• Leadership
  • The importance of eHealth cooperation

    There are considerable opportunities for eHealth to strengthen health systems. To realise the benefits however, it’s crucial to implement a successful and sustainable system. This’s easier said than done, as eHealth faces a long list of challenges.

    eHealth challenges was a critical theme at the 2015 African eHealth Forum (AeF). The scale and scope of Africa’s eHealth challenges became obvious during discussions with the African Centre for eHealth Excellence (Acfee) Advisory Board. AeF is a platform where African healthcare leaders come together to learn from each other and rethink policies, strategies and plans.

    Another key theme identified at the AeF is the value of better communication, collaboration and cooperation. While Africa's made up of unique countries, all at different stages of incorporating digital healthcare technologies, they have many common goals and challenges. eHealth’s goals are to:

    Have more healthy Africans Strengthen healthcare systems to improve quality care, communication and support healthcare workers in their daily activities

    Sharing experiences, lessons and good practices can play a critical role in moving eHealth forward. Learning from each other’s experiences, shortcomings and successes can help countries identify risks and allow them to plan to manage or mitigate them. eHealth strategies can be developed that are flexible enough to incorporate eHealth’s ever changing environment and plan ahead for new investments to ensure ehealth sustainability. When implementing eHealth strategies, identifying key insights from your region and building on their success are critical to your own success.

    eHealth systems should not be developed in isolation, with each country building their own system from scratch. African countries should cooperate to find the best way to overcome mutual problems to achieve shared goals.

    Sharing good practices and lessons learnt will be a key theme at this years eHealthALIVE Southern Africa event scheduled for 6-7 September in Johannesburg, South Africa. Acfee and eHNA will be there. We look forward to working with Southern African healthcare leaders to move eHealth forward to ensure healthier Africans.

  • Transformed health needs more than strengthening

    Health workers in African countries know a lot about facing challenges of all sizes. Sometimes they seem insurmountable. High disease burdens, resource limitations and structural issues can make it hard to move forward. Under these circumstances, it’s not surprising that they often feel ideas about strengthening health systems with eHealth don't do enough.

    African health workers hope for, and many strive for, a fundamental change in how health systems work. The change is about addressing numerous precursors to poor health and disease and shifting the balance of power and responsibility towards citizens before they become patients and every step along the way in partnership with health workers once they are.

    This deals with helping people engage in their personal health choices, supporting their health seeking decisions, influencing them towards constructive choices, nurturing their good habits, and building relationships with trust and power balances that will continue to bear fruit. 

    It’s not a new public health concept, but perhaps here’s a new perspective. This transformation will not be possible without embracing a fundamental, intrinsic role for a wide range of ICT-enabled opportunities, stretching across initiatives such as EHRs, telemedicine and mHealth. This shift, to recognise the role for eHealth’s role or citizens and CHWs, is essential. Next is to realise how hard it is to get right and how much can be done to promote success.

    Acfee’s work with African countries' health systems reveals readiness to engage in this. It’s a long road with lots of challenges, such as over 60 identified at Acfee’s African eHealth Forum (AeF) in July 2015. The list is described in Advancing eHealth in Africa.

    It needs new leaders in African health systems who recognise eHealth’s power to support transformation, acknowledge the challenges and risks, and move forward anyway with smart, step-wise decisions that move their health systems along the road to better health. 

    Acfee’s doing it’s bit to help African countries tackle some of these steps. One is strengthening national eHealth strategies. Alongside we’re matching those strategies with a skills development programme in collaboration with eight African universities. We’re also running leadership development events, like the annual African eHealth Forum for health‘s decision makers and the annual eHealthALIVE conferences, the first if which, for Southern Africa, launches in Johannesburg in September.

    We’re at the African Health Summit this week to discuss these ideas with our partners. Join the conversation live on-site or via our Twitter, Facebook and LinkedIn channels. African eHealth is on the move. What part are you playing?

  • eHealth's more than Health ICT, and it's a big challenge for Africa

    At Acfee’s African eHealth Forum (AeF) in July 2015, senior eHealth leaders from several countries identified more than 60 long-standing eHealth challenges that need fixing before eHealth can make a big impact. The list, described in Advancing eHealth in Africa, was longer, and more demanding than most people expected. 

    Expanded eHealth leadership, and eHealth capacity for skills and knowledge in the health workforce, were important challenges. These we identified in 2009 by the Commonwealth Secretariat in its support programme for eHealth strategies. In a series of workshops, African countries working on their eHealth strategies showed that they needed to develop and achieve new organisational contexts to pursue their eHealth goals effectively. Without them, the important eHealth technicalities such as interoperability, architecture, standard and connectivity would not realise their benefits fully. There still much more to do.

    Over the last few years, Acfee’s been helping Africa’s health systems to construct their organisational contexts. The AeF report confirmed that enhanced eHealth leadership and workforce capacity are essential. Their components extend across activities that include:

    Engagement with health professionals Realising benefits for healthy Africans and better healthcare Transforming healthcare delivery and health systems Sustainable health strategies Rigorous business cases for eHealth investment decisions that implement strategies Effective procurement Sustainable financing models eHealth regulation Responding to growing challenges, such as cyber-threats Responding to new eHealth opportunities and priorities, such as Big Data and surveillance.

    These are not easy to achieve. eHNA has numerous reports of countries that have struggled with many of these, and are still struggling. Putting the health ICT technicalities into the mix makes it even more demanding.

    The first step to success is recognising that it’s a long, slow road with no end. Health workers need new eHealth skills and knowledge that go beyond the health ICT technical skills that health informaticians need as specialists. Acfee is developing programmes with eight African universities to begin the journey, and will be discussing these at the Africa Healthcare Summit this week.

  • eHNA's 2016 predictions for African eHealth

    New Year resolutions seldom see out the end of January. Some don’t sustain life after New Year’s Day. Instead of resolutions, a few predictions about African countries’ eHealth might be more valuable. They’ll need judging on 31 December 2016.

    What might happen:

    eHealth and mHealth initiatives will make Africans healthierInitiatives will focus more on integrating into and improving the daily lives of patients, citizens and health workerseSurveillance will improve its use of and reliance on eHealthBig Data will make a bigger contribution to African healthMore African countries will publish new, or revised National eHealth Strategies, better aligned to their goals for better healthCountries will share more experiences, such as their successes, failures and challenges, to learn from one another, using stakeholder platforms such as Acfee’s African eHealth Forum, scheduled for 8, 9 September, shortly after eHealthALIVE Southern Africa taking place annually in Johannesburg from 6, 7 September 2016Investment in dealing with long-standing challenges, such as connectivity, will increase, with affordability improving as Africa’s economies and populations keep growingHealth systems will be better at procuring eHealth by building the strategies needed to realise eHealth’s net benefits, then aligning procurement to them, making it easier for treasuries to make necessary resources availableUniversities will expand their health informatics and health science courses to include wider eHealth themes, along the lines of the curriculum development Acfee is already leading with ten African universitiesMore eHealth leaders will emerge. 

    What might not happen:

    eHealth won’t transform healthcare much, there’s not enough of it yetInteroperability will be a continuing challengeInformation on the impact of Africa’s eHealth, and it’s economics, won’t improve muchSpecific eHealth regulation won’t develop much, if at alleHealth professionals will remain in short supply.

    A New Year action plan could include finding concrete ways to help move the items more likely to happen, forward. eHNA will be on the lookout for your successes.

    Happy New Year.

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    Image from newyearsstatus

  • eHealthALIVE 2016

    eHealthALIVE 2016: Healthy Africans, Empowered Professionals and Healthcare Transformation

    Join us at eHealthALIVE 2016 to see how eHealth projects and initiatives have impacted healthcare and gain valuable insights about how to implement successful, sustainable ehealth projects. eHealthALIVE is about coming together to showcase excellence, debate the challenges, embrace innovation and learn how every one of us can put eHealth into action to improve healthcare for all.

    For healthy Africans 

    Healthy Africans is eHealth’s most important goal. Achieving it needs eHealth to support health professionals and help to transform healthcare.

    “Africans can be healthy and while we have some well-known, almost universal healthcare challenges - eHealth is a powerful mechanism in helping Africans become healthy. And that’s why we’re doing this" said Chairman of Acfee, Dr Sean Broomhead. “There’s a misconception that the burden and complexity of healthcare in Africa means that Africans can’t be healthy, they can’t live healthy lives because the disease burden is too high and investment in health is too low.”

    eHealth isn’t a pseudo-battle between human resources and technology; it’s not a silver bullet; it’s not a luxury; it’s not on the periphery of quality care and it’s not impossible. eHealth is a powerful enabler and essential component to quality care that supports healthcare workers trying to improve the health of individuals and entire populations.

    The goal of health Africans can be realised is technology is harnessed to re-engineer healthcare to revolve around the patient and leverage the information gathered at every patient engagement to improve outcomes and measure service delivery in a useful and meaningful way.

    For healthcare transformation beyond systems strengthening

    The question of eHealth or not is no longer what we’re grappling with. Instead, the question of how eHealth can be used to help each and every individual be healthy and how eHealth can enable more efficient, affordable care and a better patient experience is what eHealthALIVE 2016 aims to answer.

    “We talk a lot about strengthening health systems with eHealth but eHealth forces us to rethink about how we deliver care and the processes that no longer serve us in the face of numerous constraints. We’re actually working to completely transform a system that currently can’t provide healthcare to every citizen – and eHealth is essential to that transformation,” said Broomhead.

    eHealth has numerous roles to play in the transformation of healthcare: it is a practical tool for delivery or communication; a driver for necessary changes in policy and it supports healthcare workers in carrying out their work and improving their job satisfaction.

    For a happier workforce

    Challenges to the healthcare workforce in Africa such as skills shortages and overburdened facilities have demonstrated that if we don’t enable more productivity and engage the people who are central to the transformation, we are going to have a problem caring for people and helping them healthy. eHealth can empower healthcare professionals and form an essential component to building the workforce and retaining essential skills.

    “We believe that the organisations and individuals who join us at eHealthALIVE 2016 will share our vision of healthy Africans, a happy, productive workforce and complete transformation of our health systems,” said Editor at eHealthNews, Taryn Springhall. “We don’t want to deliver another informative conference; we are aiming to align stakeholders to these three meaningful objectives and harness the momentum that comes from an industry-wide shared purpose that will result in tangible, measurable activity.”

    Stakeholders are invited to register early interest at www.ehealthalive.co.za to stay up to date with programme developments.

  • Forum Africain dx l'eSante (FAeS): les defis en matiere de cybersante sont enormes

    Défis, est une belle façon de décrire les inhibiteurs, et obstacles au développement de la cybersanté en Afrique. Tellement, ils sont omniprésents et difficiles à être enrayer. Les ignorer ne va pas marcher, ils ne vont pas disparaître d’eux même, nous devons nous atteler à la tâche pour y faire face. Il y’a de différents types de cybersanté. Leur potentiel pour améliorer la santé et les soins de santé est considérable. La probabilité qu'ils le feront est problématique. Il est utile d'étaler un tableau des contributions avant de plonger dans les détails. Dans le cadre de ce contexte stratégique, le Centre africain pour l’excellence en cybersanté (Acfee) par une approche novatrice tente de trouver un bon ajustement aux priorités de santé en ligne. Le dialogue d’Acfee avec ses partenaires du Conseil consultatif et de l'industrie lors du Forum a identifié une vaste gamme de défis (plus de 60) de santé en ligne. Le rapport AEF faire progresser la cybersanté en Afrique donne plus de détails. Les défis Africains en matière de cybersanté sont le thème essentiel qui à émerger de ce Forum d’ici à fin 2015. L’ampleur et la portée dépassent les seules questins de la cybersanté, et il est essentiel d’aider les pays à identifier et corriger ces problématiques avant tout investissement dans le domaine. Les pays doivent se poser plusieurs questions, qui sont les suivantes : Quelles sont nos priorités relatives? Comment décidons-nous? Comment pouvons-nous les résoudre? Quand pouvons-nous les résoudre? L’image suivante montre comment les défis sont plus larges que les autres domaines en matière de cybersanté. C’est une illustration de l’échelle et de l'importance relative des interrelations qui existent.

    De nombreux participants ont été surpris par l'ampleur des défis identifiés en matière de cybersanté lors du Forum. Ils ont appréhendés les mesures pour y faire face dans leurs politiques de santé en ligne, les stratégies et les plans de mise en œuvre. Les pays doivent allouer des ressources pour mettre en place les facilitateurs (leaders, champions) de cybersanté pour les surmonter. Il y’a plusieurs façons de le faire, et ils tournent autour de l'intégration et de l’interopérabilité des outils, le tout sou le leadership des facilitateurs de cybersanté. Acfee, en intégrant les nouvelles informations sur la cybersanté, consigne dans son programme de de renforcement de la cybersanté en Afrique : des cours, des modèles de leadership, des services de renforcement de capacité des hommes, et des conseils sur mesure, qu’il va fournir pour les pays et les projets. Un exemple de l'échelle et des domaines d’application de la cybersanté se trouve dans le diagramme suivant :

    Dans le schéma ci-dessus on a seulement la moitié des défis identifiés par le Forum. D'un autre schéma consigné dans le rapport du forum on retient la classification suivante des défis : • Stratégies • Capacité • Relations avec les fournisseurs • Durabilité • Performance de la cybersanté • Informatique de santé • Analyses de rentabilité • Réalisation des avantages • Réglementation et gouvernance • Approvisionnement • Formation médicale initiale et continue • Echelle du pays.

    Pour faire face à ce vaste éventail de défis de santé en ligne a besoin d'un ensemble d'étapes et de processus bien planifié. L’équipe de chercheurs et d’évaluateurs d’Acfee, spécialistes en cybersanté fournissent quelques suggestions à ce propos en préconisant des mesures.

    Certains succès en matière de cybersanté ont montré que les défis peuvent être relevés dans les projets de cybersanté. Le succès exige que la séquence soit réaliste et correct, que les mesures pour y faire face, sont efficaces, et que le leadership est du bon type pour réussir.

    Ces mesures sont: 1. Identifier les défis en matière de cybersanté spécifiques dans les stratégies de cybersanté et de santé 2. Élaborer des plans d'atténuation des risques afin de suivre leur impact et leur signification 3. Sélectionnez les défis pertinents pour chaque projet dans la stratégie de cybersanté 4. Sélectionnez la séquence nécessaire pour maximiser les avantages de succès de la cybersanté 5. Concevoir les mesures nécessaires pour faire face efficacement 6. Allouer des ressources nécessaires pour les mettre en œuvre les projets de cybersanté. Dans le cadre de l'évaluation des risques et d'atténuation des difficultés, il est essentiel que les pays et les fournisseurs soient clairs sur les défis qu’ils adressent. Ils en ont besoin pour le succès et pour maximiser les avantages au bénéfice des programmes ou projets de cybersanté.

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    See article in english. 

  • Rapport du forum africain de telesante axe sur les vies sauvees

    L’Afrique a bien connu les problèmes et les priorités de santé. Pour la réussite de la télésanté, il est essentiel que cela aide à faire face aux priorités d'abord. C'est dans ce contexte stratégique que le Centre Africain pour l'Excellence de la Télésanté (Acfee) commence à partir de la mise en place des politiques, stratégies et programmes de télésanté.

    Le dialogue avec ses Conseillers consultatifs et ses partenaires de l'industrie au Forum eHealth africain (AEF) a identifié les priorités de santé qui incluent deux objectifs primordiaux:

    Prévenir les décès évitables, Améliorer la santé et la productivité.

    Ces ci lient à d'autres priorités. L'un est d'améliorer l'écart de mortalité grandissant parce que les femmes vivent plus longtemps que les hommes. La télésanté aussi a besoin de fournir de l'aide à plus de personnes, en particulier:

    Les enfants, pour répondre aux besoins de plus de 50% des enfants dans les 35 prochaines années prévues par l'UNICEF; Le taux élevé de fécondité et un nombre croissant de femmes en âge de procréer, ce qui entraîne la naissance de deux milliards de bébés en Afrique au cours des 35 prochaines années ; Le doublement de la population du continent, et les moins de 18 ans augmenteront la population des deux tiers à près d'un milliard.

    Le résultat sera une immense augmentation de la demande en soins de santé et d'éducation découlant de ces données démographiques. Ils sont décrits dans « Promotion de la télésanté en Afrique", le rapport du premier sommet de la télésanté africaine de Acfee. Vous pouvez accéder à ce rapport sur l'onglet de gauche de la page d'accueil de eHNA. Il contient un schéma montrant le large éventail des priorités en matière de santé dont la télésanté doit y contribuer.

    L'importance relative de celles-ci diffère d'un pays à un autre et, certains auront d'autres priorités supplémentaires. Des liens explicites avec les plans de télésanté sont nécessaires pour établir les priorités et les projets de télésanté de manière à aider les pays à atteindre leurs objectifs de santé.

    Ces-ci ne fournissent pas du tout des avantages immédiats, mais les projets doivent s’inscrire dans une séquence qui potentialise la durabilité, le passage à grande échelle, à moyen et long terme pour un gain de santé. Une liste de contrôle comprend:

    Un accès élargi aux services de santé de la reproduction, Une plus grande responsabilisation des citoyens sur leur santé, Une meilleure santé maternelle et infantile, y compris un meilleur suivi de la grossesse et les soins prénataux et postnataux, L'amélioration de la santé des populations rurales, Rencontrer d'autres OMD et SDG, Poursuite des progrès sur les maladies infectieuses, Poursuite des améliorations portant sur les maladies transmissibles (MT) avec plus d'actions soutenues, Augmentation des améliorations dans la lutte contre les maladies non transmissibles (MNT) avec de nouvelles actions soutenues, Les services de traumatologie pour face à la demande croissante, Action de prévention des maladies, y compris la réduction de l'obésité, Meilleures ripostes aux épidémies, y compris son élargissement et l'amélioration de la e-Surveillance, Enregistrement civile plus fort ainsi que les systèmes de l'état civil.

    Ce sont les priorités de taille pour les systèmes de santé aux ressources limitées de l'Afrique. Il est essentiel que la télésanté abordable et efficace joue pleinement son rôle.

  • AeF: how can suppliers help countries before procurement?

    In July, the African eHealth Forum (AeF) reviewed the role of suppliers in helping countries with their eHealth ideas and strategies. The reverse’s needed too, so countries can help suppliers with a better understanding of countries’ needs, constraints and challenges. These relationships are valuable to both sides, but need to be transparent, available to all suppliers and not cut across procurement. 

    Models from countries in other continents, like the USA and Europe don’t fit Africa. One factor is that the difference between African countries is considerable. This makes it demanding for suppliers to have a common theme for their contributions. It makes it difficult for countries to combine into common groups,

    The African Centre for eHealth Excellence’s (Acfee) approach to finding an achievable fit’s set out oin its AeF report Advancing eHealth in Africa sets out one way of achieving it, build on the AeF model. It sees suppliers being part of capacity building. Constructive relationships at the time of strategies and well before procurement are sophisticated, so the AeF sees the need to develop eHealth leadership as a prerequisite. It’ll also help to create links with similar African countries and eHealth leaders.

    This can’t be created from scratch. It needs to grow organically around specific, realistic, sustainable, affordable and timely eHealth strategies and plans.

  • AeF: Africa's eHealth solutions are specific

    Too many simultaneous or large-scale eHealth solutions increase the risks of delay and unfulfilled benefits. It’s encouraging that the African eHealth Forum identified a fairly narrow band. It’s consistent with the African Centre for eHealth Excellence’s (Acfee) approach to finding an achievable fit to eHealth priorities. The AeF report Advancing eHealth in Africa sets out more details.

    It isn’t surprising that the range isn’t wide, with the tight sustainability and affordability constraints of African countries. The band includes:

    Integrate health information and management information systems Sharing data between health workers and health and healthcare organisations EHRs, which can incorporate patient and medical records mHealth, which extends across a wide range of health conditions eSurveillance, given increased emphasis by the WHO   Telemedicine, which can include telemonitoring Supply chain management District Health Information System (DHIS) 2 ICT collaboration eLearning for a wide range of health workers, including eHealth and professional training. 

    Each of these carries different levels and relationships of risk and reward. EHRs can be seen as the Himalayas of eHealth. When they’re successful, the benefits are spectacular. Reaching this view is laden with risks, and not everyone achieves them, and in a few cases, they have to be abandoned.

    Other types of eHealth are lower risk, but the benefits are lower too. Reporting and management eHealth has perhaps the lowest risks and offer few benefits for patients, carers, communities and health workers, hence the need for a balance of investment between eHealth at points of care and management reporting. 

    Recent experience for Africa is that eSurveillance investment needs strengthening to achieve greater rewards. The investment risk is quite high, but the risks of insufficient investment are higher. eSureveillance’s priority is increasing. After the Ebola epidemic, it’s a must.

  • AeF: eHealth challenges are massive

    Challenges, is a nice way of describing inhibitors, and eHealth’s full of them. In Africa, they’re pervasive and hard to remove. Ignoring them doesn’t work. They won’t go away.

    There are many different types of eHealth. The potential to improve health and healthcare is considerable. The probability they will is problematic. It’s helpful to spread out an array of contributions before delving into the details. This strategic context is the African Centre for eHealth Excellence’s (Acfee) approach to finding a good fit to eHealth priorities.

    Acfee’s dialogue with its Advisory Board and industry partners at the African eHealth Forum (AeF) identified an enormous range of eHealth challenges, more than 60 of them. The AeF report Advancing eHealth in Africa sets out more details.

    Africa’s eHealth challenges are the critical theme to emerge from the 2015 Forum. Its scale and scope exceed eHealth’s other facets, and it’s essential that countries identify and fix these alongside and before eHealth investment. Countries need to ask several questions. What are our relative priorities? How do we decide? How do we fix them? When do we fix them? 

    A simple picture shows how the challenges are broader than other eHealth topics. It’s an illustrative measure of their relative scale and importance.

     

    Many participants were surprised at the scale of the eHealth challenges identified in the Forum. They include measures to deal with them in their eHealth policies, strategies and implementation plans. Countries need to allocate resources to put in place the eHealth enablers to overcome them. There are several ways to do this, and they revolve around integrating and timing eHealth enablers and eHealth applications.

    Acfee’s incorporating the new information on eHealth challenges into its eHealth curriculum and courses, eHealth leadership models and human eHealth capacity services, and preparing bespoke advice to countries and projects to provide them.

    An example of the scale is in the diagram.

     

    It’s only about half the number of challenges identified by the Forum. Another diagram’s in the AeF report along with a classification of:

    Strategies Capacity Relationships with suppliers              Sustainability eHealth performance Health informatics Business cases Benefits realisation Regulation and governance Procurement Medical education Country scale.

    Dealing with this extensive range of eHealth challenges needs a set of steps. Acfee’s earlier research and evaluations of eHealth provides some suggestions. Successful eHealth has shown that the challenges can be addressed in sequence alongside eHealth projects. Success requires that the sequence is right, the measures to deal with them are effective, and that eHealth leadership is of the right type to succeed. Steps are:

    Identify specific eHealth challenges in eHealth strategy Develop risk mitigation plans to track their impact and significance Select the challenges relevant for each eHealth project in the strategy Select the sequence needed for maximised benefits from successful eHealth Design the measures needed to deal with effectively Allocate resources to them Implement them alongside the eHealth project.

    As part of the risk assessment and mitigation, it’s essential that countries and suppliers are clear about the challenges that need fixing for success and maximised benefits. While countries are often clear about the eHealth challenges face, it’s vital the vendors are too.