• IoT
  • 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:


    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.


  • Saudi Arabia’s RAH@H aims to improve healthcare quality

    Connecting and integrating healthcare resources to improve quality’s a core eHealth goal. In Riyadh, the Remotely Accessible Healthcare at Home (RAH@H) initiative offers a daily, patient centric, connected health model to achieve it. Five themes are integrated: 


    Achieving these depends on RAH@H operating at the centre of a technological hub.

    Available both on Android and IOS, RAH@H uses modern technologies for telemedicine, webinars, and observations from medical devices to serve patients. Healthcare needs of vulnerable communities that don’t have ready access to services. They include pregnant women, especially with complications such as hypertension, gestational diabetes and cardiac conditions.

    Interventions include:

    Improved nutritionPrevention and protection against diseases and illness.

    These aim for outcomes of:

    Better life qualityCreating satisfied and empowered patientsIncreased treatment compliance.

    Based in Riyadh, RAH@H’s project custodian’s the Director General of Prince Naif Bin AbdulAziz Health Research Center at King Saud University in Riyadh. It's concept and technology can have a role in African countries and their vulnerable, underserved communities.

  • Voice recognition reduces Tanzania's patient waiting times

    Patients at the Muhimbili National Hospital in Dar es Salaam no longer have to endure long waiting times for their radiology results.  This is thanks to a new technology installation in the department.  Voice recognition or speech recognition technology is now being used to encode doctors notes on patients so that they can easily be transferred to the radiology department. 

    With this new technology, Tanzanian medical professionals are able to dictate into their computers, in the normal course of speaking and have the speech engine recognise what the clinician wants, and then apply the commands or structured words, respectively, to obtain a radiology report for a patient.  There has been some concern around the effect of speech accents on the technology, but this has posed no problems since implementing it at the hospital.  

    The speech engine is also capable of showing the cardiology report template populated with the name of the patient and other demographic data. By dictating the cardiology report narrative, the computer recognises the narrative context and intent and condenses a complete, correct, and structured document.

    This translates to shorter waiting times for patients, greater operational efficiency within the hospital and reduced workload on medical staff who are required to take notes of patient examinations and consultations.  The technology, which uses natural language processing, is constantly learning speech behaviour through repetitive exposure to terms and complex algorithms that organise speech patterns into recognisable behaviour. 

    This bold technology implementation in Tanzania could be a useful pilot for overburdened health care systems in Africa hoping to achieve the same benefits.

  • Verizon sees a bright IoT future, but…

    eHealth strategies should have a prime place for IoT.  It’s role’s expanding, but there are still several challenges that need addressing. A report from Verizon Enterprise set these out. State of the Market: Internet of Things 2017 Making way for the enterprise says IoT’s taking hold in almost every industry. An example’s where pharmaceutical companies use them to track and trace medicines from production to patients. eHNA has another example. 

    What can Africa’s health systems expect from them? Verizon’s findings across economies are

    73% of executives are either researching or currently deploying IoT for the most important assets and processes 84% increase in IoT connections by manufacturers41% increase in transport and distribution industries40% increase in energy and utilities sectors19% increase in smart cities and communitiesIoT increases operational efficiencyImproved supply chain managementIt delivers unparalleled experiences to partners and customers.

    The big but’s that adoption’s slower than expected. Over 50% of executives say the reasons are a lack of:

    Industry-wide IoT standardsSecurityInteroperabilityAffordability.

    Both perspectives need to be included in eHealth strategies. Some of the inhibitors may be beyond health system’s direct control. Where they are, links to these initiatives need setting in place to monitor developments as part of investment plans.  One feature to keep on focus’s the changing supply side. Verizon says there are predictions of continuous market consolidation as larger providers acquire start-up and specialist IoT firms. 

  • India steps up certification training for medical device makers

    High quality medical devices are imperatives for healthcare. It may become more important as Africa’s health systems adopt more Internet of Things (IoT) initiatives. India’s first state-of-the-art medical devices manufacturing park in Visakhapatnam, the Andhra Pradesh MedTech Zone (AMTZ), organised a two-day industry training programme on quality certification. The aim’s to shorten the time and cost of achieving globally recognised quality certification for India’s medical device makers.

    A report in eHealth Magazine says the course was organised by Quality Council of India(QCI)  National Accreditation Board for Certification Bodies (NABCB) and Association of Indian Medical Device Industry. (AIMED). Medical device manufacturers, medical professionals and industry stakeholders were participants.

    There’s a need to fill the regulatory space in quality certification for India’s medical devices in the country.  The main themes included:

    ·       Interpretations and understanding of Conformité Européene (CE),  the European Commission (EC) the  labrynthine guidelines and regulations and product marking

    ·       Industry Indian Certification for Medical Devices (ICMED) certification 9000 and 13485

    ·       New Medical Device Rules 2017. 

    This could be a template for equivalent events for Africa’s device makers and users. As IoT expands, devices will have to keep up. Regulations and training are a vital ways to achieve it.

  • Finding the right mHealth and IoT needs a structure

    As mHealth and the Internet of Things (IoT) opportunities keep expanding, finding the right solutions for a health system becomes more challenging. A white paper from Insight, an ICT firm, sets out a ten-step approach to navigating the mushrooming landscape. 

    10 Best Practices for Discovering the Best Mobile and IoT Devices for Healthcare says healthcare organisations need a robust discovery process for acquiring and procuring mHealth and IoT devices.

    It offers a similar perspective to a concept from Marcel Proust, the 19th and 20th century French novelist. In Search of Lost Time, he said “The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.”  The ten steps can help achieve it. They’re: 

    1.     Set up a cross-functional team

    2.     Seek the experience of independent advisers

    3.     Encourage exploratory thinking

    4.     Consider working with a group purchasing organisation

    5.     Create an mHealth and IoT policy leading to enterprise management

    6.     Create and use a scoring matrix

    7.     Assess existing infrastructure and mHealth and IoT use

    8.     Focus on cyber-security

    9.     Consider Choose Your Own Device (CYOD).

    10.  Explore device technology, including sensors and IoT.

    Cyber-security has several components:

    SeparateEncryptionmHealth and IoT compliance policyVirtual Desktop Infrastructure (VDI)Geofencing to limit accessSecurity softwareSecurity softwareMulti factor authorisationRole-based authenticationAutomatic Wi-Fi connections where cyber-security’s more important than convenienceRobust Virtual Private Networks (VPN)Mobile Device Management (MDM) and containmentRemote wipe to erase all data from a lost or stolen devices.

    Moving away from Bring Your Own Devices (BYOD) should be considered too. A better alternative’s Choose Your Own Devices (CYOD).

    These offer Africa’s health systems a firm start to managing their new mHealth and IoT programmes. It can help to mix new mHealteh and IoT visions with a dose of caution. “People wish to learn to swim and at the same time to keep one foot on the ground,” as Proust observed.

  • IoT might have two inconsistent scenarios

    Africa’s eHealth plans tend to have limited requirements for the Internet of Things (IoT). As health systems mull over their IoT strategies, it’s worth considering two scenarios identified in an article in MIT Technology Review. It seems that IoT might help improve patient care by making data-sharing easier. It might also put patients at risk, especially from cyber-security challenges. A solution has a dilemma too. Some want more government oversight and regulation. Others say this approach could stifle innovation that’s crucial to IoT’s trajectory.

    The article says prominent computer security experts recently told the US Congress that the “Growing mass of poorly secured devices on the Internet of things represents a serious risk to life and property, and the government must intervene to mitigate it.”  A graphic example of the catastrophic risk was the Denial of Service (DoS) attack on Dyn, an Internet infrastructure provider. Cyber-criminals found ways in with a botnet that hacked webcams, camcorders and baby monitors. It shows that the Internet alone can’t support critical systems safely.

    A case’s made that IoT manufacturers lack incentives to assign a high priority to security. Regulation’s seen as the solution by many, but precisely how’s a matter of intense debate. Business groups such as the US Chamber of Commerce and the Consumer Technology Association say new IoT regulations could hinder innovation. A challenge seems to be to either reconcile these views or take one side.

    As eHNA posted, Africa’s eHealth regulation deficit needs a boost. Countries’ eHealth regulation start to catch up with developed countries before IoT regulation can be introduced. A better option may be for countries to start to introduce IoT regulation as a single, integrated exercise across all sectors. It can be vehicle for both IoT investment and innovation in healthcare.

  • Africa's IoT revolution's underway

    The number of connected devices around the world continues to multiply, with International Data Corporation (IDC) expecting that the worldwide market will reach a total value of $1,7-trillion in 2020, says an article in IT Online. The firm believes that the Internet of Things (IoT) opportunity in Africa is enormous, with the continent likely to house around 1-billion connected devices by the turn of the decade. 

    George Kalebaila, senior research manager at IDC Sub-Saharan Africa, believes that “the opportunities are endless, with the spread of IoT enabling smart industry, smart health, smart living, smart energy, smart transport, smart buildings, smart cities, and an overall smarter planet. Indeed, the only forces restricting the application of IoT are our imaginations and the rate at which policy frameworks can catch up to regulate the industry.” 

    IoT dependens on understanding and interpreting data for actionable insights. Without data and analytics, IoT won’t deliver its intended value. “IoT is not a technology but an ecosystem consisting of software vendors, IT services providers, systems integrators, cloud providers, and network providers,” Kalebaila adds. “These industry players have the opportunity to optimise the potential value of IoT by partnering with each other to provide end-to-end solutions. Simply put, when IoT-based products and solutions become connected, their value increases exponentially and the number of potential use cases explodes.” 

    Recent ICD research shows that 33% of enterprises in South Africa are planning significant IoT investment over the next three years. It’s being driven by the pursuit for lower operational costs, improved process efficiency, and heightened levels of product and service innovation aimed at addressing overall needs. 

    While the potential benefits are clear, the continent faces a number of challenges which it will need to overcome in order to reap the benefits. One of the current challenges is the lack of consolidated standards. There are also concerns around the security and privacy of the data being collected, as well as maturity of the regulatory frameworks. Other challenges impacting Africa’s IoT landscape include IT budgets and priorities, the dependence on stakeholders, and the shift in mindset that is required to drive digital transformation on the continent.

    These challenges are vast and need to be addressed for healthcare and eHealth to evolve. GE has already committed 2 billion to develop IoT capacity across all its customers’ machines, including healthcare. It seems that eHealth with IoT in Africa has exciting possibilities ahead.

  • How can Africa expand its broadband for health?

    Yesterday, eHNA reported on Africa’s broadband challenges. It seems that Africa’s not alone. The UK, despite being ahead of Africa, has its own challenges. What are the lessons for Africa?

    The UK’s Institute of Directors (IoD) published Ultrafast Britain, it’s remedy to the UK’s digital divide with Europe. It has some of the worst broadband speeds in the developed world, least reliable broadband in rural and urban areas and patchy mobile coverage. Investing to fix it needs to achieve two goals: 

    Immediate improvement, including peak capacity of 3.6 times the average hourly rate Future proofing to meet growing demand partly fuelled by better supply, increased video use and the Internet of Things (IoT).

    These should be Africa’s goals too, but expanded to reflect a growth in cloud computing, which will be more common and routine in the future, and may have a much bigger role in Africa’s eHealth. The IoD report sees business growth expanding in several sectors, such as rail and sir travel. In Africa, eHealth’s expanding too. 

    An important theme was emphasised in the report’s launch: broadband solutions have no silver bullet and one size doesn’t fit all. The mix proposed for the UK’s:

    Fibre to and for homes, Fibre to the Home (FTTH) Fibre to and for businesses, Fibre to the Business (FTTB) WiFi and satellite for mobility.

    This doesn’t fit Africa very well. Remote and rural homes can be many miles away from urban centres. It does offer a way to create an appropriate mix. If WiFI and satellite’s seen as needed for mobility, it can support rural and remote homes and businesses to give an African mix of:

    FTTH for urban homes FTTH, WiFi and satellite for rural and remote homes, depending on their remoteness FTTB for urban businesses FTTB, WiFi and satellite for rural and remote businesses, depending on their remoteness WiFi and satellite for mobility.

    Once it’s installed, fibre’s 20% to 30% cheaper to upgrade and maintain than copper. It offers the most affordable solution. That doesn’t mean that it’s easily affordable. Aerial fibre uses telegraph lines, where they’re in place, offers a lower cost than digging trenches for fibre.

    Financing this can rely extensively, but not entirely on the private sector. The IoD says that for rural areas, the Return on Investment (ROI) to suppliers isn’t attractive when FTTH opportunities remain in urban areas. For Africa’s event more rural and remote communities, government spending’s a requirement, but limited by affordability constraints. A long-term investment plan’s needed.

    For super-fast broadband, the UK’s in a bid of a competition bind. Four big suppliers, BT, Sky, Talk Talk and Virgin dominate about 95% of supply. Smaller firms take a shrinking 5%. This’s a supply model African countries should try to avoid. One way to do this is to engage smaller, local and national firms in supplying Internet and broadband services to rural and remote communities.

    How long will this take? The UK sees 2030 as the horizon. African countries are usually bigger, with more dispersed populations and bigger affordability constraints. An investment horizon well beyond 2030 seems inevitable. Two drivers for faster change are:

    Financial support from aid agencies Matching investment against IoT and IoT for health priorities.

    New opportunities from IoT for health need new eHealth strategies. This’s the starting point for Africa’s health systems to take new opportunities alongside accelerating business investment in broadband. It’s a challenge that needs sustainable, affordable investment year on year.

  • GE's investing in IoT for health

    Machines are chatty, at least many of them are with each other. The Internet of Things (IoT) enables them to talk digital and transfer data to other machines with the IoT capabilities. GE has lots of these types of machines used in healthcare, such as telepathology and radiology. At the recent Africa Healthcare Summit 2016, GE Healthcare Africa CEO, Faried Fezoua, reminded the audience that it’s already committed to spending $2b to develop IoT capacity across all its customers’ machines, including healthcare.

    It’s investment in IoT for health’s based on a core requirement that utilising data in healthcare machines provides information for healthcare professionals to improve healthcare for patients. Examples from its global surveys show that:

    Only 32% of nurses say their hospitals’ are excellent at capturing patient safety data 59% of nurses say their hospitals’ where patient safety data’s collected and reported, there’s no follow-up 47% have seen a near-miss that wasn’t reported during the previous year 39% have seen and adverse event that wasn’t reported during the previous year Only 8% of nurses describe their patient safety systems as innovative. 

    There’s a lot to do to bring these performances up to a high standard. IoT for health offers a way forward to both innovate process, and avoid the need for extra healthcare workers to deal with the collection, reporting and action. GE’s report on Industrial Internet Insights Report for 2015 sets these out. GE wants to develop its IoT for health in close collaboration with its users to ensure success. Africa can benefit directly as it has few legacy systems to replace, making an IoT investment cheaper, faster, providing lower risks and higher net benefits. eHNA’s tracking this.