• mHealth
  • mDiabetes to help Senegal battle Diabetes

    A new mHealth project, mDiabetes, has been launched in Senegal. It’s the first project established for a French-speaking country under “Be He@lthy Be mobile”, a joint global initiative by WHO and the International Telecommunication Union (ITU).The initiative uses SMSs and is currently in its first phase of implementation, with a larger and wider-reaching programme scheduled for roll out in November 2014. mDiabetes aims to combat diabetes with an ambitious and innovative campaign designed to improve prevention by raising awareness among diabetic patients and training health professionals. To accommodate illiterate patients and to make the initiative more effective, the Minister of Health and Social Action is planning to incorporate voice notes and voice messages.

    The WHO has estimated that there will be roughly 552 million diabetics in the world by 2030, 75% of whom will live in low-income countries where diabetes will be the seventh cause of death. The WHO believes that mHealth could significantly contribute to slowing down the increase.

    There’s a variety of major stakeholders in the project. They include the Senegalese Ministry of Health and the Ministry of Communication, ITU, WHO, the Senegalese Association for the Assistance and Support of Diabetes Patients, (ASSAD), the African branch of the International Diabetes Federation, the NGO UNFM, the Marc Sankalé Diabetes Center, Alcatel-Lucent, Sonatel/Orange, BUPA, the global international health insurance and services company, and Sanofi.

    The aim is to help implement strategies for preventing and combating diabetes and other non-communicable diseases. For diabetics, it’s an opportunity to interact directly with health professionals for better management of their disease.

    “We are convinced of the value of this project for improving the conditions for diabetes patients in Senegal and are genuinely delighted to be involved as a technological partner in contributing to the success of the mDiabetes project. This is an ambitious initiative which could ultimately be replicated in other countries in the fight against diabetes or any other disease,” said Alpin Verlet, Managing Director of Alcatel-Lucent for West and Central Africa.

    Sending SMS or voice messages has several objectives:

    Educate and raise awareness among the population Provide information on the diabetes and lifestyle to limit its occurrence Appointment reminders, lifestyle, dietary advice, and complying with treatments to limit complication risks Ttrain health professionals Provide and implement tools for prevention, screening, diagnosis, treatment and monitoring, particularly in rural areas.

    mDiabetes has a wider value beyond Senegal. It’s transfer to other African countries should follow rapidly.

  • MomConnect offers a sound focus for SA's eHealth strategy

    South Africa is a fertile home for new mHealth, with a number of initiatives underway. A new one is emerging that’s set to be important.

    MomConnect provides continuous links with pregnant women. The partners are UNICEF South Africa, Virtual Purple, Praekelt Foundation and the provincial Department of Health in KwaZulu-Natal (KZN). It’s an SMS based project.

    It’s part of the South African National Department of Health’s nationwide maternal mobile health system due for launch this year, as reported by Africa Health It News. The efforts contribute to the campaign on Accelerated Reduction of Maternal and Child Mortality in Africa (CARMMA), and aim to register 1 million pregnant mothers into a national public health database.

    GSMA describes MomConnect as an “SMS-based project that aims to remind pregnant mothers about critical clinic visits during pregnancy, as well as check-ups and immunizations until the child is 18 months old.”

    South Africa’s Minister of Health Dr Aaron Motsoaledi describes MomConnect as one of a number of important steps underway to reduce South Africa’s maternal and child mortality by improving communication with the 1.5 million women who become pregnant every year. “This service will enable us to send SMS messages to every registered pregnant woman.” He told parliament on 19 June 2014.“The messages will be appropriate to the stage of pregnancy and will advise them on what to do at that stage. It will also advise them on how to take care of their newborn.”

    It’s an ambitious programme that fits the passionate leadership style and service focused approach of the minister. “Apart from us sending messages to them, they will also be able to send us SMS messages,”  he adds, “about the problems they encounter when they try to access health services. They may also call to compliment the health facility if they think the service they received was good.”

    One of the challenges faced by South Africa’s Prevention of Mother-to-Child Transmission (PMTCT) is to provide a continuum of care to HIV positive pregnant mothers and their children from antenatal to postnatal periods.

    MomConnect aims to close the gaps in the continuum of care, using mobile technology linked with patient electronic medical records to support PMTCT, including the improvement of maternal and child health outcomes. A pilot has been running in selected KZN facilities since 2011.

    Otty Mhlongo’s is a PMTCT manager in KZN. She presented at last year’s South African Aids Conference where she said,“MomConnect aims to improve Maternal & Child Health, and ultimately eliminate paediatric HIV transmission through the use of on-going SMS messaging to the mom.”

    The pilot tests the efficiency of personalised, unique antenatal and postnatal SMS reminders to 6,000 pregnant women, irrespective of their HIV status, in two KZN districts. It showcases MomConnect’s ability to enable early recognition of HIV positive women with a low count of CD4 cells, white blood cells that help maintain the body’s immune functions, who require Anti-Retroviral Treatment (ART). Regular, tailored supportive messages and reminders during antenatal and postnatal periods, the facilitation of clinic visits for mothers and babies and the improved communication between patients and treatment providers add considerable benefits to health and healthcare effectivness.

    Messages will be in six languages at its launch, with plans to ultimately accommodate all of South Africa’s 11 official languages. It’s a substantial undertaking.

    Scaling up MomConnect is an important project. It’ll need high levels of Semantic Interoperability (SIOp) and Health Information Exchange (HIE), possibly and bi-directional levels to support information flows, EHRs and population health services. These two facilities often need an expansion in ICT capacity to support in the increased traffic that this type of scale-up needs. Dealing with these eHealth technicalities in a patient setting is a good way to proceed.

  • The mHealth super app

    Bill Gates remarked that “software is a great combination between artistry and engineering.”According to Natalie Hodge and Brandi Harless of Personal Medicine Plus, good mHealth apps are about combinations too, though for them it’s mHealth and Internet of Things (IoT), intersecting to produce the super app. They wrote about it recently in mHealthNews.

    eHNA’s had numerous posts about mHealth and a number on the IoT. This is the first time they’re together. It’s a novel idea, that if we connect all the apps that tell a patient how they are doing or what they should do next, we might end up with a health promoting, or healthcare, platform, or both. It would help people stay healthy and allow them, in some cases, to take their health into their own hands and bypass the conventional healthcare system. It’s the approach Google Fit is following too.

    Hodge and Harless suggest that winning super apps have six attributes:

    Use multiple proven technologies in mHealth in tandem Leverage proven engagement strategies Leverage application programming interfaces Use connected health devices Automate interpretation of data with actionable and immediate instructions for behavior change Build on evidence-based prevention principles.

    The themes match well with important eHealth topics, such as interoperability, analytics and sound stakeholder engagement. They also raise questions about risks of cybercrime and the complexity of conducting impact assessments.

    The list is different to those eHNA reported in eHNA’s piece on a new recipe for successful mHealth apps. Perhaps their combination would be good too.

    eHNA will watch for reviews of projects that show how the concept develops. We look forward to more posts on fortuitous combinations, particularly about new ways of using eHealth to improve health and healthcare.

  • More mHealth services coming to sub-Saharan Africa

    According to IT News Africa, GSMA has announced the launch of its new cross-ecosystem partnership. It aims to provide a range of mHealth services to women and children across Sub-Saharan Africa. The initial launch partners include Gemalto, Hello Doctor, Lifesaver, Mobenzi, Mobilium, MTN, Omega Diagnostics and Samsung.

    In September 2014, services will be launched in seven countries. They are Côte d’Ivoire, Ghana, Nigeria, Rwanda, South Africa, Uganda and Zambia. Phase two starts in 2015. It incorporates more partners and services and four more countries: Kenya, Malawi, Mozambique and Tanzania.

    Tom Phillips, Chief Regulatory Officer for GSMA said, “This new mobile ecosystem partnership is committed to connecting the mobile and health industries to develop commercially sustainable mHealth services that meet public health needs.” 

    The partnership aims to reduce barriers to handset owners and improve connectivity for consumers and health workers by:

    Offering discounted Samsung handsets and tablets to consumers and health workers across Africa Providing access to Samsung’s ecosystem, such as music, video and other value-added services as an incentive to drive health usage Pre-embeding a Smart Health application with a range of professional applications, information and services on 80 million Samsung handsets Leveraging existing and new MTN SIMs to allow free access to health content, health registration and data collection with the Smart Health application Providing simpler access to MTN mobile money, advertising and billing capabilities Making innovative diagnostics, like the Omega Diagnostics Visitect HIV CD4 gene solution, more affordable and accessible with mobiles.

    Health content, patient registration, data collection and critical diagnostics will increase the access to healthcare for vulnerable women and children across Africa. It also aims to provide a delivery mechanism for mHealth services that are commercially sustainable and scalable.

    “Healthcare in Africa has benefited greatly from advancements in mobile technology. Simultaneously, the healthcare industry is moving towards a delivery model that is more patient-centered, value-based and accessible in even remote environments,” said Thabiet Allie, Head of Content and Services at Samsung Electronics Africa. “Samsung is perfectly positioned to add value to this digital evolution in healthcare, as our devices are both at the cutting edge of innovation and available widely across the continent.”

    eHNA is looking forward to seeing the results of the monitoring and evaluation to show the net benefits and the options for expansion.

  • Google's passionate about your fitness, and health

    Does the difference between health and fitness matter? Maybe not too much. Fitness is about 17% of the USA mobile app market according to reserach2guidence in its report mHealth App Developer Economics 2014 The State of the Art of mHealth App Publishing.

    The Verge has a report on Google’s unveiling of Google Fit, its personal health application, at the launch of the Google I/O developer conference 25-26 June 2014. Google Fit aims to collect data from popular fitness trackers and health related apps. It will allow a wearable device that measures data such as steps or heart rate to interface with Google’s cloud-based services and become part of the Google Fit network. These are important components of fitness, but health too. It’s an exciting development.

    The personal health application is expected to compete with Apple’s HealthKit application, the concept modelled on Apple’s Passbook app, an effective pocket accessory for keeping important information like boarding passes, tickets, gift cards and coupons.

    Forbes reports on it too, indicating that it’s too soon to confirm whether Google Fit will be an app or whether it will be built into the next version of Android, the operating system that currently runs on over 1 billion smartphones and tablets globally.

    Google announced several partners for its Google Fit initiative. It includes Nike, Adidas, Withings, RunKeeper, and Basis. Phew, it’ll be hard to keep up with these. App developers may want to start warming up – access to the software development kit should be available in the coming weeks.

  • Mobile technology's profiled in an eBook

    Keeping up with mHealth developments is hard. FierceHealthIT has released its commentary as an eBook on the latest example and profile that helps. Verizon, a wireless and technology provider, sponsored the eBook. It includes examples of: St. Luke’s Cornwall Hospital in New York, where care transition teams send nurses into the community with a mobile EKG device that attaches to a smartphone and mobile, Internet-enabled technologies ensure that patients have the right care in the right setting at the right time

    Boston Children’s Hospital uses a range of mobile apps both patients and physicians, including one that helps patients and their families navigate the healthcare system and another that helps them coordinate and communicate with their healthcare team The Veterans Health Administration is working to make its electronic medical system available on mobile devices, with plans for apps for doctors to access other back-end systems At Children’s National Medical Center, a texting pilot program has had early success in improving care transitions and outcomes for asthma patients and has improved patients’ and parents’ experiences.

    mHealth has expanded fast and shows no signs of slowing down. It has the potential to make patients feel more connected to their care and clinicians more connected to their patients, especially during care transitions.

    The range of mHealth opportunities is both wide and skewed. Research2Guidance has published its latest mHealth economics assessment. It shows a USA mHealth distribution[1] across twelve mHealth categories:

    Fitness  30% Medical reference: drugs, disease, symptoms information  7% Wellness apps  15% Nutrition  7% Medical conditions  7% Personal health record  3% CME  2% Diagnostics  2% Compliance  1% Reminders  1% Remote consultation  1% Others  14%

    The mHealth snapshot in the eBook is a good way to keep up with this changing array.

    [1] mHealth App Developer Economics 2014 The State of the Art of mHealth App Publishing research2guidance

  • Do doctors like mHealth?

    As mHealth’s promised transformation of healthcare bumps along, Physician Perceptions of Mobile & Connected Health What Every Marketer Should Know, published by the MedData Group reveals the views of more than 500 USA physicians. Currently, about two-thirds of physicians use some form of mobile device. The biggest role, almost half, is for medical interactions. Diagnosis is next, approaching 30%. The biggest demand over the next year, nearly 60%, is for new mHealth is to have mobile access to EHRs. It’s seen as offering the most benefits.

    More than 35% want three other applications

    Secure texting Points-of-care information about drugs and diagnosis Patient portals for scheduling communication.

    The top three challenges to progress are:

    Security Interoperability Cost.

    An overarching challenge is to solve physicians’ problems first. After that, the focus can be patients, hospitals and healthcare systems.

    More than half the physicians, 57%, see the heralded mHealth connected transformation as taking more than five years. By then, mHealth technology and opportunities may be very different to the current versions.

    The demand is positive, but specific. How does this match Africa’s needs?

  • Zapmedic connects patients to doctors

    Zapmedic, the flagship product of Bitways startup, in Uganda, has launched an online medical appointment scheduling service that aims to ease the process of finding the right doctors on line. Zapmedic is a mobile and web app for both doctors and patients. Patients are able to schedule an appointment and check in online, while the app manages the doctor’s daily appointments.

    The aim is to improve access to healthcare by helping patients and medical practitioners find one another easily and conveniently. Zapmedic has been selected as a finalist for the fourth edition of the PIVOT East mobile startups event in Nairobi on 24 and 25 June.

    An article in Africa Health IT News quotes Bitways’s Chief executive officer (CEO) Wasswa Samuel saying “Our country has one of the lowest doctor to patient ratios, meaning getting access to doctors remains a huge challenge. We thought that if we could make details of these doctors available and provide direct access to them, perhaps we could in a small way improve access to these doctors.”

    The latest figures suggest that Uganda’s doctor to patient ratio stands at 1:15,000, well below the recommended WHO ratio for Africa of 1:10,000.

    The app is currently being piloted by 26 doctors in two hospital chains. The results so far are positive. The app registers anywhere between 20 to 50 appointments per week. Zapmedic charges each practice as it uses its platform to send out appointment reminders, confirmations and prescriptions.

    Wasswa Samuel plans to scale up the initiative and make it more widely available.

  • A text message program boosts diabetes care and cuts costs

    Text messaging offers a simple way to improve healthcare. A smartphone medical app with a stethoscope and a text messaging program helps patients control their diabetes, improve clinical outcomes and cut healthcare costs, according to Health Affairs,  MedPage Today. Participants in the program received educational materials and text message alerts reminding them about various diabetes self-management activities, such as medication refill reminders and self-assessments

    Researchers found that participating patients’ glucose levels declined from an average of 7.9% prior to the study to 7.2% after the study. Healthcare costs for each patient dropped by about $812, with savings of $437 each including program costs. Overall, costs declined by 8.8% for the intervention group.

    This offers good lessons for African countries contemplating an expansion of these type of eHealth.

  • mHealth apps keep coming

    Jacob F Field claimed in the title of his book that history is “One Bloody Thing After Another: The World’s Gruesome History.” The constant supply of mHealth apps feels a bit like this, but without the haematological and gruesome links. Making sense and keeping up with it is hard going. Lt Dan’s article on HIS Talk connect brings together a list of websites that assemble data on mHealth apps.

    PatientView, a UK-based healthcare research and consultancy firm, has launched an mHealth app store that collects clinically validated, trustworthy mHealth apps for patients and care providers. It is supported by several organizations, including GSK, Janssen, and Novo Nordisk, some international telecom companies, and public health entities across Europe.

    The rating system that PatientView uses has five criteria:

    Gives people more control over their condition Easy to use Can be used regularly Allow networking with other people like them Trustworthy.

    Happtique has physicians and health systems as its end users rather than patients. It certifies mHealth apps before they are added to Happtiques, its apps formulary.

    HealthTap is a platform where anonymous users can put health and wellness questions to approved physicians, who provide the answers. It has an app store too. HealthTap allows its physicians to recommend apps that they would recommend to their patients or to each other. The library shows the apps with the most recommendations.

    In England, NHS Choices Health Apps Library shows the apps judged as clinically safe by the NHS, and that the information in them is from a verifiable source. It also tests that developers do not misuse personal information that the apps collect.

    Wellocracy has an mHealth app library for fitness enthusiasts. The site, which is run by the Partner’s Healthcare Center for Connected Health in collaboration with the USA’s Massachusetts General Hospital.

    Lt Dan’s post provides a set of valuable links for African countries that are expanding their mHealth strategies. It makes it much easier than slogging through one app after another.