eHealth Articles (1,988)

Premature babies to benefit from better patient management at Groote Schuur Hospital

T-Systems South Africa helps to combine ICT into replicable, cost effective solutions. As part of their Nation Building Initiative, and an extension of their partnership with Wayde van Niekerk, 400m world record holder and Olympic gold medal winner, and his Wayde Dreamer Foundation, the company’s donated a patient management solution to the Newborns Groote Schuur Trust.

An article in IT-Online says Newborns Groote Schuur Trust, an independent NGO, raises funds to support the Neonatal unit at the Groote Schuur Hospital in Cape Town. The money goes towards care and treatment of over 2,000 of the 40,000 babies born each year in the Metro West.

The Neonatal Unit’s has been using a manual system for management of communication, especially to track patients, update contact details and schedule appointments. Keeping track of appointments and ensuring parents were notified and reminded of times and cancellations proved difficult, often resulting in missed appointments. Inefficiencies and errors didn’t help.

T-System’s solution provides better Customer Relationship Management (CRM) using Microsoft Dynamics CRM Online. It manages contact information, patient bookings, appointments, confirmations and generates appointment reminders. It can schedule and manage staff standby rosters too, reducing pressure on doctors and nurses and ensuring their availability.

Gert Schoonbee, MD at T-Systems South Africa, says “Our involvement in this project is a natural fit, particularly when considering our motto of ‘in South Africa, for South Africa’. We are proud to be involved in this initiative and, together with Wayde, are committed to contributing positively towards reducing the high mortality rate caused by complications in premature babies. We are extremely proud of the role of our partner, Microsoft, who contributed by reducing license fees for their platforms.”

This is an important development for neo-nateal care at Groote Schuur Hospital. Other hospitals across the country, and all Africa could benefit from it too.

Mar 16, 2017

Health experts at WEF aren’t too sure how eHealth will transform healthcare

Many children know exactly how Hasbro’s celebrity autobots, the Transformers, work. It seems that top eHealth and healthcare experts aren’t sure how eHealth will transform healthcare. It maybe that new medical techniques and technologies will have a bigger impact. This was the theme at a World Economic Forum (WEF) event in Davos, Switzerland.

The discussion on the hospital of the future set out a theme of healthcare industry moving out of acute care in hospital into homes and clinics. As part of this, a wide, integrated range of data sources will help inform treatment plans. It’s seen as a global phenomenon, but two pertinent questions are:

  1. How will technology companies, especially those in health ICT, develop and provide services to collect and disseminate the data needed?
  2. How will health systems and their workforces use the data to improve outcomes and transform healthcare?

As a big wealth community, the WEF event has an excessive USA emphasis. For Africa, two crucial extra questions are:

  1. Can eHealth help to close the gaps significantly between its large burden of disease, its increasing population and its paucity of healthcare resources?
  2. If it can, how can it be done sustainably?

The experts at WEF outlined some of the new clinical techniques and practices beginning to transform healthcare. There was a downside too, the barriers to data sharing.

There’s nothing new about transferring healthcare from hospitals to community care. It’s been happening since healthcare was created. It has a parallel activity too. As hospitals divest, they also invest in new and more complex medical techniques and practices drawn from research. They’re two continuous curves. This discussion’s on You Tube too.

For Africa’s health systems, an extra eHealth theme is using eHealth to support health workers already working in communities. Giving them better access to drugs and diagnostic tests and results is a priority too.

The WEF experts were unclear about how patients’ can have their data and achieving Interoperability (IOp) between health systems and clinical services. Standardised terminology and health informatics are essential to help shift healthcare models towards communities and homes. Achieving it’s crucial because healthcare’s and medicine’s future depend on doctors who use new clinical techniques and eHealth creatively to improve patient care.

Is it time to send for Bumblebee and its team of heroic Autobots? Their mission could be to capture the evil eHealth Decepticons and Resisticons who are loose in healthcare, so “Rev up and roll out”, or maybe not. The steady eHealth trajectory’s much more appropriate for Africa

Mar 16, 2017

AeHIN’s strategy has lessons for Africa’s eHealth

Last week I returned from an Asian eHealth conference in Myanmar. The trip was extraordinary for at least two reasons: exploring places, people and cultures quite different to the African environment I call home, and learning about our Asian colleagues' approach to eHealth leadership. 

As our African countries health systems move towards eHealth goals, looking at other global regions provides valuable insights.

Set up in 2011, the Asian eHealth Information Network (AeHIN) provides an overview of eHealth in that part of the world. When it started, it identified a shared problem of, at best, minimal Interoperability (IOp) “Even within Ministries of Health.”

AeHIN has a clear trajectory for its 25 country members. The Asia eHealth Information Network: Strategic Roadmap 2016-2020 sets out a wide array of initiatives to support national eHealth development in Asia. There are four strategic goals:

  1. Build eHealth capacity for Health Information Systems (HIS) and Civil Registration and Vital Statistics (CRVS)
  2. Effective networking to increase peer assistance and knowledge exchange and sharing
  3. Promote IOp in and between countries
  4. Enhance leadership, sustainable governance and M&E.

eHealth governance framework for enterprise ICT is based on COBIT5, from the Information Systems Audit and Control Association (ISACA). It’s an internationally recognised framework for ICT governance. Its three overarching themes are evaluate, direct and monitor. There are four main parts in AeHIN’s model:

  1. Align, plan and organise
  2. Build, acquire and implement
  3. Deliver, service and support
  4. M&E and assess.

AeHIN has eHealth blueprints for enterprise architecture. Its four components are business, data, application and technology. It also has a Regional Enterprise Architecture Council for Health (REACH). Its eHealth capacity framework has seven modules:

  1. eHealth service agreements
  2. Management, plans, policies and procedures
  3. IOp profiles and terminology services
  4. Health Information Exchange (HIE)
  5. National Standards and IOp framework
  6. eHealth governance framework
  7. National eHealth action plans.

Supporting these initiatives are special interest groups. They include:

  1. Geographic Information Systems (GIS) lab
  2. Routine HISs
  3. District Health information Systems (DHIS) 2, implemented in twelve countries
  4. Research, with ten PhDs to work on AeHIN topics
  5. Community of IOp labs.

The African Centre for eHealth Excellence (Acfee) has much in common with AeHIN and its aspirations. A working relationship has been initiated between Acfee and AeHIN  to begin sharing African and Asia lessons for mutual benefit.

This structured approach offers a template for Africa’s eHealth. Modest, steady, sustained investment can start to achieve it.

Mar 15, 2017

AI predicts heart failure

Heart failure’s not always easy to predict. CADence, described in eHNA post, shows how difficult it can be and how eHealth can help. Now, Artificial Intelligence (AI) can help too. It can save lives by identifying patients who need more aggressive treatment, says the UK's Medical Research Council (MRC) team in an article in BBC News. Technology’s advanced so much that AI can now calculate accurately when patients with heart disorders will die. The software can to do this by analysing blood tests and scans of beating hearts to spot signs that show they’re about to fail.  

 Researchers, at the MRC London Institute of Medical Sciences, were investigating patients with pulmonary hypertension, raised blood pressure in arteries supplying the lungs. Results indicate that high blood pressure in the lungs damages part of the heart, and about a third of patients die within five years of being diagnosed.  

The AI software helps doctors to predict how long the patients will live. The data improves informed clinical decisions, leading to more precisely prescribed and individually tailored intensive treatments, such as drugs, injections into blood vessels or in extreme cases, lung transplants if necessary.  

The AI was given MRI scans of 256 patients' hearts, and blood test results. The software measured movement of 30,000 different points in the hearts’ structures during each heartbeat. Data was coupled with eight years of patient’s health records. AI learned which abnormalities predicted when patients would die.

It estimated up to approximately five years into the future, with an 80% potential to predict whether people would live beyond a year.  This’s a third better than doctors performance of 60% accuracy.  Researches want to use AI for other forms of heart failure such as cardiomyopathy, diseased of heart muscles, to see who needs pacemakers or supplementary treatments. They also hope to test AI on other patients in several hospitals to assess whether it should be widely available to doctors.

eHNA’s previously posted about AI revolutionising healthcare. Pulmonary hypertension might be a good place for Africa’s health systems to start.

Mar 15, 2017

eThekweni District has an HIV/AIDS app

HIV/AIDS remains one of the leading causes of death worldwide. Avert has estimated that   more than 7 million people in South Africa live with HIV. About 70% of the total global prevalence lives in sub-Saharan Africa, with South Africa carrying the highest burden of the epidemic in the world in 2015. HIV/AIDS is a major health concern in South Africa, with 380,000 HIV incidences and 180,000 HIV/AIDS fatalities in 2015 as reported by Avert. KwaZulu-Natal tops the chart of the country’s nine provinces with nearly 20% of HIV/AIDS patients. 

In 2015, eThekweni District in KwaZulu-Natal’ started using mHealth to help improve services for people living with HIV. Access to HIV/AIDS treatments services remains a challenge, with only 48% of adults receiving Antiretroval Treatment (ART) in the country. South Africa, like many other African countries, face many health challenges, patient and community barriers against the smooth delivery of HIV/AIDs treatment and services.

Health system barriers include a growing shortage of staff due to high turnover, highly congested and poorly coordinated healthcare facilities and a knowledge gap between healthcare providers and their patients. Patient barriers are long distances, transport costs and longer waiting times before receiving primary healthcare or treatment. Lastly, HIV/AIDS related stigma and discrimination remains prevalent in communities.

Health-e News has a report saying the project includes an app so healthcare providers can track individual performances of caregivers in every ward, while indicating where health services are inefficient. The app enables healthcare providers to login with their own personal username to report on their activities and interventions. Managers can use the app to monitor activities in each ward. The project focuses on HIV patients and has received a twelve-month grant of £96,944 roughly R1 547 086 in 2015.

Integrating apps like these in healthcare can increase efficiency in the delivery of HIV treatment and services and can build trust between healthcare providers and their patients. It should help improve co-ordination, address staff shortages, allow healthcare providers to monitor and track their patients’ status, and enable managers to improve the functioning of facilities. It could help other districts too.

Mar 14, 2017

Medical Aid Films - A new film about safety in fistula surgery

Obstetric fistula is one of the most devastating and serious injuries that can occur during childbirth. It affects between 50,000 and 100,000 women each year, mainly in low-income countries, and it is estimated that more than 2 million women live with untreated fistula in Asia and Sub-Saharan Africa alone. Women who experience obstetric fistula not only risked death during delivery, but they also continue to suffer incontinence, shame, social segregation, and health problems. These women’s lives can be transformed by reconstructive fistula surgery provided in a safe surgical environment.

There is a clear need for this basic minimum acceptable standard to improve safety and quality assurance in fistula care. This is the worldwide issue that Medical Aid Films (MAF) aims to address. The film was made in partnership with EngenderHealth, a leading global women’s health organisation committed to creating lasting change by training health care professionals and partnering with governments and communities to make high-quality family planning and sexual and reproductive health services available for all generations to come. 

The new film provides a clear, accessible, context-appropriate, and informative tool to support the delivery of quality care around fistula surgery. Shot on location in Nigeria, it features interviews from fistula surgeons and nursing staff from a leading teaching hospital, UCH Ibadan, and demonstrates the importance and use of safe surgery checklists, which are central to ensuring the safety of patients undergoing fistula surgery.

The film, available in English and West African French, will be used as part of EngenderHealth’s Fistula Care Plus programme, which has already helped support over 39,000 fistula repairs and patients worldwide. Through this film, MAF aims to help advance safe surgery practice to improve outcomes for women affected by fistula across the world. Click here to watch and download the films for free.

Mar 14, 2017

GluSense making remarkable strides in monitoring diabetes

More than 14 million people suffer from diabetes. The  International Diabetes Federation has said if nothing’s done, this figure will reach 34 million by 2040. Africa has the highest percentage of undiagnosed people. At nearly 67%, they’ re at higher risk of developing harmful and costly complications.

GluSense, an Israeli medical device company, is developing Glyde, a miniature injectable, continuous glucose sensor. It’s injected under the skin and transmits Continuous Glucose Monitoring (CGM) values to a wearable device, like a smartwatch, for up to a year. Better quality of life is a big benefit for diabetes patients. It could improve the lives of many Africans.

“Today, diabetic patients need to endure frequent finger pricks daily in order to manage their glucose level, and even with modern CGMs, frequent calibrations, measurement verifications and replacements are still a hassle and limit efficient treatment,” GluSense CEO Dr. Boaz Brill said in an article in mobihealthnews. “In contrast, our Glyde continuous glucose monitor (CGM) will provide accurate glucose measurement for a full year with significantly fewer blood glucose calibrations. This ground-breaking technology will simplify and improve the life of people living with T1D and insulin dependent T2D worldwide.” 

There’s more to do for Glyde to attain commercial viability. New funding from the Diabetes Research Fund (DRF) T1D Fund, a recently launched philanthropy dedicated to financing early stage programs for T1D. It’ll help GluSense to launch its first human clinical trial, an important step before it seeks regulatory clearance.

GluSense says it “uses a proprietary fluorescent glucose-sensitive biosensor that ensures accurate glucose measurement across the full physiological range, with enhanced accuracy at the medically important hypo glucose range.” The biosensor’s made of “engineered live cells.” These enable it to replenish itself over a year. It also minimizes the need for less frequent calibrations.

Many CGMs last about a week before they need replacing. Others can last up to 90 days. If GluSense can deliver Glyde with a one year life, it’ll be life changing for many diabetes patients. Its value in Africa could be considerable.

Mar 13, 2017

Four apps for ER doctors

Emergency Rooms (ER) are busy. mHealth that eases workload and makes ER doctors’ working lives better are worth it. In Med Page Today, Dr Iltifat Husain has identified four that help.

GoodRx for Doctors, described by Dr Husain as “fantastic … for helping your patients be compliant with their prescriptions,” it included a bookmark to find medications prescribed frequently but may be unaffordable for patients. An equivalent for Africa’s health systems would be well received by communities.

OrthoFlow was developed by UK orthopaedic surgeons and doctors working in Accident and Emergency. Dr Husain says it’s “A great fracture management app that essentially puts an orthopedic surgeon in your pocket.” It helps with fracture management and understanding essential features of fractures, such as how much displacement needs changed management.

STD Tx Guide, developed by the US Center for Disease Control and Prevention (CDC) provides alternative antibiotic regimes for patients allergic to penicillin (PCN). The app was updated recently to include new guidelines.

Gout Diagnosis avoids tapping red or painful joints. Dr Joshua Steinberg took a validated study on gout diagnosis and created an app. He’s a bit of an appthusisast. They’re all available from iTunes.

Africa’s mHealth plans could include investment programmes in ER services. These would have to be in parallel with investment in mHealth for citizens and communities.

Mar 13, 2017

Cyber-security needs more than rules

Africa’s eHealth’s not strong on cyber-security rules and regulations. They’re essential, but a survey of ICT security experts in the US by Level 3 Communications says they’re not enough. The results, available from Health IT Security are that:

  1. 96% feel vulnerable to a data breach
  2. 63% have suffered one
  3. 69% say meeting compliance requirements is very or extremely effective in safeguarding sensitive data.

In the US, eHealth security and privacy rules are set out in the Health Insurance Portability and Accountability Act 1996 (HIPAA). It established national security standards for eHealth. They are a vital component to protect confidential information from unauthorised access. Level 3 says that since the act, cyber-threats and the cyber-security landscape has evolved rapidly, but healthcare can’t keep up. Cyber-security has become more essential to protect data and healthcare availability and continuity.

Three emerging cyber-security themes have become healthcare’s biggest cyber-security threats:

  1. Vulnerable connected devices the cyber-criminals can access to plant malware
  2. Distributed Denial-of-Service (DDoS) attacks that render computers or networks unavailable
  3. Phishing, accounting for more than 36% of cyber-security breaches.

Four lessons for Africa’s eHealth are clear. First, ensure effective cyber security standards, rules and regulations. Next, keep them up to date to match the expanding cyber-crime initiatives. Third, ensure compliance. And finally constantly strive to go beyond compliance with effective excellent cyber-security practices.

Mar 10, 2017

UK’s GCHQ technical director says cyber-security firms promote 'medieval witchcraft'

Are all the cyber-security firms misleading us about the hazards and dangers of cyber-threats? Dr Ian Levy, technical director at UK’s Government Communication Headquarters (GCHQ), an intelligence and security organisation, says they’re using “Medieval witchcraft” to exaggerate the risks and boost sales. A report in The Register records his view expresses at Usenix Enigma 2017, that their aim’s to sell security defences to tackle “Advanced persistent threats” from highly organised, smart criminals, but hackers are just “Adequate pernicious toe-rags.” The result of the sales campaigns “Are allowing massively incentivised companies to define the public perception of the problem.”  

Soon after Dr Levy’s comments, the UK Parliament’s Public Accounts Committee  (PAC), a highly respected and fiercely independent spending watchdog, released Protecting information across government. It’s critical of the UK’s cyber-security performance when the “Threat from cyber attacks has been one of the UK’s top four risks to national security since 2010.” It says the current performance “Reduces our confidence in the Cabinet Office’s ability to protect the nation from higher threat cyber attacks. The use of the internet for cyber crime is evolving fast and the government faces a real struggle to find enough public sector employees with the skills to match the pace of change.”

A quick look at a Symantec user report showed eight cyber-attacks were repelled over a week. Several phishing emails arrived most days. Some were diverted to a junk folder. One’s with new domain names made it to the inbox. Despite the NSCS’s efforts, and their improvements in response to PAC’s report, cyber-criminals are always one step ahead of cyber-security measures. Provided eHealth teams are aware of cyber-security firms’ aspirations to sell on the back of their advice and white papers, which isn’t difficult to spot, the advice offered is free and still very valuable for Africa’s eHealth cyber-security initiatives.

Mar 10, 2017