• Strategy
  • An eBook sets out six steps for clinical mHealth

    Clinical teams have increasing mHealth opportunities. mHealth strategies should provide the bases for decisions to use them. An eBook by Spectralink, a communications provider, available from Health IT Security, sets out six steps. The goal’s to invest in clinical smartphones for healthcare professionals to communicate, collaborate and co-ordinate patient care across wide arrays of teams and team members. 

    Six Steps to Developing a Successful Clinical Smartphone Strategy combines generic strategic concets, such as vision, with technical components. The six steps are:

    Define an overall vision for mHealth technology initiativesUnderstand information flows, application and technology requirementsEvaluate enterprise-class smartphone solutionsAssess ICT infrastructure and requirements, including Wi-FiImplement a proof of concept and pilot programmeAddress operational issues, including training and support requirements. 

    Creating successful clinical mHealth strategies need measured, forward-thinking. Improving patient care and outcomes, and accounting for future technology advancements  must be the focus. It should include people, processes and technology to maximise organisation’s benefits.

    The eBook extends from strategy to mHealth investment. Acfee would include a step for business cases to generate and compare options to identify and estimate:

    Strategic fitSocio- economic impact, including optionsManagement capacity to deliver and realise net benefitsFinance and affordabilityCommercial themes, such as contractual options.

    Completing this would be before and after step 5. Step 6 should also address benefits realisation issues. These lay foundations for M&E as step 7. 

    Africa’s health systems assign a high priority to mHealth. The eBook provides a process that they can adopt and ehance.

  • ADB eHealth guidance says look at the forest and the trees

    Managing and investing in eHealth’s seen as similar to forest management. Both are complex ecosystems. A Peter Drury blog from the Standards and Interoperability Lab – Asia (SIL-Asia) emphasises the large number of dynamically, interacting elements that where. Each element in the system may not know about the behaviour of the whole system. 

    Five-year strategic visions and plans help. The WHO/ITU National eHealth Strategy Toolkit provides guidance for these, but they’re not enough. Managing a complex sets of real-time elements is a greater challenge. It’s the core of Guidance for Investing in Digital Health, an Asian Development Bank initiative. 

     It’s based on how stakeholders engage, or don’t engage, with current systems, and how well, or not, they’re supported by management, technical, and workforce foundations. Investment appraisals and decisions spring from these,

    Instead of a five-year cycle, eHealth policy-makers should:

    Monitor progressAdapt to emerging challenges and opportunitiesManage expectations and investment. 

    The ADB’s Digital Health Impact Framework User Manual, linked to the Guidance, provides a methodology for these activities. It too is iterative, and addresses short and long-term requirements. 

    Pressure for quick wins doesn’t help. To counter this, the Asia eHealth Information Network (AeHIN) and SIL-Asia support work on Digital Health Governance Architecture and the Mind the GAPS programme covering governance, architecture, programme management, standards and Interoperability.

    While these are Asian initiatives, Africa can begin to adopt them. Using components that fit each countrys’ health systems is the way to start. It’ll set them on a trajectory of proven good practices.

  • AeHIN sets up its Community of Interoperable Labs (COIL)

    Six countries’ health systems have formed the Asia eHealth Information Network (AeHIN) Community of Interoperable Labs (COIL). The Standards and Interoperability Lab-Asia (SIL-Asia) is guiding the initiative. Viet Nam, Malaysia, Thailand, Philippines, Indonesia, and Taiwan commitment to interoperable health systems at the 6th Asia eHealth Information Network (AeHIN) General Meeting and Conference on Interoperability for Universal Healthcare Coverage (UHC).

     

    A blog by SIL-Asia says the Regional Interoperability Workshop organised by the AeHIN at the the Global Health Research Forum in August 2015 was the genesis. SIL-Asia was set up as a regional health interoperability lab to meet the needs of Asian countries for a facility to benchmark emerging digital health technologies in the market. The benchmarking criteria are common international standards for interoperability or systems to exchange usable data and information.

     

    COIL is a community of Asian countries committed to establishing their own interoperability labs (IOL). These will focus on digital health interoperability and facilitate national health data and information exchange to support evidence-based healthcare.

     

    It’s a knowledge sharing community too. Each country is expected to share their lab technologies, artifacts and documents with one another to promote inter-country co-operation on standards and interoperability.

     

    Other countries can join COIL too. Teaming with SIL-Asia is the way in.

     

    SIL-Asia and COIL are models that can benefit Africa’s health systems and their eHealth initiatives. Which entities will provide the sustainable finance needed.  

  • A manual for Africa to use Asia's Digital Health Impact Framework

    Following the completion of the Digital Health Impact Framework (DHIF), an Asian Development Bank project, Acfee is completing its version for Africa. It draws directly from DHIF, and emphasises ways that Africa’s health systems can start simply and use it as a platform for increasing sophistication in appraising planned eHealth investment.

    The prototype, eHealth Investment Model Africa (eHIMA), mirrors the development track of DHIF’s forerunners that include the eHealth Impact model and the Five Case Model for business cases.  Both methodologies were less sophisticated in their original formats, and have been enhanced to meet increasing needs of decision takers. eHIMA is at the equivalent entry point for African health systems.

    eHIMA combines socio-economic , financial and accounting concepts to estimate eHealth projects’ Value for Money (VFM) and affordability over time.  These are dealt with in DHIF’s ten steps:

    Identify timescalesIdentify stakeholdersIdentify benefitsIdentify resources neededEstimate socio-economic benefits' monetary valuesEstimate socio-economic costsAdjust for sensitivity, optimism and riskCalculate net benefits, the Socio-Economic Returns (SERs)Estimate financial costs and affordabilityRefine and iterate SERs and affordability to find an optimal link

    eHIMA will guide Africa’s users in selecting which steps are the most important to being modelling and appraising for decision-takers’

    A  report on eHNA describes DHIF in more detail. It was presented to the Asia eHealth Information Network (AeHIN) conference in Sri Lanka in October.

    Acfee’s overall aim is to help Africa’s eHealth decision-takers and analysts in dealing effectively with increasingly complex eHealth investment scenarios and options. Good, affordable eHealth strategies are the starting point.  eHIMA will be available in January 2019. eHNA will post updates on progress.

  • Heidelberg University launches an eHealth policy course.

    Three entities have combined to create a five-day residential course on eHealth policy at Heidelberg University. The other two are evaplan, a University Hospital Heidelberg consultancy, and the Institute for Global Health.

    Developing national digital health policy: Laying the Foundations is designed for health planners and policy advisers. It will help them to explain eHealth’s national requirements for success. A specific emphasis is on low and middle income countries. It aims to help participants to:

    Understand how well-crafted eHealth strategies support smart investment Use available toolkits to design and improve country’s eHealth policiesStrengthen participants’ eHealth adviser roles Support decision making for interoperable eHealth and avoid further fragmentation Understand organisational and behavioural changes needed to maximise eHealth benefits.

    The curriculum for the first four days includes: 

    Health Strategies and eHealth strategies in developing countriesDeveloping eHealth strategiesPlanning for interoperabilityManagement and behavioural change. 

    The dates are 4 to 8 February 2019 at the university’s Internationales Wissenschaftsforum Heidelberg (IWH), Germany. The final day includes a guided tour of Heidelberg and time for mentoring and networking. Presenters are Peter Drury and Michael Stahl, The course is in English. Applications close on 15 November 2018.

  • Commonwealth Centre for Digital Health and ECH Alliance to launch their joint action plan

    Working and sharing with eHealth agencies offers mutual benefits. At the Digital Heath Week 2018 in Sri Lanka, the Commonwealth Centre for Digital Health (CWCDH) and the European Connected Health Alliance (ECH Alliance) met and agreed their joint action plan. It was originally envisaged in the partnership agreement announced in May 2018.

    The full action plan will be announced shortly. It will include:

    On 20 November 2018, launch of an ecosystem in Malta, both a European and a Commonwealth countryUganda’s ecosystem will be a nexus for collaboration across East Africa for CWCDH. HealthOrganisation of a Commonwealth Digital Health Skills Summit early in 2019 to connect existing skills programmes with the needs of many Commonwealth countriesLaunch of ecosystems in Sri Lanka and Uganda in early 2019. 

    These will comprise the beginnings of the Commonwealth Connected Health Alliance. Its aim will be exemplars for ecosystems across the Commonwealth. 

    Prof Dissanayake’s chair of CWCDH. He said “We decided to work together because we share the same mission and values and by joining forces we hoped we could deliver faster and do more better.” He is satisfied that considerable progress has been achieved in just a few months. The plan now’s to build on the value of the partnership with ECH Alliance and move forward with constructive activities as part of the commitment to work jointly with.

    COO of CWCDH, Anoop Singh said the partnership’s main goal’s to deliver real benefits, not to try to do everything. Bringing together eHealth stakeholders and collaborators from Europe, the Commonwealth and beyond will contribute to meeting numerous needs and opportunities.

    ECHAlliance chair Brian O’Connor is convinced that the collaboration will bring mutual benefits to everyone involved. His view’s based on discussions with people from over 40 Commonwealth countries. He sees their progress, innovations, determination and passion as a vital ingredient for future success.

    CWCDH will hold an event during the World Health Assembly (WHA) in Geneva in May 2019. The goal’s to obtain the commitment of Commonwealth governments to CWCDH’s planned activities. 

    Nineteen countries are Commonwealth members. If the benefits spill into the rest of Africa, the partnership will have proven its worth.

     

  • How far into the future should eHealth strategies look?

    By definition, eHealth strategies are about investing in the future. They’re also about taking existing eHealth investments forward, either by switching, enhancing and rolling out further. In 2006, Rosabeth Kanter identified several lesson for innovation strategies. They included an “innovation pyramid” where:

    Not every innovation idea has to be a blockbusterSufficient numbers of small or incremental innovations can lead to big gainsBig bets at the top that get most of the investmentA portfolio of promising midrange ideas in test stageA broad base of early stage ideas or incremental innovations.

    The last one’s relevant for a perspective set out in an eBook from Oracle. Technology Takes Healthcare to Next Level proposes strategies for disruptive technologies of:

    AIBlockchainChatbotsIoT. 

    Each one offers promise for healthcare. Combined, Oracle sees the sum of the parts as greater than the whole. Combining blockchain and IoT allows frictionless data exchange. AI and machine learning put data in motion with minimal human intervention. AI tools can study blockchain’s large volumes of data to find patterns that need responses

    For Africa’s health systems, investment in ICT foundations and patients’ clinical and demographic data’s needed to. The strategic challenge is to choose between sequential investment and progress in an innovation pyramid where these four technologies start their journey. While leaving the disruptive technologies into the future, it can defer the costs. It will also defer the benefits.

     

  • Acfee’s director supporting SIL-Asia

    eHealth proponents know the importance of standards and interoperability. In Asia, it has an effective regional umbrella. The Standards and Interoperability Lab – Asia (SIL-Asia)’s powered by the Asia eHealth Information Network (AeHIN). It has significant, sustained support from the Asian Development Bank (ADB) and co-sponsorship by the People's Republic of China Poverty Reduction and Regional Cooperation Fund (PRCF).

    This substantial support has enabled SIL-Asia to provide a wide range of services to its members. Its Tooling page includes:

    Investing in Digital Health: Digital Health Impact Framework (DHIF)Guidance on Investing in Digital HealthDigital Health Terminology GuideTransforming Health Systems with Good Digital Health Governance: Health Governance Architecture FrameworkHealth Enterprise Architecture FrameworkSIL-Asia Cloud Set-upSIL-Asia FHIR Service.

    Countries can use SIL-Asia’s tools for their digital health implementation programmes. There’s more to come, including :

    A technology benchmarking frameworkInteroperability toolkitImplementation guide.

    SIL-Asia’s assets for countries’ use include:

    RxBox, a telemedicine device OpenMRSCHITS, an OpenMRS EMRBahmni,a HIS based on OpenMRSZato.io, a python based Enterprise Service BusWSO2, a Java-based, open source enterprise service busMedicCR, a Master Patient Index (MPI) developed by Mohawk LabOpenHIM, a JS-based mediator developed by Jembi Lab. OpenEMPI, a Java-based MPIOpenInfoMan, a health worker and facility registryDHIS2.

    Having completed his initial work on the DHIF, Acfee’s Tom Jones has taken on the role as a SIL-Asia partner. As Acfee’s Director of Strategy and Impact, it will provide a valuable bridge between Asian and African eHealth initiatives and challenges. Acfee envisages that Africa’s health systems will benefit considerably.

  • Asian Development Bank presents eHealth guidance at AeHIN conference

    Weak eHealth strategies lead to weak digital health investment. Maximising success and minimizing failure’s a core ADB eHealth theme. It sees effective eHealth strategies as requirement, and it presented its Guidance for Investing in Digital Health to the Asia eHealth Information Network (AeHIN) 6th annual conference this week in Colombo, Sri Lanka

    The guidance describes the healthcare context that’s needed for eHealth strategies. Peter Drury, the project lead, then set out essential issues that included identifying and engaging with stakeholders and pursuing digital health strategies that are drawn from health and healthcare strategies and that achieve a balance between value for money and affordability.

    He sees strategies as only part of the process, and similar to his word association of fish and chips and bacon and egg. For eHealth, it’s strategies and investment. Sharing experiences of the two are important.  There are examples of effective strategies that he’s seen across Asia available from AeHIN’s Standards and Interoperability Lab (SILA). These provide valuable insights for Africa’s health systems and for African countries contemplating new national eHealth strategies. 

  • How do Africa’s mHealth strategies match the modern profile?

    With mHealth a standard component of Africa’s eHealth strategies, what’s a good benchmark to test them against? Spok, a US communications firm, as a profile of mHealth strategies that can help. Its eighth annual survey shows some marked priorities.

    Mobile Strategies in Healthcare Results Revealed says mHealth that reflects overall clinical goals for the health system or hospital are most successful. It also underpins larger eHealth strategies to deliver more efficient, higher quality care and increase satisfaction for patients, carers and health workers.

    mHealth strategies extend across a wide range of information and areas. The top two are:

    mHealth management and security, for 56% of respondents Device selection, at 52%.

    The bottom two are mobile, and business development and reporting strategies. 

    The full profile’s:

    Management and security 56%Device selection 52%EHR integration 48%Infrastructure assessment 45%Clinical workflow evaluation 43%Device ownership, including BYOD 34%Mobile app strategy 29%Mobile app catalogue 16%Mobile strategy governance 14%Business development and reporting strategy 12% 

    The third item, EHR integration, matches findings from another Spok survey of hospital CIOs. They said integrating with the EHR was their top priority for respondents. Clinical workflow evaluation’s high score on is seen as revealing. It’s an indication that doctors, nurses, and other health workers in direct patient care roles use mHealth to define safe, efficient and effectively managed workflows.