Does mHealth care for the carers?
A recent eHNA post described a range of eHealth definitions. It included Acfee’s, which extends eHealth to mHealth and a wide range of stakeholders that includes patients, carers and communities. A report in mHealth Intelligence says a study in the US found that mHealth initiatives for older people often neglect the role of, and benefits for, their carers. It’s an important finding for Africa’s mHealth for all patient groups.
This seems to have resulted in barriers to technology adoption for carers who see a lack of awareness, cost, and time. It’s more pronounced for carers aged over 49. Carers younger than this want to use mHealth more than their older peers.
Despite this, they’re clear on what they’d use mHealth for. It’s:
- mHealth that offers peace of mind’s their top priority
- Tools to ensure medications are managed accurately and easily
- Help to monitor a loved one
- Access to trusted online services and advice.
They also want mHealth that:
- Is based on integrated, interoperable, multi-faceted platforms that help them to coordinate tasks and disseminate appropriate information
- Isn’t too expensive and complex, so should be worth the investment of time and money, especially for mHealth that’s only useful rarely and in emergencies.
While these goals can be included in Africa’s health systems’ eHealth strategies, they need reinforcing in each mHealth project. One requirement needs health ministries to take direct action on standards. Moving mHealth into an interoperable and integrated setting needs a set of standards that extend across projects and into other eHealth initiatives, such as EHRs. As mHealth expands in Africa, this will become an increasing requirement. It’s better to start now.
- 495 views
- June 14, 2016
- Lesley Dobson
Medical Aid Films help transform health worker training in Nigeria
Medical Aid Films, InStrat Global Health Solutions, Digital Campus and mPowering Frontline Health Workers, are teaming up to work with Nigeria’s Ondo State Primary Health Care Development Board to launch a new maternal and child health training curriculum for nurses, midwives, and Community Health Workers (CHW). The initiative will use tablets to access the training films.
The twelve-week pilot programme will support in-service training for 200 health workers in 18 health centres in Ondo State. It’ll provide high quality film-based training in English and Yoruba. Topics’ll include antenatal care, managing obstructed labour and resuscitating newborns. The goal’s to scale this programme to all Ondo State’s 550 health facilities and train 5,400 health workers who provide services to 1.4 million women.
At the programme launch, Dr Dayo Adeyanju, Honorable Commissioner for Health for Ondo State, said “We hope to adopt this tool in our health institutions such as the Schools of Nursing, Health Technology and University of Medical Sciences. Getting to train workers has been quite challenging and this will help in solving this challenge. This will surely save cost and extend training coverage."
Four other State Primary Health Management Boards in Nigeria have expressed interest in the programme, significantly expanding its potential benefits. It can be translated into other Nigerian languages for use across all the country’s States to play a core role in providing millions of women and children with access to high quality care and improve their survival rates and general health.
Ondo State Primary Health Care Development Board’s Director of Planning, Research and Statistics, Dr Yetunde Olagbuji, said “This is an innovation we will adopt and enforce to be a method for our trainings. We will also go further in exploring the opportunities it presents and put it to effective use. This will surely cement Ondo State's agenda of delivering quality health care services."
Nigeria is one of Africa’s economic powerhouses, but is in a global group of countries with the highest rates of maternal mortality. The new training programme will support better health worker training across all of Nigeria and enable them to identify and manage complications early and provide better quality care during pregnancy and childbirth.
eHNA will provide updates on progress. It can see the potential for the initiative across all-Africa.
- 504 views
- June 01, 2016
- Lesley Dobson
Three ways to gain doctors' support for eHealth
Doctors, like many of us, don’t like change. They are also hesitant to use new technologies that claim to make their lives easier, save time or cut cost, and who can blame them? The truth is, many eHealth initiatives can help make data capturing more effective and support decision making, but some may require more time and work from doctors and nurses.
To move beyond doctors’ reluctance, and to engage with telemedicine, Robert Pearl, MD, executive director and CEO of Permanente Medical Group and president and CEO of the Mid-Atlantic Permanente Medical Group, says "crucial steps" must be taken to encourage doctors to embrace the new technology, says an article in Fierce HealthIT.
The three steps are:
- Explain the value: guidelines alone won't attract doctors to telemedicine; they must know how it will help their patients and why it's an important step forward in effective care
- Consider workload: if doctors see telemedicine as added work, they’ll be less likely to accept it, so to lessen the burden, practices should consider having staff to help with virtual visits and reward specialists for adding new consultations no matter whether they are in-person or virtual
- Remember culture: at Permanente Medical Group, Pearl says they make sure doctors know they’re supported and won't be penalised for using telemedicine, such as the initiative to give its doctors iPhones and pay for data plans so they can communicate with colleagues and patients at no extra cost.
These simple steps may go along way to encourage doctors and healthcare workers buy in. It’s key for telemedicine and all eHealth services. Without support of healthcare workers, these initiatives can’t succeed, so it’s crucial to secure their input and support throughout the implementation of any eHealth project to make sure they deliver real value and meet users’ needs without adding extra pressure, anxiety and strain on their time.
- 607 views
- April 12, 2016
- Lesley Dobson
IntraHealth helps many African health workers
As an aid agency, IntraHealth International has a very wide range of healthcare activities. Digital health’s one of them. With extensive USA leadership, IntraHealth aims to develop technology solutions that help health workers around the world provide high quality services. It encourages open source, data-driven, sustainable and collaborative eHealth and is a pioneer of health workforce informatics. This is using technology, information and analytics to support the people at the heart of health systems.
A combination of systems approach and technological expertise builds on goals to:
- “Foster local capacity, ownership, and talent in health information technologies
- Create national health information ecosystems that use open and convergent standards and approaches to eliminate technology and data silos
- Help health officials make better, more informed decisions about health workforce policy, planning, training, regulation, and management
- Help health workers deliver better health services through effective mobile, decision-support technologies, telemedicine, and related approaches
- Provide health workers with access to digital learning and online knowledge resources to ensure appropriate just-in-time information
- Broaden the reach of health workers by facilitating communication and coordination among peers, clients, managers, and experts around the world.”
Its services include:
- iHRIS, to help countries track and manage their health workforce data
- OpenHIE Health Worker Registry, to help to understand the scope of their health workforces, and provide information on health workers.
Commentaries on the range of eHealth set out their features and impacts. They show the benefits that they offer to the 21 African countries where it works. They’re Benin, Botswana, DRC, Ethiopia, Ghana, Kenya, Lesotho, Madagascar, Malawi, Mali, Mozambique, Namibia, Nigeria, Rwanda, Senegal, South Africa, South Sudan, Swaziland, Tanzania, Uganda and Zambia.
- 730 views
- July 13, 2015
- Tom Jones
A medical Prof has a fresh eHealth vision
Gurpreet Dhaliwal is Professor of Medicine at University of California, San Francisco. He’s also a physician at the San Francisco VA Medical Center. He’s described his different eHealth vision in the Wall Street Journal. It fits the way that African countries can approach their eHealth initiatives.
It starts from his view that technology has a lot to offer doctors, but it’s different to the healthcare technology in the news, such as Big Data, EHRs and the connected patient. Improving and restoring health needs more than this physical capital. It needs investment in human capital too.
First, Big Data using correlations in huge data sets seldom changes clinical and working practices. They’re more akin to preliminary research findings, so not ready to apply until they’re confirmed, scrutinized and distilled by conventional, rigorous testing. Clinicians need constant exposure to findings from high-quality studies and synopses. Twitter can disseminate these.
EHRs are forensic document, billing and communication tools. They’re not learning tools. Patient lists and reminders are good, What’s needed now is a real time message service triggered by patients using healthcare, such as when they’ve had tests or outpatient attendance.
Prof Dhaliwal wants a connected patient service where updates are from his patients. It needs routine use of SMS, text, email and videoconferencing follow-ups. Many doctors do it, so already have a foundation to build on.
If African countries follow a more traditional eHealth route, it could diminish the benefits they realise. Building on Prof Dhaliwal’s vision can help them to achieve more.
Image from the New York Times
- 1,171 views
- July 07, 2015
- Tom Jones
EHRs may need extra staff
A claim for EHRs, and eHealth in general, is that they save time. They may save some staff time, but they also need extra staff. A report in Market Place Health Care says “The medical scribe industry has been booming in recent years, fueled largely by hospitals around the county switching to electronic medical record systems.”
It refers to Cheyenne Regional ER Doctor Amy Tortorich saying that EHRs are much more comprehensive than the paper files or computer spreadsheets the hospital used to use. They also take much longer, needing about 10 minutes per patient. She usually sees about 30 patients a day. “That’s an extra five hours charting. So half my shift, almost half my shift.”
This is only part of the story. She also says she sees more patients, who usually leave happier, making medical scribes well worth their cost. From an African perspective, the increased EHR workforce results in affordability challenges that lead to productivity gains. This makes the benefits of EHRs harder to assess.
An indication of the affordability challenge is from Scribe America, one of the biggest USA medical scribe companies. It’s tripled its growth in a year to almost 7,500 employees in 47 states. iHealth Beat says the American College of Medical Scribe Specialists estimates that the number of medical scribes in the U.S. will increase from about 20,000 today to about 100,000 by 2020. Their job includes entering patient data using medical terminology and billing codes and recording physicians’ notes during consultations.
As Africa’s eHealth moves on, it’s important it knows how these features need building in. An optimal relationship between affordability and productivity’s not easy to find.
- 634 views
- May 18, 2015
- Tom Jones
eHealth engagement means nurses too
Nurses comprise the largest group of health workers. It is obvious that eHealth engagement strategies and arrangements must include them. In an interview for HIT Consultant, Elizabeth T. Jordan, Associate Professor University of South Florida College of Nursing, sets out why this is essential, but is not in place.
She sees a generational divide in the way nurses use technology. Older nurses take longer than younger ones to adopt healthcare technology. This sounds familiar for all walks of life. Her main premise is that “Healthcare space is getting bigger, and nurses working on those units really rely on technology to be able to communicate.” The implications for the biggest workforce segment justify her proposition that she would like as part of the development and deployment stages of new technology.
For African countries to maximise the use and benefits of their eHealth initiative, it is worth reviewing their engagement models.
- 250 views
- February 24, 2014
- Tom Jones
An eHealth people shortage creates errors
"A person who never made a mistake never tried anything new” as Albert Einstein said. It seems that in eHealth, the lack of people is creating mistakes, according to Professor Enrico Coiera, director of Australia’s $2.5 million National Health and Medical Research Council (NHMRC) Centre for Research Excellence in E-health and also at the University of New South Wales’ Australian Institute of Health Innovation. In an article in The Australian, he says that eHealth is prone to design mistakes because of a lack of expertise, and he says it is probably more of a problem in Australia.
Instead of big-scale systems, he advocates lighter, smaller-scale touch and recognizing that social media could have a role in changing socially mediated diseases and health problems. This option is very relevant for African countries. It needs consideration as part of a solution to affordability and eHealth workforce constraints. There is already a strong emphasis on mHealth in Africa, and it offers a foundation for social media. It can also lead to a foundation for Big Data and analytics.
For African countries, it may be that a lower-scale strategy is not sufficient. They still need to recruit, develop and retain people with health informatics, ICT and analytics skills and knowledge, and so expand the eHealth workforce to seek more benefits from more eHealth. This needs a human resources component in each eHealth strategy.
- 289 views
- February 11, 2014
- Tom Jones
Post-2015 priority: healthcare workers
Human resources shortages are a global challenge. Africa experiences it too, particularly in healthcare where competition is fierce for most resources. It is no surprise that the AfDB has flagged this issue as a key post-2015 priority.
The Third Global Forum on Human Resources for Health (HRH) took place November 10-13 in Brazil. Some 2000 participants from 80 countries attend the event to encourage discussion and come up with innovative ideas on how to solve human resource shortages. The conference was followed by a Board meeting of the Global Health Workforce Alliance (GHWA) to set up the future health workforce agenda. Government officials, global health experts, AfDB and other key stakeholders discussed post-2015 development priorities.
“The global community needs to change its traditional approach to health workforce in a fundamental way. This is particularly important to Africa with high disease burden and low density of health workforce,” said Ages Soucat, presenting AfDB’s vision for building African human capital over the next decade. Using innovative technologies to build human capital is at the heart of the AfDB’s Strategy 2013-2022.
eHealth presents African countries with an opportunity to address the critical shortage of healthcare workers in a new way. Kenya is already experiencing the benefits of using eHealth to support development of nurses.
- 511 views
- November 20, 2013
- Lesley Dobson
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