and operate solutions. Support for better ICT security’s on place too. These should help to minimise increased cyber-security risks.

Other questions include:

  1. What extra vulnerabilities are created by IOp max?
  2. Are the technical solutions enough to mitigate them?
  3. How much IOp’s really needed, less than IOp max?
  4. How much IOp’s affordable?

Answers to all these questions are vital for Africa’s eHealth programmes. Affordability’s a permanent constraint.

Dec 05, 2016

Cyber-security needs isolated backups

Reliable backups are a vital part of cyber-security. mHealth Intelligence has a 10-minute Guide to Healthcare Ransomware Protection by  Xtium, a high-security, cloud provider. It says that secure, isolated, offsite cloud backups “stop cyber attackers and leave them “empty handed.” How?

  1. Recognise that ransomware attacks are a growing threat to healthcare
  2. The stakes are high for successful cyber-attacks
  3. Avoiding ransomware’s almost impossible
  4. Human error, like phishing replies, is the greatest risk
  5. Protection’s about effective incident responses, not just prevention
  6. Paying cyber- attackers a ransom isn’t a reliable solution, they’ll want more
  7. Reliable, isolated, offsite backups with several proactively created , secure, and physically separate copies of all servers, applications, and data are best practice for ransomware protection and business continuity that enable rapid restoration of business operations in the event of a cyber- attack
  8. Regular backups are not the same as recoverable backups that aren’t connected to the systems they’re backing up, and don’t deal with ransomware attacks
  9. Isolated backups in a virtual private cloud is one solution to inoculate against ransomware viruses.

Africa’s strategies for using the cloud should include this cyber-security benefit. Assessing the value is similar to sharing the risks by taking out an insurance policy. Two important questions are, how much risk needs transferring and how much risk transfer’s affordable?

Dec 02, 2016

HIMSS Middle East eHealth competition’s not all big systems

Good eHealth isn’t all about large-scale, all-pervading programmes. A report by Market Watch  on the Healthcare Information and Management Systems Society (HIMSS) and Elsevier competition in the Middle East includes eHealth services in specific healthcare activities. The HIMSS-Elsevier Digital Healthcare Award 2016 has two categories. Finalists for ICT Innovation Award Category and 2016 Finalists for ICT Achievement Award Category:

eHealth projects in the innovation category include:

  1. Al Baraha Hospital, Dubai, United Arab Emirates:  Creating an Open Source Custom Made Quality Data Management System in Anaesthesia & OT Department
  2. Cleveland Clinic Abu Dhabi (CCAD), Abu Dhabi, United Arab Emirates: Transfusion Service at CCAD / The Right Blood for the Right Patient: Bringing Innovation and Technology Together.

The achievements category includes:

  1. Hamad Medical Corporation, Qatar: Al Wakra Hospital Outpatient Pharmacy Automation Project
  2. SAAD Specialist Hospital (SSH), Khobar, Kingdom of Saudi Arabia: CELERITY - PACS & Radiology Information System.

While Large-scale projects are included in both categories, the competition confirms that eHealth for specific healthcare activities retains an important and valuable place in eHealth strategies. A lesson for Africa’s equivalent programmes, such as for SDGs, is to ensure excellence.  

Dec 02, 2016