• Leadership
  • Clinical eHealth leaders are essential

    The late Peter Drucker is still a global leadership guru. He distinguished it from management in his pithy quote “Management is doing things right; leadership is doing the right things.” For eHealth, tinTree sees the need for a triumvirate of clinical, political and executive leadership. It’s not surprising that the study in the International Journal of Medical Informatics confirmed the essential contribution of clinical leadership in successful eHealth.

    A team of Australian and Norwegian researchers analysed 32 peer-reviewed research articles published between January 2000 and May 2013. It found clear associations between clinical leaders who value ICT implementation and achieved positive organisational outcomes. It says the findings are important for the education, recruitment and training of clinical managers and directors. They’re also important to develop the relationship with the other two types of leaders, political and executive.

    eHealth leaders who have technical health ICT expertise at the outset are most likely to be committed to using ICT to improve processes and care quality. Their confidence in the value of ICT motivates them to remain stable through periods of change, resistance and adversity as ICT’s implemented and adopted. Previous experience with ICT project management is another factor helping clinical leaders to develop partnerships with ICT professionals. This teamwork is essential for success.

    Another vital role for leaders is guiding the behaviour and performance of clinicians and their support staff through their use of ICT. It extends to changing some of their clinical and working practices.

    The study’s authors identified seven factors associated with positive outcomes:

    Clear communication of visions and goals Providing leadership support Establishing a governance structure Training Identifying and appointing champions Changing work processes Follow-ups.

    It’d be good to see the equivalent findings for political and executive leaders, and match them with the clinical leaders findings. They should match up to another of Drucker’s aphorisms: “Whenever you see a successful business, someone once made a courageous decision.” For eHealth, it’s at least three people.

  • eHealth leadership is continuous learning

    Peter Drucker said that “leadership is doing the right things, management is doing things right.” As 2013 approached its place in history, Forbes  published their take on it. The Top 10 Qualities That Make a Great Leader are

    1   Honesty

    2   Ability to delegate

    3   Communication

    4   Sense of humour

    5   Confidence

    6   Commitment

    7   Positive attitude

    8   Creativity

    9   Intuition

    10 Ability to inspire.

    These ten-factor checklists are valuable for highlighting the boundary with other factors from other lists, such as the one from ex-New York Mayor Giuliani’s book with the uncomplicated title “Leadership” published by Hyperion in 2002.

    For eHealth, all these are good for eHealth leaders in healthcare and in suppliers. But check-lists rarely say how leaders can learn to be leaders. Learning leadership is more valuable than leadership teaching. This is the Future eHealth Leaders model where action learning sets a context where eHealth leaders can design their own approach to learning, developing and applying leadership continuously. Two of its concepts are learning to know when to stop and change direction, then, keep leading in a new context. With leadership being about change, this is probably the hardest change of all.

    Ten-factor checklists have a place. Continuous leadership learning has a better place in doing the right things.

  • Mandela - our extraordinary gift

    Bishop Desmond Tutu’s foundation calls him our “extraordinary gift”. It’s meant as a gift to South Africans, though arguably it’s a gift to the world. Mandela represents the best we can be. South Africans invoke his name as reassurance that great things are still possible as we grapple with ongoing inequality almost two decades into democracy.

    I met Mandela only once. It was one of those moments that stick. I was a public health official. He, a former Miss South Africa, and other dignitaries were opening a new hospital in South Africa’s Northern Cape Province. It was no surprise that Mandela stole the show. His humility, dignity and affection for people were overwhelming. As was his curious habit of slipping away from the entourage of celebrities to seek out ordinary people and touch their lives. On that hot, dusty afternoon in 2003 Madiba told a story, now shared many times, about dying and reaching the pearly gates. St Peter asked what part of heaven he would like to live in and Madiba asked to be taken to the billionaires. Astonished, St Peter asked why. Madiba replied “People are suffering in South Africa. We need billions to help build our rainbow nation.” Now, a decade later, foreign investment is not South Africa’s most significant obstacle and it is likely Madiba will ask St Peter for something else. It’s certainly an opportunity he won’t squander.

    Fellow Robben Island inmate Mosiuoa Lekota writes in the Mail & Guardian that Mandela “disarmed opponents with his candour”. Perhaps now that we mourn we might face ourselves with equal honestly and consider some of the lessons of Madiba’s life, to rise above our lethargy and fear and see a way to contribute to the better world he sacrificed to help build. Perhaps this makes us more ready to embrace any favour he persuades St Peter to grant.

    eHealth News Africa reported A Mandela Test for eHealth a tribute to his birthday.

  • The man in the arena - Nelson Mandela 1918 to 2013

    “The Man In The Arena” Speech at the Sorbonne Paris, France April 23, 1910

    Theodore Roosevelt

    From Citizenship in a Republic

    “It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

    Nelson Mandela gave a copy of this speech to François Pienaar, the South African rugby team captain, before the start of the 1995 Rugby World Cup Final. The South African’s defeated the All Blacks of New Zealand.

  • Invictus - Nelson Mandela 1918 to 2013

    "Out of the night that covers me, Black as the pit from pole to pole, I thank whatever gods may be For my unconquerable soul.

    "In the fell clutch of circumstance I have not winced nor cried aloud. Under the bludgeonings of chance My head is bloody, but unbowed.

    "Beyond this place of wrath and tears Looms but the Horror of the shade, And yet the menace of the years Finds and shall find me unafraid.

    "It matters not how strait the gate, How charged with punishments the scroll, I am the master of my fate: I am the captain of my soul."

    It's Invictus, by William Ernest Henley. It inspired and sustained Nelson Mandela. He recited it to other prisoners on Robben Island.

  • Botswana Pharmacist drives simple, powerful innovation

    Health workers have practical, simple ideas for sharing information to improve healthcare. Last week I was in Botswana, participating in eHealth strategy consultations. Sitting next to me was Mmatalenta Maphosa, a pharmacist with the Ministry of Health. She is charming and humble, and plays a key role in expanding eHealth in Botswana. She has been pioneering innovative ways to use everyday ICT to improve drug availability. She is the kind of eHealth innovator steadily transforming the African eHealth landscape through practical innovations.

    Early this year, she established an initiative that enhanced pharmacists’ ability to manage and share pharmaceutical supplies across the country and serve patients better. She set up email support to improve medicine availability and prudent utilization of scarce resources. Previously, if government pharmacies had excess stock, stocks with short expiry or needed something urgently faxes would be sent to other facilities to advertise or request pharmaceutical supplies. The system was slow and did not reach all facilities, so Mrs Maphosa decided to send email lists. “With a simple push of a button, I was able to get in contact with almost all the facilities and cut down their response time dramatically”, she says. As long as someone has an email address at that facility, then information flow is possible.

    Many facilities benefit from the service as information on slow moving or short-dated items can be shared between facilities, allowing stock to be moved to other pharmacies across the country, helping the government save money and helping to meet patients’ needs. Facilities in dire need of essential medicines can simply send email requests and are able to get the much needed supplies from pharmacies that have excess stocks.

    The use of ICT in the healthcare system in Botswana revolutionized their drug redistribution programme. It shows how simple ICT solutions can change healthcare, with benefits for health workers and patients. Mrs Maphosa is an important type of eHealth activist, changing the healthcare environment wherever she can, to make life better for herself, her colleagues and the patients she serves.

    When she starts overseeing optimization of the pharmacy, materials management and billing modules, she plans to report cost savings to the government achieved by using ICT. Currently, each facility has to meet targets of 97% drug availability and <3% expiries on inventory value. Her reports aim to show cost savings by utilizing stocks redeployed from other pharmacies. These would have otherwise expired, so wasted.

    She sees more benefits in using a central government server so that pharmacy personnel throughout the country can log on and check the availability of drugs in other facilities. This way, it may be possible to apply the First to Expire, First to go Out (FEFO) principle nationally.

    Mrs Maphosa is impressed with the way pharmacy personnel in Botswana embraced this idea and believes that this team spirit will take the pharmacy profession to phenomenal levels of growth and development.

  • Ousmane Ly is moving eHealth forward in Mali

    eHealth in Mali is moving ahead quickly. Helping to drive this is Dr Ousmane Ly, the General Director of National Agency of TeleHealth and Medical Informatics at Mali’s Ministry of Health. A unique, disarming style and inexhaustible passion for eHealth are two qualities that make him an effective eHealth leader.

    Ousmane is both a clinician and an informatics expert. His medical degree and diploma in Medical Informatics is from the University Pierre Marie Curie in Paris. He is reading for a PhD at Brussels’ Vrije Universiteit.

    Since 2002, he has led a number of important eHealth projects in the region. These include his diverse roles as head of African telemedicine projects for the Division of Medical Informatics of the University Hospitals of Geneva, executive coordinator of telemedicine projects in Mali, and appointment by West Afroican Health Organization, WAHO in 2010 as principal consultant to develop a regional eHealth Strategic Plan for the Economic Community Of West African States ECOWAS member states. He was an independent advisor on the European Space Agency’s (ESA) eHealth for Sub-Saharan Africa (eHSA) eHealth Regulation Study that reported in May 2013, and summarised in eHealth News Africa.

    Ousmane has a special interest in capacity building. He is executive secretary of the Research and Education Network of Mali (MaliREN) and leads the Capacity Building Committee in the West and Central African Research and Education Network (WACREN). This year he became an associate of tinTree International eHealth, a non-profit leadership and development network supporting key projects in the region.

    As African eHealth opportunities continue to expand, Ousmane is certain to play an important role, particularly in the regions Francophone countries.

  • Sam Quarshie calls for common eHealth applications for Africa

    Mr Sam Quarshie is an African eHealth expert and leader. He heads ICT at Ghana Health Services. While addressing the Nigerian eHealth summit last week he called for the creation and adoption of shared eHealth applications on the continent. He believes that shared eHealth applications will improve operational capabilities in Africa’s health systems.

    Quarshie understands from Ghana’s eHealth experience that human resistance to new technologies is a major obstacle. He is a realist; he admits that the introduction of eHealth signifies the end of some common hospital practices.

    “Some people make money from such processes. If we are trying to eliminate paper works in the hospital, we should be prepared to battle with the person that supplies A4 papers to the hospital,” he concludes.

    Quarshie’s passion for eHealth is important to drive eHealth in the region. He knows that resistance to eHealth is common and needs addressing well to realize eHealth benefits. Despite the tough road ahead for eHealth, leaders like Quarshie see success as increasing likely, with evidence of progressive interest in the potentially lucrative eHealth industry in Africa.

  • What kind of CIO are you becoming?

    As eHealth progresses steadily towards the horizon, like all expeditions, the horizon manages to maintain its distance. This is true for eHealth, but the Harvard Business Review (HBR) says that the role of the CIO is changing too, making the horizon’s perspectives more complicated to grasp. CIOs are seen as coping with five generations of workers; digital natives, digital immigrants, digital vagabonds, digital voyeurs, and analog holdouts. But, it seems they are simultaneously transforming themselves along a Darwinian continuum towards Chief Infrastructure Officer, Chief Integration Officer, Chief Intelligence Officer and the ultimate conversion to Chief Innovation Officer, conveniently, all CIO, so no need to change abbreviation on the office door. They are wrestling with three concepts; organizational DNA, accountabilities and budgets, and complaining of a trend of CIOs being accountable to Chief Financial Officers (CFO). As if this is not complicated enough, there are four drivers of change that they can operate in as leaders: 

    Cautious Adopters (50%) Market Leaders (5%) Laggards (30%) Fast Follwers (15%).

    Two themes make this fascinating for eHealth News Africa:

    The combined percentage of marker leaders and fast followers of 20% closely matches the 21% of SSA countries that top Greenfield’s combined eHealth Regulation Readiness Index (RRI), so eHealth in Africa may not be that different to a global ICT profile What does all this mean for CIO’s in Africa who are facing wide-ranging eHealth challenges every day? What kind of CIOs and eHealth leaders do they have to become to succeed in the future?

    eHealth News Africa will be exploring these issues with articles on leaders and leadership.

  • eHealth: potential or pipedream over the next 50 years

    “Harnessing technology and creating effective e-Health and m-Health services will be one way to increase access to healthcare across the continent.” So says the African Development Bank in their recently released report on Health in Africa over the next 50 years. The report examines the overall health progress on the continent over a half century, highlights health challenges and discusses a way forward for the next 50 years.

    The report suggests that leveraging eHealth opportunities will enable countries to overcome the “triple challenge” of inadequate access, finance, and human resources and contribute to greater transparency, accountability, diagnostics accuracy, access, improve quality of care and treatment of patients in Africa.

    eHealth is by no means new to Africa. Most African countries claim to use some form of eHealth, telemedicine or mHealth. Many of these projects and initiatives have been developed and implemented in isolation and are not sustainable. This may be because most African countries do not have eHealth strategies and policies in place and lack eHealth regulations.

    While few would argue that eHealth has the potential to transform the way we approach healthcare, much needs to be done before eHealth can help improve the outlook for health care in African.

    Click here to access the full report.