• Disaster recovery
  • Is eHealth vulnerable to Outer Space Events?

    After Google’s four strikes and you’re not out, what other natural phenomena can affect eHealth? Are there Outer Space Events (OSEs) that disaster recovery should prepare for? A post on Gizmodo says there are.

    The Sun’s flare ups, Coronal Mass Ejections (CMEs) shoot giant clouds of magnetised plasma into space. They’re a bit pedestrian. If the Earth’s in their paths, after about twelve hours, and sometimes several days, they can reach us. If they do, they interact with Earth’s magnetosphere, triggering geomagnetic storms.

    Two alluring affects are at the poles. Aurorae Borealis and Australis light up the sky at their poles in pretty colours and patterns, and attract tourists. Less attractive are the effects on power grids. Some big solar storms can reach the Earth’s surface and result in power surges that power stations feed into grids, which they can’t cope with.

    Geomagnetic storms vary in strength. They’re measured by Disturbance Storm Time (DST). Routine low DSTs are for the Aurorae. In 1989, a high DST storm knocked out power across Quebec. The worst on record was the Carrington Event in 1859. If we have one like it now, it could bring disaster. The CME was visible without magnifying aids. It electrified telegraph lines and caused power cuts.

    Because of our reliance on electricity, a lot of which relies on networked underground assets, the effect would be direct and widespread. Copper wires could melt. Tablets, laptops, desktops and mobiles connected to the power supply could cop it. Server farms could take a direct hit. The Internet would cease. GPS wouldn’t work.

    It seems some of these big scale CMEs might have come close to Earth since 1859. Sooner or later, another Carrington’ll happen. Luckily, meteorology services can see them coming at their cosmologically slow pace. Disaster recovery systems might just work, provided they can be unplugged and don’t touch the ground. Can it be done?

  • Lightning does strike more than once

    It’s a myth that lightning doesn’t strike twice. The probability’s the same if you’ve had a strike before or if you haven’t. Google has recent evidence to support this.

    A post on Extreme Tech’s an invaluable reminder about the need for disaster recovery services. Google’s Europe-west1-b data centre in Belgium was struck four, yes, four times on one day. Data was affected. The disks for Google Compute Engine seem to be the main problem. They store data for businesses and run virtual computers in the cloud. As you’d expect, Google restored many of the drives to working condition and salvaged most of the data, but a very tiny fraction was lost for ever. Google says it’s about 0.000001%.

    Africa has more spectacular lightning than Europe, so it’s a timely reminder for Africa’s health systems to review, and probably upgrade their disaster recovery arrangements. A simple question might be, if Google can withstand four lightning strikes in a day, can we withstand one?

  • Remote diagnostics for Ghana

    Ghana’s Medical Knowledge Fiesta kicked off in Accra on the 15th of September. The conference lasted 5 days and saw a range of innovations showcased, including the launch of Mahiri-telmedx RemoteCare™. Mahiri-telmedx is a joint venture between Mahiri Mobile Services Ltd (Ghana) and telmedx Inc. a San Diego, a video-based telemedicine provider. By combining their technologies and market knowledge, the partnership developed their telemedicine-managed remote diagnostics serviceoffering preventative, diagnostic and aftercare solutions for public hospitals, private hospitals and the insurance sector.Video demonstration of teams in action with ambulance services and medical teams working together on outreach programmes with mobile clinics where provided at the conference.

    The eight-month pilot in Ghana demonstrated positive results for doctor-nurse-patient engagements and interventions and set the stage for the formal launch. Consultations allowed images and videos to be analysed and stored in patient records. One of the benefits of Mahiri-telmedx’s RemoteCare™ Managed Services is secure handling of patient data and monitoring of service levels, which is challenging to achieve in Africa’s infrastructure environments.Mahiri-telmedx RemoteCare™ provides real-time support to emergency and rapid response services such as ambulance teams, disaster recovery and infectious disease management. It allows specialists and other health workers to participate remotely in patients care, in real-time, as events and needs unfold.

    Collaborative features of the managed service help to support workgroups in the same, or different hospitals to provide joint, integrated care. The service also has a learning environment. The learning management application features enable medical teams to engage in online and remote learning.

    Mahiri-telmedx has been designed to provide a holistic solution including EPR management using  structured forms on Mahiri’s tablet PCs, a high resolution HIPAA-compliant video-based application providing medical grade videos, and imaging that is USA FDA approved and meets the EU medical privacy requirements. Sophisticated management reporting features provide analysis of vital signs, geographical information, demographic information, ailments, treatment and treatment plans.Feedback from health workers involved in the pilot project is encouraging. Examples are:

    Nurse at Nsawam Government District Hospital, Ghana, “This has boosted home visits and school health service visits. We now know more about ailments and skin disorders.”Consultant Neurosurgeon, Tamale Teaching Hospital, “In existing approach the doctor does not see the patient. With the Mahiri-telmedx solution the doctor sees all aspects including the face. This is the way forward. For the community, they can be comforted by the knowledge the doctor is seeing them live and they will see a specialist. Someone in the big hospital is coming to see them and that has a psychological effect.”

    Director for Health Service, Nsawam Government District Hospital, “When nurses discharge patients we are able to follow up based on the image and records sent. We are using it for teaching and learning purposes as we come across rare things we would not find when sitting in the classrooms.”

    The next phase of Mahiri-telmedx’s development will include the launch of a customer services and triage service.Mahiri-telmedx is now available in Ghana and Nigeria and will soon be launched throughout Sub-Saharan Africa, accommodating health institutions of different sizes in hub and spoke collaborations, large public hospitals supporting community health care centres and small medical practices.  RemoteCare™ offers models for the insurance sector for corporate healthcare schemes and homecare.

    Medical Knowledge Fiesta is hosted by the Ghana College of Physicians and Surgeons (GCPS) in collaboration with the African Partners Medical (APM) and the Ghana Physicians and Surgeons Foundation (GPSF) of North America. It’s good to see it as a launch site for e+mHealth across Africa. 

  • The cloud needs careful decisions

    The cloud has a few issues that healthcare users need to resolve. That’s an overall view of a USA survey by the Institute for Health Technology Transformation (iHT2) in Answers to Healthcare Leaders’ Cloud Questions. It points out that healthcare is a relatively slow cloud adopter, with many healthcare organisations reluctant to move their main information systems to the cloud. From this position, the trend is to use it more, but there are important trade-offs between barriers, opportunities and benefits.

    Security, with some distrust of the cloud despite even though cloud services say their data centres are more secure than in-house information services Compliance with healthcare regulations, especially for security and privacy is a concern Availability gains are achievable with cloud services where downtime is lower and disaster recovery and backup better than in-house services Bandwidth capacity can be better Costs are starting to show gains from the cloud over the medium term, but some users see cloud as a higher cost with its subscription cost profile Complexity is about the same for the cloud and in-house services, but the cost profiles are different ICT support can be better with the cloud that can free up ICT staff time to work on other projects.

    The cloud has a steadily expanding role in health information. Precisely what that role is, is a matter that organisations have to decide for themselves. The recent cyber-theft of celebrity pictures from Apple’s iCloud won’t help to allay security fears and bolster claims of superior security compared to in-house health systems. Apple’s subsequent proposals for security alerts reported in the Wall Street Journal might. The issues identified by iHT2 will help African health ministries and healthcare executives with their decisions on their eHealth infrastructure development paths.

  • Robots can be health workers

    Why is Google buying robotics firms? Apart from the obvious answer, to make money, there is a considerable market potential in healthcare that it can contribute too. Robots as surgical devices is well known, and can continue to expand as a market that benefits patients and new clinical techniques, but there are many other uses too.

    Best Thinking Computers & Technology is an online information service dealing with, unsurprisingly, computers and technology. It’s Artificial Intelligence site sets out a range of uses of robots in healthcare.

    If Google can see the opportunities, it is important that African countries consider a section in their eHealth and technology strategies that supports plans for an increasing role for robots as part of healthcare and related services such as disaster recovery. The potential needs rigorous assessment in order to realize the full, affordable potential.