eHealth Articles (1,988)

A cyber-security workbook can help achieve good practice

A common feature of cyber-security’s its general lag behind cyber-threats. Data Breach Incident Response Workbook, from AllClear ID, a cyber-security company, provides general guidance and assistance in developing security standards. It’s essential for Africa’s eHealth.

Health IT Security says it provides an outline and recommendations for a start to planning well-orchestrated responses to a data compromises. The next step’s engaging external stakeholders. An essential theme’s ensuring plans are recorded and tested thoroughly to achieve effective financial and operational responses to cyber-attacks.

Its contents include:

  1. The cyber-threat world and operational and reputational damage
  2. Anatomy of a data breach
  3. Preparing for a data breach
  4. Building a strong internal response team
  5. Data breach checklist
  6. Data breach notifications
  7. The Incident Response Plan Guide.

Incident response teams shouldn’t be just from ICT teams. They should draw and appoint an incident lead from:

  1. Executive management
  2. ICT
  3. Customer and patient services
  4. Risk management and security
  5. Compliance and audit
  6. Legal
  7. Privacy
  8. Public relations.

The checklist should document everything that happens and is discovered. Prompt action’s vital, so every action needs fitting into a timeline. Actions include:

  1. Implement the data breach incident response plan
  2. Specify the information needed for reporting summaries
  3. Identify the problem
  4. Start the incident reporting process
  5. If the data breach could harm a person or business, contact local police
  6. Create an incident summary report for executives
  7. Create a technical incident summary report.

The Incident Response Plan checklist’s comprehensive. It includes important advice: “Continuously update the information in the contact lists and other documents – don’t get caught in an emergency with outdated information.” It’s obvious, but an elementary error to avoid.

Feb 09, 2017

Are Africa’s EHRs expanding?

At the core of eHealth sits EHRs. The WHO Global Survey 2015 and Capter 5 of the  WHO and Global Observatory for eHealth (GOe) publication eHealth Report of the third global survey on eHealth Global diffusion of eHealth: Making universal health coverage achievable, say there’s been steady growth in adopting national EHRs over the last 15 years. It’s’ jumped by 46% in the last five years. Africa has much more to do.

More than 50% of upper middle and high-income countries have adopted national EHRs. The rate in poorer countries is 15% and 35%. Africa’s average’s at the lower end.

EHRs depend on other eHealth for much of their data. Most, over 70%, national EHRs integrate with laboratory and pharmacy information systems. About 56% integrate with Picture Archiving and Communications Systems (PACS). African countries trail the global average on these too. Their investment’s about a third of the global average. Catching up on EHRs needs investment in these systems too, so a considerable resource, affordability requirement and undertaking.

WHO identified lack of funding, infrastructure, capacity and legal frameworks as investment barriers. eHNA has posted on numerous others. They’re mainly parallel investments needed to maximise benefits. Examples are cyber-security, ID management, an example in a recent post, and ferreting out and quelling undesirable “digital dystopia” of ineffective EHRs that doesn’t improve health, healthcare or make it more efficient, posted on the snake oil speech at the American Medical Association.

Africa’s need for more investment in EHRs and related eHealth and overcoming the barriers points to the important role of rigorous eHealth business cases. These lead to better eHealth investment decisions, so better eHealth, including EHRs. Healthier Africans is the overarching goal. EHRs are an important part of achieving, but only a part, and a part with significant dependencies that need to be in place too.

Feb 09, 2017

SIMWAY tackling Kenya’s obesity

Obesity is an increasing health issue for many countries. It's become the leading cause of heart disease, hypertension, diabetes and other Non-Communicable Diseases (NCD). The  Ministry of Health’s Department of Nutrition and Dietetics says, 40% of women in Kenya, aged 30 to 40, are either overweight or obese. Groups most affected are women of reproductive age. In total, an estimated 1.8 million people in Kenya are obese, about 5% of the total population. 

ITWeb Africa  has an article saying Kenya’s Health Department’s tackling obesity in collaboration with three Japanese companies. They have introduced SIMWAY to help. It’s currently in a pilot phase.

 Kasumi Sawada, MD of AfricaScan says the app aims to reduce the rising prevalence of obesity in Naivasha, a Kenyan sub-county. The mHealth service will support  local community health volunteers to be weight management planners, supporters and consultants. SIMWAY enables them to personalise weight loss plans and update data in real time so volunteers can track clients’ weight loss progress.

SIMWAY has a messaging function so heath volunteers can communicate with clients, tracktheir behaviours and their progress and enable clients to monitor themselves.The app formulates intake targets using algorithms to calculate energyconsumption levels, which creates a personalised weight loss plan for each individual. 

SIMWAYS's stillin a two-year trial period in Kenya but hasthe potential to be implemented in other parts of Africa where obesity is anissue too. It’s only currently available on Play Store in Naivasha. It’ll beavailable to the rest of Kenya after it has been revised. 

Feb 08, 2017

Africa’s EHRs are trailing – unpacking the 3rd Global Survey on eHealth

EHRs are one of eHealth’s building blocks. WHO Global Survey 2015the data source for the WHO and Global Observatory for eHealth (GOe) publication eHealth Report of the third global survey on eHealth Global diffusion of eHealth: Making universal health coverage achievable, provides insights for Chapter 5.

Key findings include:

  1. Steady growth in adopting national EHRs over the last 15 years
  2. About a 46% global increase in the past five years.
  3. Over 50% of upper middle and high income countries have adopted national EHRs
  4. Much lower adoption rates in the lower middle and low-income countries at 35% and 15%
  5. Most national EHRs integrate with laboratory and pharmacy systems at 77% and 72%, with Picture Archiving and Communication Systems (PACS) at 56%.

Africa’s national EHRs match the low-income rate. Their integration with other information systems is lower than the adoption rate, so well below the global position. While some of the shortfall may be due to the definition of countries’ EHRs not matching WHO’s survey definition, so possibly understated, as the report mentions, it’s still a big gap.

Catching up needs African countries to step up their investments. It also needs investment barriers to EHRs removing. WHO says these include lack of funding, infrastructure, capacity and legal frameworks. For Africa, parallel investment’s also needed in laboratory, pharmacy and imaging services and cyber-security, eHealth governance, business cases and M&E.

Catching up alone isn’t a good investment goal. Adopting EHRs at a sustainable, affordable pace that results in healthier Africans and enables health professionals to improve their contributions are best.

Feb 08, 2017

Eltek to provide electricity for 104 Zimbabwean hospitals

Uninterrupted and reliable electricity is vital for eHealth. Many healthcare facilities across Africa still lack this basic necessity, making eHealth impossible. Zimbabwe’s eHealth is taking a step closer.

Eltek has announced a contract with United Nations Development Programme (UNDP) to provide complete photovoltaic solar solutions for 104 hospitals in Zimbabwe. It will provide full delivery, installation, service and monitoring of the solar systems that use Eltek’s breakthrough Rectiverter technology. With a modular design, these solar power solutions can easily be adapted to different demands in the field. An article in ITNEWS Africa Says installation is expected to be completed during the summer of 2017.

The service aims to provide safe, reliable and environmentally friendly electricity to hospitals in remote areas that currently have no, or poor, grid access. It’s not just eHealth that will benefit. A key challenge for many hospitals is keeping medicines refrigerated and to provide other essentials necessary for the hospitals to treat their patients.

“This contract represents a new and exciting area for Eltek and our technology,” said Morten Schøyen, Chief Marketing Officer at Eltek. “It makes us proud to work together with UNDP and to contribute to improved health care and reduced operational cost, by providing pure and reliable renewable energy,” Mr. Schøyen added.

The solar for health programme’s aimed at health facilities across Africa, the Arab States and Central Asia. It addresses several Sustainable Development Goals.

Feb 07, 2017

AI’s good at diagnosing skin cancer

Conventionally, skin cancer’s primarily diagnosed visually. It starts with a clinical screenings, then, if needed, followed by dermoscopic analyses, a biopsies and histopathological examinations. A team mainly from Stanford University, California, has reported in Nature that mHealth can provide an alternative. It’s a technological step up for Africa’s mHealth.

Classifying skin lesions using images is challenging, owing to fine-grained variabilities in their appearance. Convolutional Neural Networks (CNN) offer potential for dealing with fine-grained object categories. The team demonstrates skin lesion classifications using a single CNN, trained end-to-end directly from images using only pixels and disease labels as inputs. Trained CNN used a dataset of 129,450 clinical images and 2,000 skin lesions.

Its performance was tested against 21 dermatologists using proven clinical images from biopsies in two use cases:

  1. Keratinocyte carcinomas versus benign seborrheic keratosis, identifying the most common cancers
  2. Malignant melanomas versus benign nevi, identifying deadliest skin cancer.

CNN achieved performance in both use cases that matched all tested experts. It shows that the algorithms in Artificial Intelligence (AI) can classify skin cancer as well as dermatologists. Equipped with CNN, mHealth can potentially extend dermatologists’ reach beyond their clinics. An impact is lower-cost universal access to vital diagnostic services.

As healthcare researcher teams extend AI across other conditions, it offers Africa’s mHealth initiatives a much wider role and impact. It seems that mHealth can have much more to offer.

Feb 07, 2017

Check your sexual health at home with Everlywell

Most Sexually Transmitted Diseases (STDs), sometimes referred to as Sexually Transmitted Infections (STIs), do not reveal their symptoms initially. This covert nature creates a risk of passing the disease on to other people.

The WHO says there’s a daily global prevalence of more than a million acquired STD. Trichomoniasis, chlamydia, gonorrhea and syphilis are the most common STDs. Globally, they’re responsible for 143 million, 131 million, 78 million, and 5.6 million infections respectively. 

In 2015, the Centre for Disease Control and Prevention (CDC) reported a record increase of STDs in the age group between 15 and 24 years old. Over 1.5 million chlamydia cases and 400,000 new cases of gonorrhea were reported. These alarming rates propelled Everlywell to add STDs testing to their repertoire to equip young people with a simple, hassle-free way to access tests.

Everlywell, based in Austin Texas, launched its diagnostic testing kit last September. It offers a digital platform which provides a convenient at-home testing for clients says an article in MobiHealthNews. By avoiding numerous doctors’ appointments and lab results, Everlywell provides online test orders with required samples sent to the nearest certified laboratory for analysis. Here, expert physicians review the results and report them back online after a few days. It’s like Computerised Physician Order Entry (CPOE) with patients replacing physicians.

The STD diagnostic test kit costs $249. It deals with diseases such as HIV, syphilis, herpes type 2, gonorrhea and chlamydia. In cases of abnormal results, like testing positive for a curable or incurable condition, trained physicians follow-up, provide prescriptions for required medications and, for life changing results, will provide counselling services and guide you through the next steps.

Young people globally face many barriers when they access or receive reproductive health services and quality STD prevention and management services. This is especially true for many African countries that don’t have the resources to allocate to STD prevention and treatment.  These barriers include, lack of transportation, long waiting times, conflicts between clinic hours and work or school schedules, embarrassment and stigma attached to seeking STD services, and concerns about privacy and confidentiality. Consequently, many would rather suffer in silence than try to seek help. By enabling people to perform STD tests in the comfort of their own homes, Everlywell, bridges these gaps. It encourages and increases STD testing, and provides a frequent, easier, less embarrassing and more convenient way to test, treat and manage STDs. For this initiative to succeed in African countries, the cost and healthcare capacity to care for more patients need addressing.

Feb 06, 2017

IHE wants comments on endoscopy

Four aspects of endoscopy can be seen as the instrument, the technique, a diagnostic tool and minimally invasive surgery. It’s a very valuable medical technology. Looking inside people is a clever way to avoid cutting them open.

Endoscope’s aren’t a modern idea. Primed Canada says its inventor identified by most medical historians is Philip Bozzini. In 1805, he used a tube, lichtleiter, a light guiding instrument, he created, to examine urinary tracts. Antoine Jean Desormeaux, a French surgeon renamed it the endoscope. It’s claimed that in 1868, Adolph Kussmaul was the first person to use an endoscope to see the inside of a stomach of a living person. In 1878, two doctors, Max Nitze and Josef Leiter, invented an endoscope to inspect the urinary tract and bladder.

None of these men concerned themselves with the informatics or eHealth standards and interoperability of their innovations. Integrating the Healthcare Enterprise (IHE) does. It’s released for consultation two supplements:

Endoscopy Image Archiving (EIA)

Endoscopy Ordering Workflow (EWF).

The IHE Endoscopy Technical Committee wanted comments on these by 18 January 2017. They will now complete the supplements as part of the planned IHE Endoscopy Technical Framework.

Feb 06, 2017

Identifying patients incorrectly is a big problem

ID mistakes can be costly. Sir Thomas Browne, a 17th century polymath, said “Rough diamonds may sometimes be mistaken for worthless pebbles.” It seems that identifying patients incorrectly is a big problem too. In its 2016 National Patient Misidentification Report, Ponemon Institute says “Patient misidentification is far too common,” sponsored by Imprivata. About 63% respondents to the survey said the primary cause is identifying patients incorrectly at registration. Time pressure when treating patients is similar at 60%. The effect’s that patients and hospitals suffer significantly.

The causes are:

Incorrect patient identification at registration
Time pressure when treating patients
Insufficient training and awareness
Too many duplicate medical records in system
Human registrar errors                
Issues across departments and workflows
Inadequate safety procedures
Over reliance on home grown, obsolete ID system
Patient behavioural issues        

Addressing the weakest links in patient identification needs three main actions:

  1. If the healthcare facility is too reliant on home grown ID, the business case is investing in technologies, such as biometrics, to increase the patient information accuracy that can realise savings
  2. Assess and analyse vulnerabilities in the patient registration process and implement procedures that reduce them
  3. Conduct clinician and administrator training and awareness programmes to address common patient registration errors and related tasks to ensure the correct healthcare’s delivered to the right patients.

African health systems can adopt these directly. As their EHRs expand, it offers opportunities to sustain high-quality data from the outset, maximising benefits.

Feb 03, 2017

GE and Standard Bank’s new Healthcare Accelerator programme

GE and Standard Bank have launched their new 'Accelerator Programme' for South African health professionals. The two companies say the six-month healthcare Accelerator Programme aims to equip health professionals with technical, clinical and business skills they can use to improve and grow their public or private practices. An article in ITWEB Africa say only delegates from South Africa will take part in the Programme as it’s a pilot to inform strategy on future plans.

GE South Africa's BBBEE partner Londvolota will oversee courses on the programme. It covers business planning, digital practices, human resources and marketing. It’ll be held at the GE Africa Innovation Centre, at Standard Bank’s Incubator and Standard Bank's Durban and Cape Town offices.

Farid Fezoua, President and CEO of GE Healthcare Africa, says the Programme will bring competencies from GE and Standard Bank in a new and meaningful way. "You can make a difference by putting together technology and financing and in our case service and maintenance as well along the way. In Africa this has not always been the case and we usually buy technology and without a focus on training and building capability or we don't think about getting affordable financing or the servicing of equipment. I think this is where we will be bringing change and I think it can be done because, together with Standard Bank, (we) have already contributed to modernise 98 hospitals in 47 counties across Kenya and we are going to be working over a sustainable solution over a seven to ten year period and we can ensure that the hospitals at least within the radiology and the diagnostic units will run in an optimum manner."

Bringing together these two sectors is crucial for strengthening Africa’s healthcare. Hopefully, participants beyond South Africa will benefit from the programme soon.

Feb 03, 2017