Africa has a very long history of mathematics, especially fractal geometry. Ron Eglash and Toluwalogo B Odumosu describe it in Fractals, Complexity, and Connectivity in Africa, a chapter in What Mathematics from Africa? Polimetrica International Scientific Publisher. It can be replicated in Africa’s long eHealth Interoperability (IOp) journey.
The US National Governors Association (NGA) has released its IOp road map for states to improve their health information flows between providers, Getting the Right Information to the Right Health Care Providers at the Right Time. It offers Africa’s provinces and healthcare entities an approach they can adopt in parallel to national health ministries’ IOp initiatives. Two benefits are:
- IOp’s enormous and interminable, so national governments can’t do it all alone
- Local IOp priorities may not be national priorities.
The NGA set out five core principles and two IOp strategies:
- Five principles:
- Assemble a core team
- Conduct legal and market analyses
- Determine primary barriers
- Select strategies
- Implement and evaluate
- Two strategies to overcome legal and market barriers.
These aim to overcome numerous inhibitors that restrict the exchange of clinical information between providers. Currently, it either doesn’t happen or it doesn’t enable meaningful data use to support optimal patient care.
The legal strategy aims to:
- Develop eHealth’s legal and regulatory aspects
- Create standardised consent forms for patient permission for sharing information
- Provide guidance and education for legal and regulatory requirements and misconceptions
Strategies to address market barriers include:
- Creating economic interests that encourage Health Information Exchange (HIE) and penalise the lack of it
- Using legislative, regulatory and contracting to bolster HIE and prohibit information blocking
- Setting the vision and holding people accountable
- Setting a vision for IOp HIE and elevating best practices and placing pressure on laggards
- Bringing key stakeholders together to work towards HIE IOp.
Some of these are specific to US states that have legislative powers that Africa’s healthcare entities don’t have. Despite this, the NGA initiative reveals how Africa’s healthcare entities can move their own IOp initiatives on as a sub-set of their countries national IOp plans.
The road map helps states evaluate and implement changes to achieve better health and healthcare and lower costs by increasing clinical healthcare information flows between providers. It protects patient privacy too. Both are steps towards national IOp, a valuable opportunity for Africa’s healthcare entities. As Eglash and Odumosu conclude, “Ideas can be powerful, and we are convinced that the fractal heritage of Africa holds great promise for its future.” Can it work for widespread eHealth IOp across Africa?