• Leadership
  • AMA sets eHealth leadership role and vision for doctors

    Africa’s eHealth is characterised by fragmented data. So is eHealth data in the US, where doctors have stepped up their eHealth leadership and set up a new collaborative initiative. Is it a role and approach for those of us practicing medicine in African countries to consider?

    The American Medical Association (AMA) announced its move into a new data evolution era of better, more effective patient care to improve, organise and share health care information. Its Integrated Health Model Initiative (IHMI) provides a platform to bring together health and technology sectors around a common data model that’s missing from healthcare and eHealth. A profile’s on YouTube.

    IHMI is the national imperative to pioneer a shared framework for organising health data, emphasising patient-centric information and refining data elements to those that support predictive actions for better outcomes. Its online platform will support a continuous learning environment enabling a common data model to evolve with real-world use and participants’ feedback. By evolving available health data to provide a complete pictures of patients’ journeys across wellness, illness, treatment and beyond allows healthcare to focus on patient outcomes, goals and wellness.

    Another innovative aspect of IHMI is its support for collaboration. All healthcare and ICT stakeholders can participate. Initial collaborators include IBM, Cerner, Intermountain Healthcare, American Heart Association, American Medical Informatics Association. More are set to join. Their collaboration will help the health system learn how to collect, organise, and exchange patient-centred data in a common structure that captures the most important data needed to improve care, long-term wellness and transform the data into a rich stream of accessible and actionable information.

    Its effects could be far-reaching. A common data model with clinically validated data elements can accelerate development of better data organisation, management and analytics. It’s likely to foster patient care models with better outcomes, create technical innovations to address poor interoperability, cumbersome and inadequate data structures, and avoid data overload that harms clinicians’ morale.

    As we move our eHealth programmes on in African countries, IHMI highlights a vital, sophisticated health informatics and analytics theme to consider. It shows the importance of doctors’ role in eHealth, as a model for our doctors and other health professionals to consider taking on an equivalent eHealth leadership role.

  • HISP’s global eHealth role expands

    As the global eHealth community matures, lessons and good practices are beginning to emerge. Some of these are about organisations and their business and software models. The Health Information Systems Programme (HISP) organisations provide a cogent example. They operate in numerous countries across global regions and are as different as they are similar.

    The differences are pronounced. The businesses range from informal, two to three-person teams, to large, formal company structures such as HISP-India and HISP-South Africa that have adopted robust business systems, employ experienced technical experts and managers, and enjoy long-term contracts.

    Where the differences end is when it comes to software. HISP entities share an almost ubiquitous commitment to the District Health Information System (DHIS) software platform. The latest version is DHIS2. It’s a success story for Free and Open Source Software (FOSS). It combines two essential components of successful FOSS:

    A highly customisable platformA highly professional core development team.

    The HISP network is developing and enhancing its role across several regions. The emerging HISP Partnership Organisation (HPO) is a collaborative effort to watch. Its members include HISP organisations in South Africa, Malawi, Namibia, Nigeria, Zambia, Zimbabwe, Rwanda, Côte d'Ivoire, West Africa, Bangladesh, India and the Philippines. Its founders are key personalities who’ve been closely associated with HISP entities and DHIS developments. They believe in collaboration and the need to build local capacity to ensure sustainability of DHIS implementations and broader health information management.

    Regional networks

    Regional networks are also taking notice of HISP and the DHIS. At the Asian eHealth Information Network (AeHIN) annual conference in Myanmar in March, DHIS2 was a hot topic of conversation in most sessions. The DHIS2 platform provides the foundation for many AeHIN countries' routine information systems.

    Africa’s AeHIN equivalent is growing too. It's the African Centre for eHealth Excellence (Acfee). The potential synergistic relationship between these regional networks and the HISP entities presents a substantial opportunity for cooperation and collaboration to move eHealth forward.

    Acfee supports local eHealth capacity building to develop the eHealth leadership and policy strengthening essential for sustainability. Learning from AeHIN's success is critical. The keynote address by AeHIN governing committee member Jai Ganesh Udayasankaran, at eHealthAFRO 2017 in Johannesburg 2-4 October 2017, provided tangible suggestions that will move the partnership into action. 

  • Acfee internship applications open today

    At Acfee, the interns in the first cohort complete their year of service in December. They've set the bar high for those who follow in 2018, engaging actively in Acfee initiatives and becoming advocates for eHealth in transforming health systems.

    The Acfee Internship Programme offers enthusiastic graduates the opportunity to develop themselves professionally through practical experience in Acfee's work. These activities stretch across various areas such as its four main pillars: healthier Africans, building eHealth knowledge bases, strengthening and securing good eHealth and improving health outcomes. Internships are offered depending on the needs and capacity of the Acfee team to receive and supervise interns. 

    Today, Acfee begins accepting internship applications for 2018. Four places are available. Interns will be part of Acfee’s operational team, working closely with eHealth experts and supporting Acfee’s work in developing eHealth leadership and capacity for Africa. They will also contribute to posts for eHealth News Africa (eHNA), Acfee’s daily blog and even collaborate on publications.

    Do you have what it takes to be part of this dynamic team? Enquire and send your CV and a one-page motivation to interns@acfee.org.

  • Gates Foundation highlights Africa's challenges

    This year’s annual report from the Gates Foundation sets a clear, optimistic tone with a practical view ahead.

    “Fewer people than ever before contracted polio, and more women had access to contraceptives than at any other time in history. We supported the fight against Zika virus. And this was the year that almost $13 billion was raised to support the Global Fund's mission to accelerate the end of AIDS, tuberculosis and malaria as epidemics. While we are deeply proud of this progress - and all that we have achieved together so far - we remain mindful of the great challenges that lie ahead.”

    The Economist has extracted from the report a gloomy side for Africa. Its commentaries include:

    Campaigns to eradicate extreme poverty, HIV and malaria are going awryDemography’s one of the biggest reasons for gloomAn enormous fertility gap’s opened between benighted places and everywhere elseHigh birth rates lead to high dependency ratios where relatively small adult populations support lots of childrenThe fertility gap between Africa and the rest of the world’s set to close very slowly, taking 40 years to drop from five to under threeAfrica’s population of over 1.2 billion will be 2 billion by 2046 and 3 billion in 2071By 2030, there’ll be over 280 million 15 to 24 year olds, over 20% of the current populationFewer Africans living in deep poverty but the slow reductions leave about 415 million people, about a third, and are outstripped by population growthAbout 50% of the world’s poor are thought to be in AfricaFuture funding for HIV, malaria and Neglected Tropical Diseases (NTD) such as lymphatic filariasis that can lead to expanded body parts, river blindness and sleeping sickness, is uncertainVaccine-resistant malaria could evolve and spreadA risk of AIDS increasing despite objective such as AIDS free generationBetter HIV survival rates means more expensive and expanding treatment and costs, possibly leading to inadequacies and more casesHealth spending in 32% of sub-Saharan African countries, about 17, is less than 3% of their GDP, less than the 5% seen as a minimum for the basics.

    The Gates report says the biggest risk to progress is failing to control infectious disease. The impact in Africa of more HIV and malaria will be rapid. Is this the essential focus of the next wave of Africa’s eHealth investment? With Universal Health Coverage (UHC) as a priority, it may not be enough if infectious diseases rampage across Africa.

    Should prevention and surveillance be the top priority for the next few years so eHealth can help to stabilise the substantial achievements already secured?

  • AeHIN and Acfee to collaborate on supporting regional eHealth

    At today’s eHealthAFRO, Jai Ganesh Udayasankaran, Council Member of the Asian eHealth Information Network (AeHIN) presented his organisation’s history and successes. It plays a substantial catalytic role in supporting eHealth’s development in the Asian region.

    Mr Udayasankaran confirmed that AeHIN will collaborate with Africa’s emerging network, the Africa Centre for eHealth excellence (Acfee), on several aspects of eHealth that are priorities both for Africa and Asia. The main themes include:

    eHealth governanceeHealth regulationCyber-security.

    eHealth governance is well-developed in AeHIN. It promotes COBIT 5, a sophisticated standard. Most of Africa’s eHealth governance needs an initial entry point. Countries can use AeHIN’s experiences to see a trajectory of where their eHealth governance could lead.

    Acfee’s research on eHealth regulation in Africa reveals a significant deficit. The 2013 data are a few years out of date, though progress remains slow. They show an extensive reliance on telecommunications regulations, with little specific eHealth regulation, as shown below.

    These figures are well behind good practices. The deficit’s about 45% points, showing that progress is vital to avoid the African region falling further behind.

    Cyber-security has become increasingly critical. Acfee accumulates data on issues, priorities and guidance, much of which is posted on eHNA. Acfee’s basic cyber-security handbook for Africa sets out some features in what are rapidly changing and more effective cyber-threats.

    Collaboration with AeHIN will move further ahead this year. Progress will be reported at next year’s eHealthAFRO 2018 and in eHNA

  • Safe, seamless, secure: Australia's digital health strategy

    There’s no doubt about Australia’s vision for its eHealth: safe, seamless and secure: evolving health and care to meet the country’s modern needs. Produced by the Australian Digital Health Agency  (ADHA), Australia's National Digital Health strategy up to 2022 has seven strategic priorities to support the option for every citizen to have their own “My Health Record”:

    Health information available whenever and wherever it is neededHealth information that can be exchanged securelyHigh-quality data with a commonly understood meaning that can be used with confidenceBetter availability and access to prescriptions and medicines informationeHealth-enabled models of care that improve accessibility, quality, safety and efficiencyA workforce confidently using eHealth technologies to deliver health and healthcareA thriving eHealth industry delivering world-class innovationSafe, seamless and secure: evolving health and health care to meet the needs of modern Australia.

    It sets out six Critical Success Factors (CSF) too:

    Trust and security assuranceCommitment, cooperation and collaboration across all governments to leverage existing assets and capabilities to avoid duplication and speed up benefits realisationEstablishing legislative, regulatory and policy frameworksStrong consumer and clinician engagement and governanceEffective governance and leadershipLearning from others.

    A core concept’s that eHealth’s information is the “bedrock of high quality healthcare.” Its five patient benefits are significant and compelling:

    Avoided hospital admissionsFewer adverse drug eventsReduced test duplicationBetter care coordination for people with chronic and complex conditions Better informed treatment decisions.

    The strategy builds on considerable eHealth progress. About 20% of the population have a “My Health Record.” An estimated 98% will have one in 2018. Many already access their health information from My Health Record using mobile apps.

    It will help to overcome the challenge of disjointed and hard to navigate care for people with chronic conditions. Developing new models of care are being constructed on their EHRs.

    A National Cancer Screening Register will create a single view for Australians participating in cervical and bowel cancer screening. It will integrate with GP clinical information systems to help GPs to identify patients’ screening eligibility and history to support real-time clinical decision-making.

    Recognition of the risk of uncoordinated eHealth investment may not meet a common set of standards shows the strategies realism. A combination of agreed priorities underpinned by standards is a signal to the market about the role of priorities of eHealth vendors.

    Enabling the exchange of high-quality data between healthcare providers and the systems is a core goal, so semantic interoperability (IOp) is a high priority. It includes co-ordination between people, organisations and systems. The goal is to preserve data’s meaning when it’s shared between people and systems and one context to another, so information is used and interpreted in the same way.

    The Global Open Data Index produced by Open Knowledge International (OKFN) recently ranked Australia number one in the world for its open data policies that create an IOp environment and using data assets as a national resource.

    There are many lessons for Africa’s eHealth, such as the way that new eHealth strategies can build on previous ones, lessons learned and approaches to implementation.

  • DG for Health Precious Matsoso to open eHealthAFRO 2017
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    Ms Malebona Precious Matsoso will open eHealthAFRO 2017. She is passionate about eHealth's transformative potential and believes that achieving "UHC depends on effective, patient-centred eHealth". We are thrilled to confirm that she has accepted our invitation to open the conference with a personal address and perspective on eHealth in South Africa.

    Ms Matsoso is no stranger to eHealth, information systems and their role in transforming health and healthcare. She has led South Africa’s eHealth strategy and its current review. The overarching objectives that place eHealth in a core role to support Universal Health Coverage (UHC) are challenging to achieve. Her leadership is essential in securing these for the long term. Her vision sets the context for the provinces and local health services for their eHealth endeavours.

    Ms Matsoso drives the Ministerial Advisory Committee (MAC) that I have the honour of serving on, alongside ten South African eHealth leaders. She recognises that eHeath is essential to achieve better health for all and is leading the MAC to ensure that South Africa's eHealth will support health transformation, helping sustain the health of South Africans in line with international good practice.

    The conference theme “eHealth for UHC” emphasises UHC’s dependence on effective, patient-centred eHealth. Ms Matsoso sets the direction and a realistic timescales for successful eHealth.

    Ms Matsoso was appointed Director General of the National Department of Health (NDOH) by the President of South Africa on 08 June 2010. She serves under the Minister of Health, Dr Aaron Motsoaledi. 

    She holds a degree in Pharmacy, a Postgraduate Diploma in Health Management from the University of Cape Town, and a Masters degree in Law and Ethics (LLM) from the University of Dundee. Her career has included posts as Head of Medicines Control Council (MCC), member of the National Research Ethics Council of South Africa, and the Director of the Essential Drugs and Traditional Medicines Programme for the South African Health Department. She was a Director in Public Health Innovation and Intellectual Property (PHI) in the office of the Director General, of the World Health Organisation (WHO) serving as WHO Secretariat on Public Health, Innovation and Intellectual Property. She served as the Chair of the Executive Board at World Health Organization from 2015 to 2016.

    Ms Matsoso has a bold vision for health transformation and we look forward to her comments when she opens eHealthAFRO 2017.

    Get your tickets here.

    #eHA2017 #AreYouReady?

  • England’s NHS spending on a digital academy

    Developing eHealth leaders is an essential component of successful eHealth. NHS England has announced it’s creating the NHS Digital Academy. Its goal’s to train and develop informatics capabilities for Chief Information Officers (CIO) and Chief Clinical Information Officers (CCIO). The one year programme’ll provide specialist ICT training and development support to 300 senior clinicians and health managers.

    It implements the recommendation in a report from the National Advisory Group on Health  Information Technology  in England, lead by its chair, Prof Robert Wachter, chair of University of California, San Francisco  Department of Medicine. The report identified a shortage of CCIO and CIO professionals who can advance eHealth transformation. Harnessing the Power of Health Information Technology to Improve Care in England proposed spending of £42m, about US$55m, €46m, to strengthen and expand CCIOs’ capacity, especially in informatics, and health ICT professionals. It’s about 1% of the England’s £4.2b eHealth plan. It’s about 0.04% of NHS England’s total spending.

    NHS Digital Academy will have three main partners in the initiative, Imperial College London, the University of Edinburgh and Harvard Medical School. Part of the programme’s remit’s to support the development of vibrant professional societies for clinician and non-clinician informaticians, informatics researchers, programme evaluators and system optimisers. It’ll be mainly online, with some residential events.

    eHealth success needs many other leaders across the whole reach of programmes. It seems that their development needs are not part of this initiative. NHS England already has its Leadership Academy.

    Can Africa’s health systems start a journey towards this? Several Universities across Africa already provide health informatics degrees. Several Africans attend the Master’s in e-Health Management course at Rome Business School, supported by Acfee, which also provides Future eHealth Leaders events, including pre-conference workshops at this year’s eHealthAFRO 2017. While modest compared to NHS England’s initiatives, these combine into a start-point for eHealth leadership capacity.

  • SAVE THE DATE! eHealthAFRO 2017 Southern Africa 2-4 October 2017

    We are thrilled to announce dates and the venue for this year's eHealthAFRO Southern Africa 2017 conference.

    2 - 4 October 2017Emperors Palace, Johannesburg

    The event will be hosted by the South African National Department of Health (NDoH) in collaboration with an Acfee-led consortium of leading eHealth organisations, including Health Information Systems Program-SA (HISP-SA), the South African Health Informatics Association (SAHIA) HealthEnabled, and a growing array of partners.An extensive pre-conference programme will run at the Emperors Palace from 27 September 2017. Themes, programme, speakers and much more will be pushed through to the conference website in a regular series of releases building up to the event.Join us for an unforgettable event, where healthcare professionals, government leaders and industry stakeholders explore tangible eHealth opportunities and eHealth excellence in Southern Africa. eHealthAFRO 2017 will empower participants to advance eHealth in the region by showcasing proven strategies, best practice and real-world learning to realise measurable benefits for patients, communities, clinicians, and the industry as a whole.The event has an extended programme of seminars, an academic programme and high-level policy meetings to discuss and build a roadmap for eHealth to move forward in the region. 

    -------------------------------------

    NDoH is the government department responsible for health service delivery in South Africa. It's vision is "a long and healthy life for all South Africans". Its mission is "to improve health status through the prevention of illnesses and the promotion of healthy lifestyles and to consistently improve healthcare delivery system by focusing on access, equity, efficiency, quality and sustainability". 

    Acfee is an African network of eHealth experts. Acfee develops eHealth capacity and leadership for African countries to support improved health outcomes for our people. Acfee leads the eHealthAFRO 2017 initiative.

    HISP-SA develops and implements sustainable and integrated Health Information Systems that empower communities, healthcare workers and decision makers to improve the coverage, quality and efficiency of health services. 

    SAHIA is an independent organisation formed to promote the professional application of Health Informatics in South Africa. SAHIA is a member of the International Medical Informatics Association (IMIA). 

    HealthEnabled is an Africa-based non-profit. They are digital health architects that help governments and other health organisations integrate proven life-saving digital health interventions into their health systems at scale.

  • The next WHO DG is from Africa - are these the main challenges and opportunities?

    It’s with considerable pride that eHNA can post about WHO’s next Director-General’s from Africa. Tedros Adhanom Ghebreyesus, a former health minister and foreign minister of Ethiopia, will be WHO’s next Director-General (DG). He’s the first African to lead the UN agency.

     

    The Thomson Reuters Foundation asked global health experts and charity leaders what the new DG’s priorities should be. Their answers are in an article in allAfrica.

     

    He’ll immediately be confronted by an extensive array of urgent, long-term public health challenges. They include:

    Outbreaks of highly infectious global epidemics such as Ebola, cholera, yellow fever, Zika and MERSGlobal rise in Non-communicable Diseases (NCD), such as cancer, diabetes and heart diseaseImpact of stress and hardship on mental health and wellbeingContinuing fight against HIV, malaria, TB and maternal, adolescent and child health.

    WHO must also help drive Universal Health Coverage (UHC) and bridge the divides between global, national and local communities’ health systems. These can determine the courses of outbreaks or health risks.

    Health challenges start and end in communities, so the new DG must be ready to put people at the centre. One way’s to give local communities a seat at the global public health table to contribute to building a stronger, more resilient and healthier world.

    Building on Africa’s health ministers’ recent eHealth leadership initiative in Geneva, reported on eHNA, is a specific priority for Africa. It includes leading advances in technology and using open access data bases and data warehouses, eHealth innovation and mHealth technologies. There’s an opportunity for WHO to embrace and promote these more effectively. This needs a context of WHO calling on new ideas and innovations if it is to meet the numerous health challenges facing communities.

    Other initiatives include:

    Expanding strong confidence in WHO’s role in rapidly responding to, managing and containing emerging and re-emerging infectious diseasesEnsuring there is international and national leadership regarding the major health threat of antimicrobial resistance and the management of drug resistant infections, including CDC’s outpatients antibiotic stewardship plans, reported on eHNAEmphasising healthcare workers’ protectionAddressing inequality in health by promoting quality healthcare to disadvantaged communities, especially women and childrenExpanding and broadening WHO’s funding base beyond the US and Europe

    The WHO has a tremendous opportunity to accelerate recent advances in global health. Tedros can spearhead a highly effective, efficient, and forward-thinking WHO that embraces innovation, to achieve a world where affordable, quality healthcare’s in reach of those currently denied it. It’ll take time. It’s a never ending journey. eHNA looks forward to the new DG taking Africa further along the road.