• mHealth
  • mHealth to test male fertility

    Infertility’s an important health challenge. Globally about 15%, 48.5 million, couples are affected by infertility. A study shows that underlying fertility issues are often associated with sperm abnormalities. A unique view on male infertility around the globe says that social stigma and lack of access to testing meant that many men never pursue diagnosis evaluation.

    Researchers at Harvard Medical School and Brigham and Women’s Hospital in Massachusetts  have developed an mHealth device that can accurately diagnose mens fertility by testing sperm counts. The innovative smartphone app and device pairing is fast, highly accurate and affordable.  It could become as prevalent for male fertility tests as the at-home pregnancy test is for women.

    A device for semen analysis and rapid infertility diagnostics attaches to a smartphone to count sperm numbers and measure motility, the markers for infertility. Fortune publications has reported that the combination can accurately measure sperm concentration and linear and curvilinear velocities using a small volume, less than 35 ?l, of unwashed, unprocessed semen samples. Using the solution requires drawing semen samples into disposable microchips plugged into the side of  phones’ attachments, similar to a USB. In less than five seconds, analysed results are displayed on the screen.

    Recently, the mHealth device was tested in comparison to lab equipment. Results in the journal Science Translational Medicine show 350 semen samples of both infertile and fertile men were analysed and found to be 98% accurate in identifying abnormal sperm samples. The device could also help to test sperm count of men who recently underwent a vasectomy to determine if the procedure was successful.

    The team’s currently performing additional tests to gain approval by the US Food and Drug Administration (FDA). An article on ehealth news says the device will cost about US$50 when it’s ready to go to market.

  • There’s an mHealth generation gap

    Technology adoption’s becoming shorter. Larry D Rosen said technologies that used to take dozens of years to become mainstream now achieve it in three to five years. Radio took 38 years to reach an audience of 50 million. Television took 13 years. Personal computers took 16 years. The Internet took a mere five years. Within these changes, different generations use technologies in different ways. Their questions, choices and web navigations aren’t the same. 

    Research in the Journal of Medical Internet Research (JMIR) aimed to learn more in the context of chronic conditions, an increasing challenge for people and healthcare systems. Smartphones and health apps are promising tools to change health-related behaviours and manage chronic conditions, but they may have different roles across generations. The study explored:

    •  The extent of smartphone and health app use
    • Socio-demographic, medical and behavioural correlations of smartphone and health app use
    • Associations of app uses and characteristics with actual health behaviours.

    A survey of 4,144 Germans aged 35 and older identified socio-demographics, presence of chronic conditions, health behaviours, quality of life, health literacy and the use of the Internet, smartphones and health apps.

    About 61% of the sample were smartphone users. Younger users undertook more Internet research net, were more likely to work full-time, have a university degree, engage more in physical activity, ate low fat diets and have a higher health-related quality of life and literacy.

    Almost 21% of smartphone users also used health apps. They were younger, less likely to be native German speakers, undertook more research on the Internet, more likely to report chronic conditions, engaged more in physical activity, ate low fat diets and were more health literate than people who used only smartphones.

    The profile of their health apps was:

    ·       Planning                            51%

    ·       Smoking cessation           44%

    ·       Healthy diets                     39%

    ·       Weight loss                        23%

    ·       Reminders                         36%

    ·       Prompting motivation        34%

    ·       Providing information         34%.

    There were significant associations between planning, health behaviour and physical activity. Equivalent links were found between feedback or monitoring and physical activity, and between feedback or monitoring and adherence to doctors’ advice.

    Two overall findings emerged. One’s that there were many smartphone and health app users. The other’s that a substantial proportion of the population was not engaged. The difference is attributed to age, socio-economics, health literacy and health disparities in mHealth use. A recommendation’s that health app developers and researchers should include the needs of older people, people with low health literacy and chronic conditions in their innovative endeavours. As Africa’s population increases and the demographics slowly change, this will be important to maximise the benefits.

  • AskNuma’s Nigeria’s latest eHealth service

    Personal health’s a big step forward from one size fits all. It’s also challenging to achieve and sustain, which is where eHealth, and especially its mHealth component fits.

    Nigerian digital health company Numa Health has launch AskNuma, an mHealth personal health assistant. It provides patients with high quality health information and creates a network for healthcare vendors.

    An article in BIZTECH AFRICA says the platform has revolutionised healthcare delivery in the country. Its Artificial Intelligence (AI) healthcare system hosts a wide database of health information which users can access in real-time. The services also serve as a personal health record, allowing users to manage their health wherever they go.

    AskNuma provides users with diagnoses based on the results of their interactions with the platform and connects them with nearby health facilities using  the diagnoses to find them. To access AskNuma, users can visit www.asknuma.com.

    Co-founder, Dr. Obisanya identified the lack of information and poor supporting healthcare infrastructure as leading to poor health in Nigeria. “In maternal health, over 2,300 children under five and 145 women of childbearing age die daily in Nigeria and according to UN figures, Nigeria contributes to over 10% of the maternal mortality figures globally. These figures highlight the wider issues and challenges in the Nigerian healthcare system and exist due to fragmentation in the healthcare system, a lack of information regarding healthcare options and a lack of basic medical records.”

    Co-founder, Anthony Ajose added, “Numa directly addresses these gaps in healthcare provision by leveraging existing healthcare resources with novel technology, increasing access to healthcare for patients and caregivers. Our personal automated health assistant is accessible via AskNuma.com, patients can manage minor conditions while securely and confidentially connecting to verified healthcare professionals and services when needed for further treatment locally.”

    The Numa platform aims to give patients control of their health, and provide a space where healthcare professionals can offer high quality services to their patients. It can be a catalyst for Africa’s health systems by encouraging healthcare organisations to be more responsive to their population’s needs.

  • Are mobiles part of Africa’s eHealth last mile?

    Connecting all Africa’s communities and citizens to communication networks has been a longstanding and challenging objective. It seems that the ambition remains unfulfilled. In an interview with Health Enabled, Dr Dustin Gibson, Assistant Scientist at the Johns Hopkins Bloomberg School of Public Health, described his research activities in Kenya. He said it’s “been very difficult to reach the last mile populations – that last 15-20% – with public health interventions.” Scaled up to all Africa, that’s between about 190,000 and a quarter of a million people.

    A solution included leveraging the widespread access to mobile phones combined with financial incentives through a widely used mobile-money system, like m-pesa. The result was an increase in full immunisation coverage in Kenya’s children from about 82% to 90%. The project took some four years to complete.

    Does this show that the mobile phone network’s an essential part of the solution to eHealth’s last mile? It seems that it can be.

  • Samsung's launching new telemedicine features

    At the launch of Samsung Galaxy S8 and S8+ phones, the company announced the re-invention of its S Health app as "Samsung Health". An article in mobihealthnews says the upgrade includes tracking and social features already in S Health and  adds new features and a new user interface.

    Ask an Expert’s Samsung's most-popular feature. Users can connect via video to a doctor for US$59 without insurance. It includes real time insurance verification. 

    The app taps into American Well's system so users can see several doctors. The company says its network contains more than 1,200 certified, licensed doctors with an average of 10 to 15 years of clinical experience.

    "This isn’t telemedicine, this is a connected healthcare ecosystem,” American Well CEO and President Dr. Roy Schoenberg told MobiHealthNews. “And we’ve been building up so that it is bigger than anything we have done, and what Samsung is saying is, ‘I’m not going to build healthcare on my product, I’m going to tap into that ecosystem and open the door through technology that touches a lot of people.'”

    In addition to the telemedicine features, Samsung Health includes:

    • Access to lifestyle, food, and fitness trackers
    • A step leaderboard to compete with friends
    • A Discover feature for health content
    • Integration with connected health devices
    • Rewards for signing up with Ask an Expert or Health Insights, a feature that adds analytics and coaching to Samsung's health trackers. 

    The app will be available on all devices that run Android 4.4 and higher. Some older devices and devices in certain countries may not have access to all features. It highlights an important component of Africa’s drive towards Universal Healthcare (UHC).

  • mHealth gives South African women access to legal abortions

    Illegal abortions are unsafe. WHO has a global survey showing there’s a death every eight minutes from preventable, unsafe abortions. Of the 21.6 million unsafe abortions globally, 18.5 million, more than 85%, are in developing countries like South Africa.

    Abortion in South Africa’s a reproductive right. Even after introducing the Choice on Termination of Pregnancy Act, 50% to 60% of abortions are illegal and unsafe. Research by Ipas says that 30% of South African women are unaware that abortion is legal.

    To give all South Africans access to immediate and locally relevant sexual health services, Safe2Choose has launched a new mHealth initiative. It includes evidence-based information and counselling to encourage having safe abortions. Safe2Choose's innovation arm, Fem, will run the campaign.

    The first will refer women to legal, safe abortion providers in their area privately and quickly. To use the services, users will have to:

    • SMS FEM to 30816
    • Answer standard questions on the platform, after which they will receive a referral SMS to a nearby legal and safe healthcare facility providing abortions
    • Authorise the system to map their geographic locations
    • If unable or unwilling to authorize geo-location, users will have access to a manual look-up option so they can select their preferred location and receive referrals.

    The pilot phase is currently underway in Gauteng. The campaign will gradually roll out to other provinces. In the first month, Fem referred some 300 pregnant women to safe and legal abortion facilities. The campaign was promoted on radio stations, flyers at local clinics and social media.    

  • Babyscripts allows doctors to track pregnant patients remotely

    Maternal mortality is a top priority for all health systems. In the US, seeking improvements has spawned several mHealth solutions that may benefit Africa too.

    An editorial by the Association of Reproductive Health Professional says that the US‘s 50th in the world for maternal mortality. Most countries reduced their maternal mortality between 1990 and 2008. There was a 34% decrease globally. But, in the US, maternal mortality doubled.

    To improve the pregnancy experience and maternal mortality in the US, Babyscripts was founded. The start-up focuses on maternal health and has developed an mHealth tool allowing obstetricians to monitor their pregnant patients' health and progress remotely. Obstetricians receive a Mommy Kit with a WiFi and Bluetooth-enabled blood pressure cuff and weight scale. These collect data, sending it back to doctors to monitor using the app. Women use this to replace some pre-natal appointments, saving time and money by not having to pay for a prenatal checkup. These are very valuable benefits for Africans.

    MedCity has a report saying the app's algorithms detect abnormal readings and notify providers to schedule any required visits with patients. Forbes has said the kit and app have already detected cases of pre-eclampsia earlier than conventional diagnoses. The team’s now working on a kit that includes a glucometer to help monitor patients at risk of gestational diabetes.

    This app is unique to existing apps such as Ovia Health App, Text 4 Baby, Due Date Plus and MomConnect. It's aimed at clinicians, while these other apps focus mainly on providing women with information regarding pregnancy and helping women to track their milestones. These don't share data with doctors.

    With Babyscripts receiving more funding, it’s now working with ten health systems. Six more will be added in the next month. The next project’s to track children's health remotely, moving the company into paediatrics. It seems like a very valuable addition to Africa’s health systems’ mHealth portfolios.

  • mHealth needs a structured context

    As mHealth expands across Africa, it’s important that it fits into a structure. It helps to maximise its benefits. A whitepaper, from Athena, Going Mobile: Integrating Mobile to Enhance Patient Care and Practice Efficiency, and available from EHR Intelligence offers a model.  It has seven components that can help to integrate mHealth into healthcare reform and retain privacy, workflow efficiency, clinical outcomes, and patient satisfaction and engagement. The seven are:

    1. Secure, protect and comply with regulations
    2. Focus on efficiency and measurable results
    3. Integrate with patient communication and EHRs
    4. Provide clinical support for better health outcomes
    5. Easy to use for clinicians and patients
    6. A platform for patient engagement
    7. Flexible to accommodate the continuing changes and opportunities to come.

    Secure Text Messaging (STM) is an important part of mHealth. It includes texts between health workers and health workers and patients. Athena proposes that it should integrate with EHRs. It includes effective levels of cyber-security supported by user awareness and training, reinforcing the need for all Africa’s eHealth.

  • SMS security’s essential for Africa’s mHealth

    Talking can be an expression and communication of thoughts and ideas. Same for texting. Isaac Asimov, the scientist and sci-fi author said “Writing is, to me, is simply thinking through my fingers.”  The steady expansion of SMS communication in healthcare shows there’s plenty of thinking in the health systems, even if a lot of it’s generated electronically.

    As with all ICT, health SMSs are cyber-criminal targets. It’s essential that SMSs are secure. The CIO’s Guide to HIPAA Compliant Text Messaging by ec first and imprivata, and available from Health IT Security, provides a generic way to do it. Three combined activities are needed, policies, products and practices. The content’s considerable.

    Policies extend across five main areas. The subsets include seven routine actions: 

    1. Confirm recipients of texts 
    2. Confirm delivery and receipt of texts and that confirmation receipts are ideal 
    3. Don’t use shorthand or abbreviations 
    4. Review texts before sending them to ensure accuracy, especially being beware of autocorrect changes
    5. Ensure all text messages, or their annotations, used for clinical-decisions are documented accurately and promptly in medical records  
    6. Delete all texts containing protected health information as soon as the contents are no longer readily needed.

    Product checklists are long. There are 32 criteria from four perspectives. They’re features, usability, administration and security requirements, and vendor requirements. 

    Practices are mainly tracking and monitoring. When a secure SMS solution is deployed, its compliance must be sustained. Active management includes monitoring log files and other audit information to ensure appropriate use. Four core activities are:

    1. Track and monitor users and policies
    2. Ensure authentication events are appropriately captured
    3. Ensure message read receipts are time stamped.  
    4. Ensure a proactive audit practice aligns with an established policy is implemented for managing the secure SMS framework in line with regulations.

    Like all eHealth, there are considerable risks using unencrypted text when sending Electronic Protected Health Information (ePHI). Privacy and confidentiality can be damaged and diminish SMS’s benefits of improved communication with patients and between health workers. Africa’s health systems can benefit by applying the guide.

  • M-Afya app helps ease worries about maternity fees in Kenya

    Many pregnant women live in informal settlements in Embakasi, Kenya. They have to rely on private healthcare, and so find the money to pay the hospital bills. It’s due to the limited availability of public hospitals in their area. Mobile phones and pre-payment plans can help.

    An article in the African Healthcare IT News says the average maternal billing for medical check-ups and delivery and postnatal care received at a private health facility in Kenya is estimated at 10,000 to 15,000 Kenyan shillings, roughly US $100 to $150 or €95 to €142. It’s a considerable financial burden for women and their families in this community.

    While most people in the settlements are wage earners, they often rely on  unpredictable means of income. The added stress of pregnancy and the fears of not easily affording medical treatment are realities for many women living here.

    These maternal challenges caught the attention of relief organisation Malteser International. It led to the mHealth system M-Afya, M for Mobile and Afya meaning health in Kiswahili.

    The app doesn’t provide financial support, but helps in saving the money that is needed. Women who register at private clinics are provided with a birth plan and encouraged to create accounts. They can then use M-Pesa to deposit money in their accounts. People pay as much as they can afford each time, so having no requirement of fixed amounts is very helpful. The system uses SMS to send updates and other information too.

    M-Afya also provides access to a database that helps promote maternal and child health. Twice a week, women who have registered, receive messages on their mobile phones with information about their pregnancy. They’re reminded of doctors’ appointments, given advice about their pregnancy and sent health data about their unborn children. After they've given birth, M-Afya sends messages of support to mothers and family members.

    The initiative has two main benefits. It reduces levels of stress associated with medical bills. Secondly, it promotes maternal and child health, helping to address core issues of the Sustainable Development Goals.