• Leadership
  • High eHealth leadership event set for Geneva

    Africa’s health ministers have set up an event alongside the World Health Assembly (WHA) to discuss the government leaders’ critical role developing, costing, and implementing national eHealth strategies. Topics include co-ordination and relation shipbuilding between ministries of health and information and communications technologies (ICT).

    Arranged for Monday 22 May 2017 from 1800 to 2100 in Geneva, African Ministerial Dialogue on Digital Health Leadership organisers extend an invitation to a wide audience to participate. Developing and expanding eHealth leadership’s vital for realising eHealth’s benefits.

    Acfee see eHealth leadership as a triumvirate of clinical, political and executive leadership, and extending across eHealth’s wide range and depth. This dialogue, jointly hosted by African health ministers, is a huge step forward in developing Africa’s eHealth leadership.

  • eHealth’s like all initiatives, it’s more than just health ICT

    As eHealth becomes more sophisticated, its demands on integrated investment in health ICT and health and healthcare transformation increases to realise its benefits. Acfee has always advocated a combined approach to eHealth programmes, with an overarching goal of healthier Africans. It’s supported by similar requirements for scientific innovations for healthcare. 

    In an article in the New England Journal of Medicine, a team from Brigham and Women’s Hospital and the Pennsylvania University says advances in genomic and molecular research that lead to precision medicine will have insufficient benefits without parallel innovations in how predictive analytics is applied in healthcare delivery. Their new data and eHealth requirements have to adopt the same principles.

    It proposes two integrated activities. One’s a Precision Medicine Initiative (PMI). The other’s a Precision Delivery Initiative (PDI). Their common goals are integrating predictive analytics into clinical workflows and using innovative data sources to establish best practices that are clinically validated, and empower patients to use their own data to support personalised medicine. This should help to speed up the transformation of clinical care.

    PDI requirements match those for eHealth. The team sees them as including: 

    • Partnerships between a wide range of clinical and ICT stakeholders
    • Incorporating PMI in Clinical Decision Support (CDS) systems
    • Using real-time alerts in clinical workflows
    • Putting PMI into patients’ hands.

    These changes for PMI and eHealth are demanding to achieve. Without them, benefits can’t be maximised.

  • Sierra Leone sets up a National eHealth Coordination Hub

    Succeeding with eHealth’s complexities across national health systems invariably needs a core organisation. Sierra Leone’s Ministry of Health and Sanitation has set up its National eHealth Coordination Hub to co-ordinate and regulate eHealth. It’ll also support eHealth expansion across the country’s health system. The Ministry of Information and Communications is a leading part of the initiative too.

    A report in Awoko says support’s provided by UNICEF as part of a US$2 million project financed by the United States Agency for International Development (USAID) to strengthen Sierra Leone’s eHealth Management Information System in Sierra Leone. It’s part of the US Government’s commitment to strengthen health systems and services after Ebola. Laurie Meininger, Deputy Chief of Mission, said the Awoko that “Sierra Leone is taking a step in the right direction, recognizing the growing importance of health coordination for the future health and sustainable development goals in Sierra Leone.”

    The Hub has three main goals I supporting the government’s eHealth ambitions. They’re:

    • Co-ordination
    • Regulation
    • Improve alignment of data with national health system goals.

    Acfee’s regulations database has extending across 64 eHealth regulation topics shows Africa’s health systems trailing those on other continents. Catching up’s a big task that needs resources for regulation risk assessments, regulation decisions and compliance reviews. Selecting and implementing relevant and appropriate priorities are essential to expanding eHealth regulations.

    It’s an important achievement. For Africa’s health systems, affordable, sustainable eHealth decisions are tough to take. Creating the Hub provides Sierra Leone with a constructive way to take them. 

  • A roadmap for image-based mobile technologies in Africa

    "We need new energy to change the world,” said Maud Olofsson, former Swedish Deputy Prime Minister. She was opening the fifth STIAS-Wallenberg Roundtable in Stellenbosch, South Africa. She was talking about the energy of innovation and the people driving it. She emphasised how mHealth experts should help politicians to understand these rapidly changing technologies and work with them how to secure the benefits and opportunities for health systems strengthening. 

    The roundtables are an initiative of the Marianne and Marcus Wallenberg Foundation. They have been run every year since 2013. Delegates are from South Africa, Sweden and the broader international community, invited to engage in dialogue and debate to explore solutions to global challenges.

    The February 2017 Roundtable focused on image-based mobile health. Over 60 participants attended from 16 countries. The event provided an opportunity for cross-sectoral and cross-disciplinary discussions and networking, says an article in africahealthnews.

    A tangible output of the roundtable is a roadmap to be published in a special issue of Global Health Action devoted to mHealth. eHNA will share it once it's available.

    The roadmap emerged from discussions on five key questions about the implementation, expansion and up-scaling of image-based mHealth in resource-constrained settings:

    1. How should the most important barriers to the implementation of image-based mHealth in the clinical setting be overcome?
    2. How can frontline healthcare workers adopt image-based mHealth in their practice?
    3. Which key strategies are needed to overcome organisational challenges to implementing image-based mHealth?
    4. Which are key strategies to overcome technical challenges in implementing image-based mHealth within the health sector?
    5. For each stakeholder groups represented, what are the most important priorities to build and sustain mHealth leadership?

    Emphasis on finding solutions and crafting a tangible roadmap provides a constructive model for this type of sector engagement. African eHealth experts included African Centre for eHealth Excellence’s (Acfee) Dr Sean Broomhead (South Africa), Prof Peter Nyasulu (South Africa and Malawi), Dr Ousmane Ly (Mali) and Dr Eddie Mukooyo (Uganda). They will take lessons from the roundtable experience into the Acfee stakeholder events planned for Southern Africa and East Africa towards the end of 2017.

    Helping end users make better decisions and provide better care was critical a focus. Discussions included how best to deal with barriers such as regulatory aspects, costs, Internet accessibility, airtime, power shortages, lack of training, use of personal phones and safety issues around phones, data accuracy and security - a long list - so that users are able to embrace mobile health.

    Delegates included nurses and doctors sharing practical experiences using mHealth in clinical settings, overcoming implementation challenges, and leading change. Their stories fuel optimism for what is possible. We look forward to reading the roadmap and to sharing it with eHNA readers.

    Image courtesy of STIAS

  • AeHIN’s conference on ICT and SDGs starts today

    AeHIN’s five-day conference starts today in Nay Pyi Taw, Myanmar. Its the fifth general meeting and focuses on Achieving the SDG's with ICT.

    In 2007, the foundations of the Asian eHealth Information Network (AeHIN) were laid. Canada’s International Development Research Centre (IDRC) set up the PAN Asian Collaboration for Evidence-based eHealth Adoption and Application (PANACeA). It brought together 16 researchers from ten Asian countries to learn about eHealth and eHealth research. In parallel, eight multi-national research projects were implemented. Its Advisory and Monitoring Team (AMT) mentored the project teams dealing with a wide range of eHealth themes, including evaluating effectiveness of technologies and health informatics to manage health information in hospitals and communities and using telehealth to provide patient care at a distance.

    AeHIN became the vehicle for these endeavours in the region. Its aim is to promote better ICT use to achieve better health through peer-to-peer assistance, knowledge sharing and learning through a regional approach for greater country-level impacts across South and Southeast Asia. Four strategic areas underpin its concept that better health can be achieved by strengthening evidence-based policies and health systems with better quality and timely Health Information Systems (HIS), Civil Registration and Vital Statistics (CRVS) and eHealth enables better information flow to support the delivery of quality and equitable healthcare and management of health systems. The four goals are:

    1. Enhance leadership, sustainable governance and Monitoring and Evaluation (M&E)
    2. Effective networking to increase peer assistance, knowledge exchange and sharing
    3. Promote standards and interoperability (IOp) in and across countries
    4. Build capacity for eHealth, HIS and CRVS in the countries and in the region.

    These fit Africa’s eHealth initiatives. Partners for the event include Ministry of Health and Sports, the Government of the Union of the Republic of Myanmar, the WHO, the Asian Development Bank (ADB), United Nations Children's Fund (UNICEF).

    The Conference objectives include:

    1. Sharing, learning, and preparing to implement digital health capacity building strategies standardized processes, tools and techniques, and ready-to-use IT solutions towards achieving UHC and SDG.
    2. Sharing current state-of-the-art digital health in Asia Pacific region for example interoperability architecture (OpenHIE) implementation, Regional Interoperability lab activities
    3. Motivate stakeholders to invest in digital health to strengthening health systems

    Sustainable Development Goals (SDG) are high priorities for Africa’s health systems too. Two of Acfee’s directors, Dr Sean Broomhead and Dr Ousmane Ly are at the event. They’ll be sharing Acfee’s eHealth initiatives and bringing lessons back for Africa.

  • Will your eHealth New Year resolutions help secure better health for Africans?

    Happy New Year to everyone. Congratulations on your 2016 eHealth efforts. It's been quite a year, setting us up for an extraordinary African 2017.

    Thank you for reading our stories of Africa’s eHealth development. They reflect a small part of our passion to explore and support eHealth’s role in securing better health for Africans. They showcase some of the exceptional work already underway through you and our international eHealth colleagues.

    At the September African eHealth Forum (AeF), our Advisory Board set out African eHealth priorities. Details are in the AeF Report, Advancing eHealth 2016, and summarised in posts on eHNA.

    Acfee’s response will be delivered in the New Year. It will focus on bringing our five priorities to life in tangible ways that can help lead to healthier Africans.

    1. eHealth strategy

    Acfee’s research and support for African countries’ national eHealth strategies will expand. This includes a special focus on issues highlighted by the Acfee Advisory Board, including:

    • Cloud computing: learn from global experiences of the challenges and opportunities and synthesise these for health ministries to review
    • eHealth surveillance: explore the contribution of Acfee’s eHealth impact and benefits realisation research and expertise for HISP’s planned eHealth surveillance initiative in West Africa
    • Architecture: finalise the commentary on eHealth architecture to fit expanding mHealth and social media for health ministries to review
    • Interoperability (IOp): seek finance to establish Acfee technical working groups for IOp and support an IOp workshop on a use case and a development programme in an African country in collaboration with Integrating the Healthcare Enterprise (IHE) to set the process of use case development in Africa

    2. eHealth governance

    Acfee’s review of start-up measures for health ministries will be published in an eBook, leading on to sophisticated arrangements as reported on eHNA.

    3. eHealth regulation

    Acfee will continue to develop affordable, sustainable approaches to eHealth regulation for health ministries to review.

    4. eHealth cyber-security

    Acfee’s on-going review of global threats, initiatives and actions will be synthesised in an expanding eBook for health ministries to use to combat cyber-threats, as reported on eHNA.

    5. eHealth impact

    Acfee will continue to develop sophisticated impact models appropriate to Africa’s needs, to help health ministries to select good initiatives, monitor and evaluate them and promote positive socioeconomic impact.

    The 2017 programme will include Acfee’s internal development, such as the internship programme to develop emerging professionals and future leaders and promote their contributions to eHealth’s advancement across Africa.

    Engagement of partners is critical too, such as professional bodies, with an important step being to work with Africa’s Public Health Associations (PHA). Developing Acfee’s eHealth curriculum will advance too with collaboration with Health Information Systems Program (HISP) and selected African and international universities, including New York University, Monash South Africa and Rome Business School for Masters degrees for Africans.

    Finally, Acfee’s two landmark events will continue, with the eHealthALIVE broad stakeholder forum planned to run in Southern Africa and the East African Community (EAC) in 2017. AEF meetings of Permanent Secretaries and other health leaders will follow these, to extract the lessons from the eHealthALIVE platform and channel them into decisions by ministries.

    Acfee’s relationships with African health ministries are growing, as are our efforts to collaborate with like-minded partners to expand stakeholder engagement to advance African eHealth.

    Our shared goal is healthier Africans, in 2017 and beyond.

  • WHO’s third global eHealth observatory report is out and Africa’s trailing

    WHO’s third global eHealth observatory report is a meaningful update on global developments and trends and poses important challenges for African countries embracing eHealth for their health systems’ transformation.

    Helping to review content for the report, along with colleagues from the WHO eTAG and many other eHealth experts, I was exposed to the considerable work underway globally, and the extraordinary teams helping to explore eHealth's role in improving our health and health systems.   

    At Acfee, we're especially interested in the implications for Africa. eHNA will post separately on each of the eight chapters in WHO’s report. Each post will take an African perspective to offer an assessment of features of its eHealth and Universal Healthcare Coverage (UHC) opportunities and constraints.

    It’s widely recognised that Africa has a considerable healthcare deficit and high disease burden. The combination creates a constant, long-standing struggle and much more than the policy and management euphemism of a challenge. Africa’s average healthcare spending per head’s some US$145, about 14% of the World Bank global average of about US$1,061. The highest’s about 62%, the lowest less than 2%. These aren’t adjusted for the high disease burden, or the difficulties of providing healthcare to extremely remote communities. It’s unrealistic to expect Africa to achieve the huge productivity increase needed to provide UHC, provide the extra cash and capacity needed, or a combination of both over the medium-term.

    Aiming to achieve UHC in this economic context is a lot more than demanding. The Global Observatory for eHealth (GOe) publication Report of the third global survey on eHealth Global diffusion of eHealth: Making universal health coverage achievable, says “It has become increasingly clear that UHC cannot be achieved without the support of eHealth.” I've heard similar sentiments expressed by African colleagues such as Liberia's Luke Bawo, speaking about his country's response to Ebola and Acfee's Ousmane Ly, describing the eHealth initiatives he's leading in West Africa.

    It's a reasonable proposition, but for Africa, it’s not enough for all people to receive the high-quality health services they need without suffering financial hardship.

    Africa’s UHC solutions are a combination of:

    • Substantial and rapid economic growth
    • Significant, sustainable increase in finance for health and healthcare
    • Converting the extra cash into sustainable real healthcare resources, including all types of healthcare workers, medicines, medical and surgical supplies and extra and better facilities
    • Proven eHealth, especially proven mHealth.

    WHO’s report says 90% of eHealth strategies reference the UHC objectives or its key elements. This is for the 58% of countries that have eHealth policies or strategies, so about 52% of all countries. For Africa, 39% of countries report having an eHealth strategy, of which 58% have UHC objectives, so about 23% of countries. Consequently, Africa’s eHealth role in UHC isn’t specified formally yet, indicating the need to enhance or replace them.

    Other limitations are that Africa’s eHealth strategies seldom integrate with related economic growth, healthcare finance and real resource strategies and plans, and none have sustainable, longer-term horizons. Africa’s eHealth strategies need upgrading for other factors either understated or not referred to in the report. Four are:

    • Effective, consistent patient unique ID
    • Interoperability (IOp), which is in its infancy across Africa
    • Cyber-security, which is becoming an increasing global challenge
    • eHealth governance, not yet well developed across Africa.

    Acfee’s African eHealth Forum (AeF) report included these in its identified priorities. Acfee will release commentaries on cyber-security and eHealth governance early in 2017. It will also be able to offer health systems opportunities to participate in developing IOp use cases using a globally recognised methodology and standard.


    Image from the global eHealth observatory report 

  • Acfee’s Advancing eHealth 2016 report is out

    The African Centre for eHealth Excellence (Acfee) has released its Advancing eHealth 2016 report. The report findings are that eHealth initiatives are expanding in African countries, though their impact on health systems strengthening and transformation, and ultimately their contribution to healthy Africans, is less certain.

    The African eHealth Forum is where Acfee’s management team consults with its Advisory Board, industry partners and other stakeholders, to exchange their experiences of eHealth in Africa to find ways to support eHealth to strengthen healthcare and make Africans healthier. The second annual forum was in Sandton, South Africa on 8 and 9 September 2016. It followed the successful eHealthALIVE event.

    During AeF, Acfee's Advisory Board identified five eHealth priorities. They are:

    • eHealth strategy
    • eHealth governance
    • eHealth regulation
    • eHealth cyber-security
    • eHealth impact.

    The AeF believes that developing these will help eHealth to advance. They are discussed and elaborated on in the report and Acfee will be investing in moving each one forward.

    eHealth in Africa still has a long way to go. The AeF report sets out some of Acfee’s contributions to moving it on. eHNA’ll be reporting on its progress.

    The AeF followed the first annual eHealthALIVE Southern Africa conference, a broad stakeholder engagement platform for exploring eHealth's opportunities in the region. Read it's report here.

  • eHealthALIVE 2016 The Report now available

    The exuberance and energy of eHealthALIVE still smoulders. It was a first and a success, bringing together a wide spectrum of stakeholders, who found good value in the unique opportunity to engage, challenge and debate the rapidly developing eHealth sector in Southern Africa.  

    The eHealth spectrum of the event in Johannesburg early September is captured in eHealthALIVE 2016 Southern Africa The Report. The African Centre for eHealth Excellence (Acfee) and eHealth News have now released it.

    Prof Peter Nyasulu, Acfee executive director is clear about why eHealth, is important. “Healthy Africans is eHealth’s most important goal in Africa. Achieving it needs eHealth to support health professionals to help them transform healthcare. Africans can be healthy and while we all know of the considerable challenges, eHealth is a powerful tool to help Africans be healthy.”

    This was a core focus of the event. I was struck by how comparable eHealth challenges were across African Countries and beyond. Presentations were drawn from eHealth initiatives and programmes from Namibia, South Africa, Sri Lanka, Swaziland, Uganda, Zambia, Zimbabwe and the East African Community. Master classes supplemented these, covering interoperability, a deep dive into MomConnect and presentation of multiple District Health Information System (DHIS) use cases. The spread reflects Acfee’s goal to help advance eHealth and eHealth capacity in African countries.

    The lessons learned at the event are set out in the report. It helped delegates to:

    1. Fix eHealth challenges and support extended data use, such as analytics and research, through Interoperability masterclasses
      1. Develop use cases for eHealth initiatives
        1. Design structured, formal eHealth capacity-building programmes for healthcare professionals
        2. Emphasise the need to expand eHealth’s role in direct and clinical benefits for patients and health workers
        3. Set an eHealth balance between managing reporting and data for patients and healthcare professionals
        4. Explore benchmarks for eHealth strategies and plans.

    eHealthALIVE 2016 brought them together. It was” a unique forum for stakeholders in health systems transformation to come together to engage on real-world practical issues and find opportunities to bring about tangible change - a platform for engagement we hope to continue to build year on year” according to Taryn Springhall, Editor at eHealth News.

    Planning is already underway for next year’s SA event; set to be a highlight on Southern Africa’s annual eHealth calendar. In parallel, planning is underway for an equivalent event with the East Africa Community (EAC). These help to lift eHealth’s profile and promote its value and benefits.

    eHealthALIVE was followed by the African eHealth Forum, a platform for strategic discussions between Acfee, its Advisory Board of eminent African health leaders, and representatives from the sector. Read about it here.

  • Calling African software developers

    It’s not often one gets to be part of a rapidly expanding eHealth programme supporting health systems transformation. For innovative software developers looking for such an opportunity in South Africa, this one’s a gem.

    Health Information Systems Program HISP South Africa’s created seven new positions for software engineers. It’s a substantial expansion. HISP's website has the adverts or you can contact me directly for more information.

    New developers will work with HISP’s existing software team to build health information solutions for use in South Africa and abroad. Together, they will help shape HISP’s software development strategy and its role in supporting governments’ health strengthening efforts. It’s an opportunity to collaborate, grow your skills and contribute to Africa’s emerging digital health industry.

    Applications close 30 July.