Is eHealth mature enough for healthcare?
Two opposing views of eHealth could be optimism and cynicism. An article in Fierce Healthcare identifies a view in between. It sees eHealth as a maturing endeavour that’s in an adolescent stage. While it’s a view of US eHealth, if it’s right, it has implications for Africa’s eHealth strategies too/
It starts from a position where basic ICT infrastructure’s in place, such as EHRs, analytics and population health tools. This has created lots of data, but healthcare organisations don’t seem to know what to do with it. They’re entering a phase of trying to pull it together into a cohesive unit. Doctors are taking a core role in this, such as the Integrated Health Model Initiative (IHMI) reported on eHNA.
EHRs aren’t as communicative as they could be, and doctors don’t like the extra time they have to commit to eHealth’s demands. This extends to data entry too.
Wearables can be full of potential for better health and healthcare. Unresolved challenges include designing effective service models and creating appropriate reimbursement arrangements. Reimbursement for telehealth remains elusive too, which doesn’t augur well for rising investment trajectories. It’s especially disappointing when over half of healthcare executives plan to expand their current programmes based on improved patient satisfaction and healthcare coordination achievements.
Recent huge global cyber-attacks, WannaCry and Petya/NotPetya. revealed healthcare’s vulnerabilities. WannaCry breached several hospital systems in the UK’s NHS. For many weeks after the attack, the US Department of Health and Human Services was dealing with it’s operational aftermath for two multi-state health systems.
Petya:Damaged a US-based drug companyForced a West Virginia hospital to replace its entire computer systemCost Nuance some US$68 million by shutting down it’s medical transcription services.
Repairs weren’t confined to technical cyber-security matters. They had to address a severe lack of ICT security talent too.
In this setting, US eHealth investment’s up. For Africa, it’s eHealth strategies need recognise and deal with both the challenges and opportunities. A wide range of resources need deploying to drive through eHealth’s complexities that extend beyond ICT.
- 229 views
- December 27, 2017
- Tom Jones
Nigeria’s ATM telehealth device to enhance services in rural communities
Primary and rural healthcare delivery in Nigeria face a number of longstanding challenges. An estimated 66% of the rural community in the country do not have access to critical medicine, and are in dire need of effective medical infrastructure to support healthcare delivery. While 31% of the population travel more than 20 kilometres seeking standard healthcare in the rural regions.
In order to address some of these challenges, Springville Management Consulting Limited has partnered with Tele-health Technology Company, to introduce its primary healthcare diagnostic technology solution, 'YOLO Health' says an article in allAfrica.
The YOLO Health ATM kiosk is an innovative integrated preventive healthcare solution, designed in form of an ATM machine. It offers various health screening capabilities and medical benefits such as online data consulting with doctors, health checkup and health history.
Managing Director, Chuks Melville Chibundu said "As we continue to seek solutions to challenges in various development sectors, we have recently partnered with one of India's leading healthcare technology solutions providers to proffer easy, quick and affordable diagnostic healthcare services to urban and rural dwellers in Nigeria."The YOLO health ATM allows patients to get a quick preventive health checkup or to video consult with reputed healthcare providers. It checks weight, height, BMI, Oxygen saturation and Hemoglobin.
- 404 views
- September 29, 2017
- Tom Jones
India steps up certification training for medical device makers
High quality medical devices are imperatives for healthcare. It may become more important as Africa’s health systems adopt more Internet of Things (IoT) initiatives. India’s first state-of-the-art medical devices manufacturing park in Visakhapatnam, the Andhra Pradesh MedTech Zone (AMTZ), organised a two-day industry training programme on quality certification. The aim’s to shorten the time and cost of achieving globally recognised quality certification for India’s medical device makers.
A report in eHealth Magazine says the course was organised by Quality Council of India(QCI) National Accreditation Board for Certification Bodies (NABCB) and Association of Indian Medical Device Industry. (AIMED). Medical device manufacturers, medical professionals and industry stakeholders were participants.
There’s a need to fill the regulatory space in quality certification for India’s medical devices in the country. The main themes included:
· Interpretations and understanding of Conformité Européene (CE), the European Commission (EC) the labrynthine guidelines and regulations and product marking
· Industry Indian Certification for Medical Devices (ICMED) certification 9000 and 13485
· New Medical Device Rules 2017.
This could be a template for equivalent events for Africa’s device makers and users. As IoT expands, devices will have to keep up. Regulations and training are a vital ways to achieve it.
- 415 views
- September 12, 2017
- Matt Jones
A microchip can regenerate cells
A research team at Ohio State University Wexner Centre has set out its’ achievements that will revolutionise regenerative medicine. Using Tissue Nanotransfection (TNT), they can generate any cell type in patients’ own bodies. The technology can repair injured tissue or restore aging tissue’s functions, including organs, blood vessels and nerve cells.
Injured or compromised organs can be replaced using TNT. The team’s successfully shown that skin can be fertile, and used to grow any cell type for a failing organ. Two organisations collaborated. Dr Chandan Sen led the team from Ohio State’s Center for Regenerative Medicine & Cell Based Therapies and Ohio State’s Nanoscale Science and Engineering Center in the College of Engineering. Its results are in Nature Nanotechnology.
After studying mice and pigs in these experiments, the team reprogramed skin cells to become vascular cells in badly injured legs that lacked blood flow. Within a week, active blood vessels appeared in the injured leg. By the second week, the injury was saved. Lab tests showed reprogramed skin cells in a live body into nerve cells that were injected into brain-injured mice to help them recover from strokes.
This breakthrough has huge implications for Africa’s health systems. Nano-technology programmes should find a firm place in their eHealth strategies, or have their own strategies. The benefits for patients, families and communities are considerable. The technologies tractor needs sustained, increasing benefits to secure the achievable sustained benefits.
- 490 views
- August 30, 2017
- Lesley Dobson
A healthcare equipment tracking seizure shows eHealth’s risks
eHealth’s never easy. Combining technical ICT with changing organisations’ and people’s behaviour’s always difficult. A project at the US Department of Veterans (sic) Affairs (VA) has come against these.
A recent report from the DVA’s Office of the Inspector General (OIG) set out serious deficiencies in the way medical equipment was managed. They included:No effective inventory system for managing medical equipment and supplies availabilityNo effective system to stop the use of supplies and equipment with patient safety recallsOver 70% of 25 sterile satellite storage areas for supplies were dirtyOver $150m of equipment or supplies weren’t inventoried, so not accounted forA lease on large warehouse of non-inventoried equipment, materials and supplies had a very short remaining, but subsequent accommodation was plannedSenior staff vacancies inhibit prompt solutions.
Now, an eHealth solution started in 2012 track medical equipment’s seized up. Worth $543m, the contract with Hewlett-Packard Enterprise Services, now DXC Technology, offered a Real-Time Locating System (RTLS), a type of Internet of Things (IoT) that should be able to resolve some the OIG’s concerns. A report in My Statesman says in 2016, some four years later, the pilot was facing “catastrophic failure". The VA and DXC say it’s due the change challenges of big-scale ICT projects.
This’s a routine eHealth phenomenon with healthcare as a Complex Adaptive System (CAS), so not an unexpected challenge. My Statesman also discovered two other factors. VA’s ICT spending seldom realises its benefits, and bureaucratic barriers often stifle innovation.
Fierce Healthcare has also highlighted VA’s plans to replace Veterans Information Systems and Technology Architecture (VISTA) with a Cerner EHR, another change challenge. A review by a House Oversight committee recently says the VA was ranked F on its data centre consolidation and ICT portfolio savings. In addition, the OIG had found “material weaknesses” in the VA’s cyber-security.
This string of events shows that converting large healthcare organisations into fleet-of foot eHealth users isn’t easy. Without the transformation, eHealth risks rocket, bot salutary lessons for Africa’s health systems and their eHealth programmes.
- 346 views
- July 12, 2017
- Tom Jones
Technology is key for South Africa’s healthcare future
South Africans generally evaluate their health positively. This is what the annual Future Health Index found. Released by Royal Philips, most South Africans, 80%, rate their health “good, very good or excellent.” Healthcare professionals on the other hand are less optimistic. Roughly 33% of healthcare professionals agree that the overall health of the population in the country is positive says an article in IT-Online.
The discrepancy between the two views is vast. They likely stem from healthcare professionals perceptions of access to healthcare. Results suggest that both groups perceive more access to healthcare than the system provides. It seems to offer a requirement and an opportunity to improve healthcare access.
“Through the Future Health Index, (FHI) we are examining current realities of how well the healthcare system is set up for the future in order to quantify the readiness of health systems across five continents to meet future healthcare challenges,” says Jasper Westerink, CEO of Philips Africa. “The FHI has uncovered a number of significant areas where our healthcare system must transform if we are going to succeed in delivering long-term value based care.”
The report says both the general population and healthcare professionals in South Africa acknowledge the importance of connected care technology in preventing medical issues and contributing to the population’s health. Most participants believe that technology and innovations are underutilised, providing opportunities to increase healthcare’s effectiveness. eHealth and mHealth investment’s essential to set up a modern healthcare system for South Africa’s future.
- 480 views
- June 15, 2017
- Lesley Dobson
Medical devices’ cyber-security testing’s not good enough
As cyber-attacks expand, and since the alarm bells after WannaCry, reported on eHNA, cyber-security’s priority should’ve increased dramatically. It seems it’s starting from a low baseline for medical devices.
A survey by Ponemon Institute for Synopsis says device suppliers think the chances of cyber-attacks on their products are 67%. US healthcare organisations as users think the probability’s 56%. These may be a bit low, but despite this, the survey shows only 5% of healthcare providers test their medical devices at least once a year. More alarmingly, 53% don’t test their cyber-security at all.
A similar deficit prevails with device makers. Only 9% say they test their devices at least once a year. About 43% don’t test their device’s cyber-security. This highlights an important procurement criterion for Africa’s health systems.
These are vulnerabilities that Africa’s health systems should address too. It’s especially critical when 80% of medical device makers and users say medical devices are very difficult to secure. Another vulnerability’s revealed by only 25% of respondents who say cyber-security protocols or architecture inside devices provide adequate protection for clinicians and patients.
Medical Device Security: An Industry Under Attack and Unprepared to Defend says patients have already suffered from cyber-attacks and adverse events. About 31% of device makers and 40% of healthcare providers say they are aware of these. Of these, 38% of providers say inappropriate therapy or treatment was provided to patients. About 39% of device makers say cyber-attacks have taken control of their medical devices.
Ponemon’s report sets out a string of risks. They’re:Device makers and users low confidence that patients and clinicians are protectedUsing mobile devices affects healthcare organisations’ cyber-security’s risk postures. Clinicians depend upon their mobile devices to more efficiently serve patientsBudget increases to improve medical devices’ cyber-security often happen after a serious breachMedical device security practices aren’t the most effective, relying on cyber-security requirements instead thorough practices such as testingMost organisations don’t encrypt traffic between Internet of Thins (IoT) devicesMedical devices contain vulnerable code because of a lack of quality assurance and testing procedures and a rush to releaseTesting rarely occurs, with only 9% of makers and 5% of users testing at least once a yearAccountability medical devices’ cyber-security is lackingMakers and users aren’t aligned on current cyber-security risks, with healthcare providers more likely to be concerned about their devices’ cyber-security and risks, and suppliers’ lack of action to protect patients and usersInsufficient compliance with regulatory advice and guidanceMost makers and users don’t disclose their medical devices’ privacy and security risks.
Ponemon says makers and users say cyber-security’s hard to achieve. It suffers from accidental coding errors, lack of knowledge and training for secure coding practices and pressure on development teams to meet product deadlines. It seems that the clichéd paradigm shift’s needed.
- 562 views
- June 12, 2017
- Tom Jones
Philips helps to accelerate healthcare in Kenya
Transforming Africa’s healthcare’s a generic goal. Philips is partnering with Kenya’s government and the United Nations to transform the country’s primary healthcare. The initiative focuses on gaps in human resources, healthcare financing, essential medicines, medical supplies, health information, and using technology, says an article in IT News Africa.
Philips is the first private sector company to collaborate on this type of initiative and establish a Sustainable Development Goals (SDG) Partnership Platform. The company will support the platform to establish a common knowledge base on primary healthcare by assessing current and future healthcare needs. It’ll enables platform members to work together to identify, design and implement initiatives.
This project brings together executive leadership from government, development partners, private sector organisations and civil society. They'll investigate opportunities to accelerate universal access to Kenya's primary healthcare.The country’s constitution “Guarantees the rights to health as contained under article 43. The Council of Governors of Kenya is looking forward to closely collaborating with the SDG Partnership Platform to help accelerate universal access to primary healthcare in Kenya’s 47 counties through unlocking transformative public-private partnership investments,” said Mrs. Jacqueline Mogeni, CEO, Council of Governors, Kenya.
Kenya’s been implementing healthcare technologies for some years. This partnership aims to accelerate its impact by making better use of healthcare information. It should help healthcare providers and policy makers make more informed, so better decisions.
- 598 views
- May 11, 2017
- Lesley Dobson
IHE’s point of care ID management
Accurate unique patients’ IDs are more than essential. Deviations from them can cause harm when using electronic sensors to observe patients’ physiological states are a common part of clinical treatment of patients, especially those critically ill. Recognising the importance of correct patient IDs in this context, the IHE Patient Care Device Technical Committee has published Point-of-Care Identity Management, a white paper for consultation. It considered comments submitted by 26 February 2017 and will now be moving on to finalise the proposals.
With devices providing routine and regular mission-critical data, clinicians must be able to rely on the accuracy, currency, completeness and routing of eMessages between these devices and systems. Where this fails, treatment may be harmful rather than helpful. The IHE concept of Device-Patient Association (DPA) is consistent with the five rights of medication administration, the right patient, drug, dose, route and time.
For devices, it translates into the right patient, devices and time. Every measurement must go to the right chart, every chart must have every measurement, and every device command affecting a patient must be sent to the correct device acting on that patient.
The white paper:Reviews use cases and system architectures in which electronic information exchanges about device-patient associations may and may not be beneficialDiscusses risk analysis approaches that may be appropriate for institutions reviewing their risks of data misdirection due to incomplete, incorrect or untimely DPA assumptionsSuggests basic eMessaging formats for reporting, collecting, disseminating and querying DPAs.
As Africa’s health systems expands in EHRs, mHealth and medical device investments, adopting and applying the IHE’s standards are crucial. The white paper’s a lot more than just essential reading.
- 614 views
- March 03, 2017
- Tom Jones
IHE wants comments on endoscopy
Four aspects of endoscopy can be seen as the instrument, the technique, a diagnostic tool and minimally invasive surgery. It’s a very valuable medical technology. Looking inside people is a clever way to avoid cutting them open.
Endoscope’s aren’t a modern idea. Primed Canada says its inventor identified by most medical historians is Philip Bozzini. In 1805, he used a tube, lichtleiter, a light guiding instrument, he created, to examine urinary tracts. Antoine Jean Desormeaux, a French surgeon renamed it the endoscope. It’s claimed that in 1868, Adolph Kussmaul was the first person to use an endoscope to see the inside of a stomach of a living person. In 1878, two doctors, Max Nitze and Josef Leiter, invented an endoscope to inspect the urinary tract and bladder.
None of these men concerned themselves with the informatics or eHealth standards and interoperability of their innovations. Integrating the Healthcare Enterprise (IHE) does. It’s released for consultation two supplements:
Endoscopy Image Archiving (EIA)
Endoscopy Ordering Workflow (EWF).
The IHE Endoscopy Technical Committee wanted comments on these by 18 January 2017. They will now complete the supplements as part of the planned IHE Endoscopy Technical Framework.
- 607 views
- February 06, 2017
- Tom Jones
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