What's preventing eHealth adoption in Africa?
African countries are converging under a common desire: to transform African healthcare through technology. But they also share a common frustration: African healthcare's slow and unsteady embrace of new technology.
Why do so many seemingly great technologies fail to penetrate the health care system?
This was a question I asked myself while undertaking my master’s research. I hope the following answers shed some light on the realities of technology adoption in healthcare.
1. Many eHealth innovations don’t address the real problem
eHealth innovators start by discovering a useful technology. Later, they figure out how people can use it. eHealth should not only address a problem, but needs to be goal directed. Meaning, innovators should start with the goals of the end-user. The solutions come next. When the order is reversed, the results usually disappoint.
As an example, the introduction of wearable health tech has excited innovators in the industry. These wristbands, watches, sensors and headsets can obtain and transmit large amounts of data on heart rhythms and blood pressure. However, there’s little evidence those wearing them overcome abnormal heart rhythms or elevated blood pressures better than those who don't.
2. No one wants to pay for new technologies
Creating an innovative technology to help doctors and patients isn't enough. Patients, doctors, healthcare facilities and insurance companies long for the benefits and value that these technologies provide, however, each thinks someone else should pay for it.
Furthermore, new technologies that lowers costs and reduce patient visits discourage doctors and healthcare facilities from embracing these technologies because they work on a fee-for-service model instead of a fee-for-value model.
3. The infrastructure to share information is underdeveloped
The introduction of the electronic health record (EHR) allows healthcare providers to share patient information and collaborate across different specialties to provide holistic treatment plans for the patients. However, in Africa the supporting infrastructure, policies and standards for data sharing across multiple platforms and geographies are lagging. Several African countries have started investing in strategic working groups to address this challenge.
4. Technology slows down users
For many healthcare providers, entering data into an EHR takes longer than keeping a paper record. The structured format of the EHR also frustrates healthcare provider when the application prevents them from skipping steps or leaving out clinical details.
Frustrating as it may be, the added information reduces the risks of medical error, avoids redundant testing, and facilitates easier access to test results. The benefits to the patient are clear, but less so for the healthcare provider. Getting healthcare providers to embrace these more effective approaches is the next big challenge for innovators to overcome.
- 419 views
- June 03, 2019
- Ameera Hamid
Will the new Apple watch be a big hit?
Apple is renowned for technological advancement and innovation. During their annual product launch this year, Apple announced the new series 4 watch. It’s not your average wearable. This watch boasts mHealth features such as electrocardiogram (ECG) monitoring and fall detection, and allows you to share this data with your healthcare practitioner.
These features are impressive. Apple is snapping up opportunities to break into the rapidly expanding mHealth market, from fitness tracking to a health app and now wearable ECG. But there’s a nagging concern too. What impact will this wearable ECG have on the healthcare system? Could Apple’s new innovation spur an increase in unnecessary healthcare utilisation?
These are concerns that I seem to share with other healthcare practitioners who worry that consumers may incorrectly attempt to diagnose complex cardiac conditions themselves. There are also concerns about the sensitivity and specificity of the device, which if not great, could spark a mass of panic-stricken consumers due to false positives.
While this new innovation is an important movement towards better patient management, it is vital that the counsel of healthcare practitioners is not diminished. Consumers must be advised to use it cautiously to augment their healthcare management rather than replace professional management.
Similarly, the medical community needs to work more closely with companies like Apple who drive much needed innovation.
- 518 views
- September 20, 2018
- Ameera Hamid
A smart watch can detect epilepsy
Epilepsy is a leading serious neurological condition worldwide. It has particularly significant physical, economic and social consequences. Recognising the need for an intervention, Empatica Inc. has developed a smart watch to detect seizures in epileptic patients. They’re calling it Embrace.
Embrace uses machine learning algorithms to monitor and detect different seizure types, including grand mal or generalised tonic-clonic seizures. Electrodermal Activity (EDA)* sensors in the watch are used to measure multiple indicators of a seizure.
It’s also accompanied by an app that will send an alert, via text message, to a healthcare provider or caregiver once a seizure is detected. Additionally, the app serves as an electronic seizure diary and health record for the user.
During a clinical study involving 135 epileptic patients, Embrace’s algorithm was shown to detect 100% of the seizures, including the 40% of silent seizures that were unreported in patient clinical diaries. Following this, the smart watch has received FDA approval as well as approval in Europe as a medical device for epileptic monitoring.
Embrace’s high sensitivity is revolutionising seizure reporting. It serves as a much awaited alternative to wearing an EEG, that is automated, and isn’t bulky or cumbersome to wear.
*signals used to quantify physiological changes in the sympathetic nervous system
- 667 views
- March 05, 2018
- Ameera Hamid
Health wearables keep evolving
Sensors in wearables are becoming less expensive and increasingly homogenous as devices and services become relatively indistinguishable across the market, the phenomenon of commoditisation. An article in HIT Consultant says health wearables makers have to develop more holistic offerings with software that makes wearables smarter and offer more benefits.
It’s one reason why wearable makers are focusing on using AI in their devices. An Apple initiative, AirPods, could use Siri to become a high-impact wearable. At Amazon, Alexa, a voice service, has already been integrated into several devices.
Somewhat gruesomely, sweat sensors offer potential. The ideas captured the digital health ecosystem’s attention when a study from Stanford University found they can help diagnose disease.
A characteristic of sweat wearables is its fast pace of advances. Spectrum, the Institute of Electrical and Electronics Engineers (IEEE) outlet, says, researchers at Saudi Arabia’s King Abdullah University of Science and Technology have created an inexpensive paper watch using flexible sensors that measures body temperature, sweat and blood pressure. A team at Purdue University has developed paper skin patches that measure dehydration. North western University has created patches too. Measuring hydration may lead to bloodless screening for diabetes.
Some experts believe sweat sensors are health wearables’ next big step up. They could provide critical medical and wellness data. Developments are happening quickly, and African countries and start-ups are facing new opportunities.
- 1,136 views
- July 18, 2017
- Lesley Dobson
Fitness trackers are unfit for counting calorie burning
For some enthusiasts, fitness without trackers is an unfulfilled goal. Unfortunately, trackers aren’t good at everything they claim. A study by a team at Stanford University School of Medicine, and reported in the Journal of Personalized Medicine, found that fitness trackers can accurately measure heart rate, but not calories burned. It reviewed the accuracy of seven wristband activity monitors with 60 users. Six measured heart rate within 5%. None measured energy expenditure well.
The not quite magnificent seven were Apple Watch, Basis Peak, Fitbit Surge, Microsoft Band, Mio Alpha 2, PulseOn and Samsung Gear S2. Their performance is determined by their technological prowess. Skin colour and Body Mass Index (BMI) can affect their measurements.
For calorie burning, the best performer was out by an average of 27%. It was much closer than the least accurate, which was out by 93%. These disparities indicate that they not very dependable for dietary life-style decisions. It seems like suppliers need to go back to the drawing board after a substantial lunch.
- 870 views
- June 06, 2017
- Tom Jones
Is data from wearables reliable enough?
As the number and type of wearables increase, doctors seem divided about the value of the data they provide. A report in Medical Economics refers to comments by John Sharp. He’s a senior manager at the Personal Connected Health Alliance, a non-profit organisation set up by the Healthcare Information and Management Systems Society (HIMSS). Its goal’s to support activities in the wearables market.
One of the benefits of wearables is the opportunity for patients to share data with their doctors. Sharp says wearables can help improve healthcare outcomes and help doctors with patients needing to control chronic conditions, such as diabetes or high blood pressure. Readings from wearables between visits to doctors can indicate the status of their patients’ conditions.
He also points out that some doctors won’t rely on data from wearables. In contrast, some encourage patients to use them and report on the data to help achieve better outcomes for patients. Which group has the proven approach? Medical economics doesn’t shed light on it.
It does say the number of patients using wearables is expected to grow significantly. Research and Markets identified almost 250 health wearables in its report Smart Wearables in Healthcare, 2016-2030. Most are activity and fitness trackers, but the emphasis’s switching to more advanced wearables that produce data. Examples are Electrocardiograms (ECG), blood pressure readings and blood glucose data. Overall growth in the wearable healthcare market is estimated as nearly 14% a year for the next 15 years.
As more clinically valuable wearables become available, they play an increasing role in Africa’s health systems. Initiatives that combine wearables and mHealth apps could have a valuable role in improving healthcare across much of Africa. However, engaging doctors from the outset’s vital to realising the benefits.
- 1,259 views
- May 01, 2017
- Lesley Dobson
There’s a new wave of wearables
Wearables in mHealth act as an extension of the wearer’s body and brain. The device usually works in partnership with smartphones that allow us to access digital content without being distracted from the physical environment. The increase in the use of wearables is highly driven by the growth in mobile apps which are designed to monitor and improve the users’ health and wellbeing. MobileEcosystem Forum has estimated that the global health and fitness app market is approximately $4 billion now and could be worth $26 billion in 2017.
Mhealthwatch has a new report on wearable from ABI Research. It says there’s good reason for immense growth in mHealth wearables. Data shows that these devices boost patients’ healthcare, both inside and outside hospitals. The surge in patients using wearables to monitor their healthcare’s is helping to reduce readmission risks and prevent the occurrence of serious medical traumas. It’ll help alleviate the growing performance pressure on healthcare services and providers too.
Devices include blood pressure monitors, continuous glucose monitors, pulse oximeters, and newer devices, like Fatigue Science’s fatigue monitor. These send prompt, real-time alerts about condition, deteriorations or fluctuations. It’s effective by reducing response times by health workers to potentially life-threatening changes, saving healthcare resources.
Stephanie Lawrence, Research Analyst at ABI Research, sees a new wave of wearable benefits. “While previously professional-grade patient monitoring largely limited itself to a doctor’s rounds, new wearables allow medical professionals to remotely and continuously monitor patients in the hospital and beyond.” These offer Africa’s health systems new opportunities to improve health, healthcare and resource utilisation.
- 931 views
- February 16, 2017
- Hlobisile Vilakazi
Mamaope’s a biomedical jacket that diagnoses pneumonia
Pneumonia accounts for 16% of all deaths of children under five, killing roughly 920,000 children globally each year. It’s a massive challenge for Uganda, where nearly 24,000 children die each year. A lack of access to laboratory testing and infrastructure in rural communities means that health workers often have to rely on simple clinical examinations to make their diagnoses. This often leads to misdiagnosis and preventable deaths.
To tackle this problem, Olivia Koburongo Brian Turyabagye and a team of doctors from Uganda, created the MamaOpe (Mother's Hope) kit to help diagnose pneumonia. It comprises a mobile app and a biomedical wearable smart jacket, says an article in Daily Nation.
MamaOpe kit is simple and easy to use. Health workers simply slip the smart wearable onto a child so the sensors on the jacket can detect his or her breathing rate, temperature and the lungs’ sound patterns. The information’s then sent via Bluetooth to the mHealth app. An analysis determines the severity of the disease. Once the information’s captured and stored in the cloud, doctors can access it remotely, helping health workers make better decisions.
Although the smart jacket’s still a prototype, early results are promising. Studies by the engineers indicate that it can detect and diagnose pneumonia three times faster than a health worker can. It reduces human error too.
The team’s currently patenting the kit, which’s shortlisted for the 2017 Royal Academy of Engineering Africa Prize. Plans are underway to pilot the kit in Uganda's referral hospitals, then distribute it to remote health centres.
- 950 views
- January 31, 2017
- Tshiamo Mmotsa
Clinical health apps to outpace fitness trackers
Fitness apps and wearables have been flooding the market. There’s a fitness app to track just about anything these days. From how many steps you take, your heart rate and your eating and sleeping patterns. If you can imagine it, there is almost surely an app for it.
While the popularity of fitness apps continues, there may be a change coming. A survey by Silicon Valley Bank shows that clinically-focuses health apps and devices are more likely to be more popular this year than consumer-focused products. Innovators and investors are more interested in the switch too, an article in HealthcareITNews says.
Of the 122 executives and investors in health-tech companies interviewed, 45% said clinically-driven health programmes will have grow most. Only 8% selected mobile health apps and 7% named wearables. The report says “Investment trends in digital health are shifting from consumer wellness applications to clinically driven solutions that drive better health outcomes at lower costs. This next wave focuses on encouraging consumers and patients to change health-related behaviors, underscoring the greater opportunities for companies with solutions that create value for payers, providers, employers and consumers.”
About 55% of all digital health investments since 2011 have been in companies providing consumer-facing tools. Investors have recently preferred clinically-focused startups, seeking tools designed to affect patient behavior and generating better health outcomes and cost savings.
In 2015, 60 early-stage funding deals in clinical enablement, totaled US$600 million. In 2016, there will be more than 70 deals, up by more than 16%, amounting to more than US$850 million, up more than 40%. The average deal value’s increased from about US$10 million to over US$ 12 million. Consumer deals for fitness and wellness are heading in the opposite direction, There were 45 deals valued at US$550 million in 2015 compared to there will be 10 deals at less than $20 million in 2016. The change’s a drop in deals of about 80% and average deal values down by from about US$12 million to about US$2 million.
Disease management and remote monitoring companies are shifting to specific disease to help patients and providers manage conditions better. Instead of providing general solutions, “Now the focus is on digital solutions for disease management. Going forward, clinically proven software and hardware will be integrated to drive better health outcomes and cost savings.”
These are encouraging healthcare development. Its potential benefits are considerable, although often in eHealth, potential benefits are seldom realised fully. Hopefully, this trend will make it way to African countries soon and add to its mHealth ambitions.
- 514 views
- October 07, 2016
- Lesley Dobson
OMsignal launches smart sports bra
Wearables are quickly becoming part of our everyday lives. Helping us track and monitor our health and fitness levels. OMsignal, which makes smart clothing and companion apps, has officially launched OMbra, a smart sports bra. Its available online on the company’s website and in select retail stores across the US and Canada says an article in Mobihealthnews.
The smart bra is embedded with sensors to capture biometric signals like heart rate and respiration, delivering actionable insights via the wearer’s mobile device on OMrun, the personalized running app. OMbra’s sensors also count steps and measure cadence, pacing and running rhythm. The OMrun app determines each runner’s intensity level to enable them to progress and maximize fat-burning results, while also helping to reduce the risk of injury and fatigue.
"OMbra came to fruition through years of research, development and experimentation with female runners of all levels," Stephane Marceau, CEO and Co-Founder of OM said in a statement. "From the hundreds of women who tested the bra, we tried to enable a very simple and mindful approach to running that strikes a balance between the will to progress and achieve specific fitness goals, and the simple, healthy pleasures of running."
Joanna Berzowska, head of electronic textiles at OM said "Boasting specially engineered fabrics and advanced sensory technology, OMbra truly is a product of science and engineering that simultaneously features innovative and inspired design."
OMbra is the company’s first available product. With wearable technology constantly evolving, we look forward to what they come up with next.
- 434 views
- September 22, 2016
- Lesley Dobson
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