Lesley Dobson

eHNA Profile

  • eHealth Africa pilots AVADAR to track Toward Polio Eradication progress

    In response to the reported cases of wild poliovirus in Nigeria, eHealth Africa (eHA) partnered with Bill & Melinda Gates Foundation, the  WHO, and Novel-T to pilot a mobile surveillance app for Acute Flaccid Paralysis (AFP) in children. It’s a condition of a rapid onset of weakness of people’s extremities, and includes Guillain-Barré syndrome.  AFP often causes weakness of respiration and swallowing muscles, progressing to maximum severity within one to ten days. 


    WHO defines AFP surveillance as six goals:


    • Track wild poliovirus circulation
    • Use data to classify cases as confirmed, polio-compatible or discarded
    • Monitor routine coverage and surveillance performance using standard indicators in all geographical areas and focus efforts in ones that are low-performing
    • Monitor seasonality to determine low season of poliovirus transmissions to help to plan National Immunisation Days (NID)
    • Identify high-risk areas to plan mop-up immunisation campaigns
    • Provide evidence to certification commissions of interruptions of wild poliovirus circulation. 


    Standard indicators are: 


    • >90% of expected monthly reports
    • >1/1000,000 annualised non-polio AFP rate per 100,000 children under 15
    • >80% of AFP cases investigated within 48 hours
    • >80% of AFP cases with two adequate stool specimens collected 24-48 hours apart and less than 14 days after onset
    • >80% of specimens arriving at laboratories in good condition
    • >80% of specimens arriving at a WHO-accredited laboratories within three days of despatch
    • >80% of specimens for which laboratories’ results sent within 28 day turn round. 


    AFP surveillance’s one of four cornerstone strategies of polio eradication. The objective’s to identify all cases of polio through a system that targets any case of AFP as a potential case of polio.  AVADAR’s a surveillance tool on android mobile devices provided to health workers and community informants. It aids AFP detection and reporting both in health facilities and local communities.


  • Rwandan hospital uses telepathology to diagnose cancer

    The Rwanda Military Hospital (RMH) has a new tool that enables medical professionals to carry out pathology test using telecommunications technology to facilitate the transfer of image-rich pathological data for diagnosis, education, and research. The OMNYX VL4 system consists of an indoor scanner, cameras, a microscope, and computers says an article in ITNEWS Africa.

    The system scans the samples and then displays the results on a computer screen. The images can then be shared online with other medical professionals in the hospital and hospitals globally. RMH has partnered with US doctors who’ll work remotely reviewing the images and responding within 24 hours.

    “Testing and treating cancer is a big challenge globally, and here in Rwanda, we have a specific challenge of not having many specialised doctors in both testing and treatment of the disease. So, this new system comes as a way of helping us to test and diagnose cancer faster as we communicate among us so that we can be able to administer immediate treatment that will give patients more chances to recover,” said Lt Col Fabien Ntaganda, the head of laboratory services at RMH.

    The new technology can test for all types of cancers. Doctors will be able to provide the diagnosis and treatment plans within five days compared to the average two weeks it usually takes..

    Other East African countries, including Uganda and Tanzania, are looking to roll out the technology soon. They aren’t the only African countries that can benefit from the technology. 


  • Will the mHealth app market expand by 2020?

    Despite the hype around mHealth apps, the global mHealth app market is still niche. A report, mHealth App Market Sizing 2015 – 2020, by Research2Guidance believes it’ll change drastically over the next two years or so as mHealth app publishers refine their business models. Traditional apps store revenue sources like paid downloads, in-app purchase and in-app advertisement won’t be big enough to support the growing number of mHealth app publishers.


    The report focuses mainly on rich high-income clients, such as those in China, USA and France, all of which are in the top ten major country markets. Not surprisingly, no African country ranks in the top ten. This doesn’t mean that it’s not relevant for African countries.


    The report has five main parts:

    1.     Current market size, with  current mHealth market sizing in terms of app numbers, app downloads and app store revenues for all mHealth apps or by app category and identifying key app segments according to their current reach

    2.     Country mHealth markets, reviewing  the mHealth app markets of 56 countries. profiling ten countries which currently offer the best market potential for mHealth app publishers and information about the country mHealth app market characteristics, such as which platform leads in the country and required download numbers to enter a top five ranking position

    3.     Seventeen mHealth business models, describing of mHealth app publishers’ performance, their different monetisation strategies and the most commonly used business models for mHealth apps and  examples of best practice

    4.     Top mHealth app publishers, with their background and performance for the Health&Fitness and Medical app section and lists and descriptions of current, most successful Health&Fitness and Medical app publishers,  analysing their product portfolios and performance

    5.     mHealth market forecasts, with estimated market size and revenue until 2020, with  a detailed outlook on the demand and supply side of the mHealth app market, forecasting the number of mHealth app users, their platform preference and the number of downloads.


    Analysts, mHealth decision makers, mHealth app publishers and investors can all benefit from the insights in the report. It looks at important trends that African countries implementing mHealth solutions should be aware of. 


  • Missouri HC estimates HIE savings

    Limited knowledge of eHealth benefits relative to eHealth costs is long-standing deficiency. There are several partial estimates that offer some light on the subject, but partial means incomplete. A report from InterSystems, a health ICT supplier, Measuring ROI: Missouri Health Connection quantifies the benefits of an HIE doesn’t include a Return on Investment (ROI), as its title suggests. It’s an estimate of cost savings at Missouri Health Connection (MHC), relying mainly external cost estimates rather than estimates from MHC’s own costs.

    ROI’s a ratio of benefits to costs. There’s several ways to compile data needed to use the generic formula. Providing estimates of one part of the formula can be informative, but cannot be an ROI.

    Donaldson Brown, an engineer, invented ROI in 1914 when he was Assistant Treasurer at the Du Pont Powder Company, a multi-activity firm. It was the ratio of net earnings to the costs of operations. The methodology’s still used, and when applied to internal initiatives to improve performance, it’s a ratio of total benefits to total the costs of investment. Both costs and benefits can include extra cash and redeployed existing resources both over time.

    ED savings comprised 83% of the total estimated savings of almost US$12.9m. Clinical savings in the ED were 80% of the total, operational savings 20%. Total savings for all five categories were:

    Estimated Savings

    US$m

    %

    ED visits and costs

    10.7

    83%

    OP medication errors

    0.3

    2%

    IP medication errors

    0.2

    1%

    Preventable readmissions

    0.8

    6%

    Preventable litigation

    0.8

    7%

    Total

    12.9

    100%

    One MHC site using HIE has reduced ED blood specimens by 18%. It compares to studies claiming 56% fewer laboratory tests and a 36% drop in radiology examinations.

  • A microchip can regenerate cells

    A research team at Ohio State University Wexner Centre has set out its’ achievements that will revolutionise regenerative medicine. Using Tissue Nanotransfection (TNT), they can generate any cell type in patients’ own bodies. The technology can repair injured tissue or restore aging tissue’s functions, including organs, blood vessels and nerve cells.

    Injured or compromised organs can be replaced using TNT. The team’s successfully shown that skin can be fertile, and used to grow any cell type for a failing organ. Two organisations collaborated. Dr Chandan Sen led the team from Ohio State’s Center for Regenerative Medicine & Cell Based Therapies and Ohio State’s Nanoscale Science and Engineering Center in the College of Engineering. Its results are in Nature Nanotechnology.

    After studying mice and pigs in these experiments, the team reprogramed skin cells to become vascular cells in badly injured legs that lacked blood flow. Within a week, active blood vessels appeared in the injured leg. By the second week, the injury was saved. Lab tests showed reprogramed skin cells in a live body into nerve cells that were injected into brain-injured mice to help them recover from strokes.

    This breakthrough has huge implications for Africa’s health systems. Nano-technology programmes should find a firm place in their eHealth strategies, or have their own strategies. The benefits for patients, families and communities are considerable. The technologies tractor needs sustained, increasing benefits to secure the achievable sustained benefits.

  • A cyber-security guide addresses healthcare’s increasing vulnerability

    Healthcare’s data’s attractive to cyber-criminals. Protecting it from criminals and general misuse’s essential because it’s highly sensitive, identifiable information. These are two core themes from a white paper from Osterman Research. It helps Africa’s health systems to move their cyber-security initiatives on, 

    Sponsored by Quest, an ICT firm, Protecting Data in the healthcare Industry goes on to identify the types of threats and their subsequent impacts. It succinctly summarises regulatory requirement from the US, UK, the EU and Australia. These provide helpful insights for Africa’s health systems in developing their eHealth regulations. These need supplementing with actions that deal with numerous increasing trends, including:

    • Healthcare professionals are increasingly using cloud solutions
    • Increasing prevalence of phishing and ransomware, with 72% of healthcare’s malware incidents being ransomware attacks, and 88% of all ransomware attacks during April to June 2016 were on healthcare
    • Data breaches are common, with  healthcare attacks up by 35% since 2015
    • Disruptions undermine the reputation and value of affected organisations
    • Healthcare’s systematically underinvested in cyber-security
    • Health workers face a growing array of communication and collaboration tools and trust them as secure and reliable, but they’re not
    • Healthcare professionals are directly vulnerable too.

    Best practices for cyber security defences include:

    • Taking cyber-security risks seriously
    • Build cyber-threat awareness
    • Develop cyber- security strategies
    • Establish thorough and detailed cyber-security policies
    • Enable encryption at every point
    • Use threat intelligence to enhance cyber-security
    • Test cyber-attack recovery plans
    • Invest in cyber-security awareness training
    • Govern user behaviour for tools, devices and repositories
    • Tighten password policies and account access
    • Have effective cyber-security defences, including

    o   Backups of core data, especially offline

    o   Next-generation firewalls that provide deeper analysis and remediation of active threats

    o   Endpoint security technologies

    o   Robust perimeter defences.

    Total security’s isn’t the goal. Cyber-criminals can often be one step ahead, such as with WannaCray and NotPetya. The objective’s to mitigate and minimise the risk. It’s important that Africa’s health systems keep this focus, making them less attractive targets for cyber-criminals.

  • HDC’s first year shows good progress

    Health Data Collaborative (HDC) is a global collaborative aiming to improve health data quality. Its 2017 progress report sets out achievements in its first year: 

    HDC’s future priorities are set around a core theme. It’s giving careful consideration to activities needed to scale up successes that support a broader range of countries aiming to strengthen scaled, credible and sustainable national health information systems. This’s a vital objective. HDC says Recording and reporting for specific diseases and programmes can take up to 33% of the time available for providing services. Liberating and redeploying these resources are extremely valuable in countries with tightly constrained healthcare resources.

  • AI helps to identify schizophrenia

    Artificial Intelligence (AI) is on the move. It’s becoming an integral part of healthcare. Research by IBM and the University of Alberta published in a report in the Nature Partner Journal Schizophrenia, a Nature publication, shows that machine learning algorithms can predict schizophrenia with 74% accuracy, says an article in IT-Online.

    It also shows that the technology can predict the severity of patients’ specific schizophrenic symptoms based on correlations observed across different brain regions. This predication of symptom severity could help clinicians identify customised treatment plans for each patient.

    Schizophrenia’s a chronic neurological disorder affecting up to eight out of every 1,000 people. Patients experience hallucinations, delusions and cognitive and physical impairment.

    Dr Serdar Dursun, professor of Psychiatry and Neuroscienece at Alberata University’s optimistic that the new technology’s. “Innovative multidisciplinary approach opens new insights and advances our understanding of the neurobiology of schizophrenia, which may help to improve the treatment and management of the disease.”

    The study can also extend these techniques to other psychiatric disorders such as depression or post–traumatic stress disorder, both of which are often tricky to diagnose and harder to treat. 

    Using AI is one way that Africa’s stretched mental health services can expand their impacts. The research provides a justification for it as part of eHealth strategies.

  • Kenya launches app to protect health workers from HIV

    HIV’s still a big public health challenge for Africa’s health systems and their health workers. Many health workers see HIV+ patients every day, so exposed to cross-contamination risks, such as accidental pricks from contaminated needles and surgical blades and blood and other body fluid splashes that can result in contracting the HIV virus. Kenya's Ministry of Health (MoH) has partnered with Care for Carers (C4C), a carers’ platform, to provide an app to help healthcare workers have prompt medical care for accidental exposure to infections.

    It’ll provide a tool for health workers to ask for immediate attention says an article in Kenya Tech News. Post-Exposure Prophylaxis (PEP) drugs can reduce infection risk by over 80%, but have to be taken within three days of exposure. The dose’s needed for 28 days. They work by attacking and killing viruses before they cause HIV after they’ve multiplied. After the 28days, patients have to have two HIV done, each taking place after three months. Dr Martian Sirengo, head of the National Aids and STI Control Programme (Nascop), said “The time PEP is initiated, and the completion of the recommended dose is of great importance. And this new platform will help us with that.”

    Health workers have to log into the C4C platform and register. It then records information such as personal, employment, demographic data and any treatments. It then provides users with detailed procedural advice the MOH guidelines. The app also sends follow-up messages to encourage and advise practitioners to adhere to the requirements and provide information on PEP drug side effects.

    C4C enables county and national governments to monitor real time data on HIV exposure incidents in healthcare facilities. It also provides data on causes and risk exposure rates for locations. This can help to frame policies on safety in hospitals, creating safer working environments.

    M-health and Nascop helped developed the app. It’s currently used in Kisumu, Turkana, Meru, Embu and Murang'a counties.

    Kenya’ s not the only country struggling with these challenges. Other African countries need similar mHealth solutions to protect their healthcare workers. 

  • Healthcare innovations claim top spots at this year’s Innovation Prize for Africa

    The sixth edition of the Innovation Prize for Africa (IPA) culminated with the African Innovation Foundation (AIF) awarding three African innovators for their innovations that tackle unique African challenges. Over 2,500 applications were submitted. Only ten nominees were selected.

    From these, Egypt’s Aly El-Shafei, a Professor of Vibration Engineering at Cairo University was the US$100,00 Grand Prize winner. Ugandan Philippa Ngaju Makobore, an electric engineer won the second prize of US$25,000, and Dougbeh-Chris Nyan of Liberia, a research scientist won the US$25,000 Special Prize for Social Impact, says an article in BIZTECH Africa. Two of the three African innovation wines focused on healthcare.  

    Inadequate medical solutions to administer drugs efficiently or diagnose diseases adversely affect healthcare quality in many parts of Africa. Makobore’s invention, Electronically Controlled Gravity Feed Infusion Set (ECGF) and Dr Nyan’s multiple disease rapid detection test both offer solutions that can improve Africa’s healthcare quality.

    AIF collaborated with the Government of Ghana, represented by the Ministry of Environment, Science, Technology and Innovation (MESTI), Ghana Investment Promotion Centre (GIPC) and Ghana@60 Planning Committee to host IPA 2017. The theme was African Innovation: Investing in Prosperity.

    AIF Founder, Jean-Claude Bastos de Morais was enthusiastic about the event. He said “AIF has rewarded IPA 2017 for developing solutions that can truly add value to the lives of Africans, and I believe that these innovations have incredible commercial potential and will succeed in attracting the right investments to go to the next stage.”

    Makabore’s ECFG’s  designed to administer Intravenous (IV) fluids and drugs accurately by controlling the rate of fluid flow using feedback from a drop sensor. IV infusions are critical for administering the right flows and volumes that patients need. Over 10% of children admitted to East African hospitals need immediate infusion therapy. Findings from the Fluid Expansion As Supportive Therapy FEAST trial indicate that over-infusion in children increases the risk of death by 3.3% at 48 hours. By increasing accuracy and safety, ECGF can save lives.

    Dr. Dougbeh developed a test to detect and simultaneously differentiate seven infections.  with similar symptoms, such as yellow fever, malaria, and Ebola. Most common testing methods take between three to seven days. His device provides results in ten to 40 minutes. He’s currently working on the second prototype. It’s a valuable step up  in detecting and managing infectious diseases.

    IPA has seen a large growth in applications and increasing interest from innovators and enablers. It’s attracted more than 7,500 innovators from 52 African countries. Hopefully next year’s winners will incorporate eHealth and mHealth in their innovations.