• AeF
  • Acfee’s Advancing eHealth 2016 report is out

    The African Centre for eHealth Excellence (Acfee) has released its Advancing eHealth 2016 report. The report findings are that eHealth initiatives are expanding in African countries, though their impact on health systems strengthening and transformation, and ultimately their contribution to healthy Africans, is less certain.

    The African eHealth Forum is where Acfee’s management team consults with its Advisory Board, industry partners and other stakeholders, to exchange their experiences of eHealth in Africa to find ways to support eHealth to strengthen healthcare and make Africans healthier. The second annual forum was in Sandton, South Africa on 8 and 9 September 2016. It followed the successful eHealthALIVE event.

    During AeF, Acfee's Advisory Board identified five eHealth priorities. They are:

    eHealth strategyeHealth governanceeHealth regulationeHealth cyber-securityeHealth impact.

    The AeF believes that developing these will help eHealth to advance. They are discussed and elaborated on in the report and Acfee will be investing in moving each one forward.

    eHealth in Africa still has a long way to go. The AeF report sets out some of Acfee’s contributions to moving it on. eHNA’ll be reporting on its progress.

    The AeF followed the first annual eHealthALIVE Southern Africa conference, a broad stakeholder engagement platform for exploring eHealth's opportunities in the region. Read it's report here.

  • The importance of eHealth cooperation

    There are considerable opportunities for eHealth to strengthen health systems. To realise the benefits however, it’s crucial to implement a successful and sustainable system. This’s easier said than done, as eHealth faces a long list of challenges.

    eHealth challenges was a critical theme at the 2015 African eHealth Forum (AeF). The scale and scope of Africa’s eHealth challenges became obvious during discussions with the African Centre for eHealth Excellence (Acfee) Advisory Board. AeF is a platform where African healthcare leaders come together to learn from each other and rethink policies, strategies and plans.

    Another key theme identified at the AeF is the value of better communication, collaboration and cooperation. While Africa's made up of unique countries, all at different stages of incorporating digital healthcare technologies, they have many common goals and challenges. eHealth’s goals are to:

    Have more healthy Africans Strengthen healthcare systems to improve quality care, communication and support healthcare workers in their daily activities

    Sharing experiences, lessons and good practices can play a critical role in moving eHealth forward. Learning from each other’s experiences, shortcomings and successes can help countries identify risks and allow them to plan to manage or mitigate them. eHealth strategies can be developed that are flexible enough to incorporate eHealth’s ever changing environment and plan ahead for new investments to ensure ehealth sustainability. When implementing eHealth strategies, identifying key insights from your region and building on their success are critical to your own success.

    eHealth systems should not be developed in isolation, with each country building their own system from scratch. African countries should cooperate to find the best way to overcome mutual problems to achieve shared goals.

    Sharing good practices and lessons learnt will be a key theme at this years eHealthALIVE Southern Africa event scheduled for 6-7 September in Johannesburg, South Africa. Acfee and eHNA will be there. We look forward to working with Southern African healthcare leaders to move eHealth forward to ensure healthier Africans.

  • Forum Africain dx l'eSante (FAeS): les defis en matiere de cybersante sont enormes

    Défis, est une belle façon de décrire les inhibiteurs, et obstacles au développement de la cybersanté en Afrique. Tellement, ils sont omniprésents et difficiles à être enrayer. Les ignorer ne va pas marcher, ils ne vont pas disparaître d’eux même, nous devons nous atteler à la tâche pour y faire face. Il y’a de différents types de cybersanté. Leur potentiel pour améliorer la santé et les soins de santé est considérable. La probabilité qu'ils le feront est problématique. Il est utile d'étaler un tableau des contributions avant de plonger dans les détails. Dans le cadre de ce contexte stratégique, le Centre africain pour l’excellence en cybersanté (Acfee) par une approche novatrice tente de trouver un bon ajustement aux priorités de santé en ligne. Le dialogue d’Acfee avec ses partenaires du Conseil consultatif et de l'industrie lors du Forum a identifié une vaste gamme de défis (plus de 60) de santé en ligne. Le rapport AEF faire progresser la cybersanté en Afrique donne plus de détails. Les défis Africains en matière de cybersanté sont le thème essentiel qui à émerger de ce Forum d’ici à fin 2015. L’ampleur et la portée dépassent les seules questins de la cybersanté, et il est essentiel d’aider les pays à identifier et corriger ces problématiques avant tout investissement dans le domaine. Les pays doivent se poser plusieurs questions, qui sont les suivantes : Quelles sont nos priorités relatives? Comment décidons-nous? Comment pouvons-nous les résoudre? Quand pouvons-nous les résoudre? L’image suivante montre comment les défis sont plus larges que les autres domaines en matière de cybersanté. C’est une illustration de l’échelle et de l'importance relative des interrelations qui existent.

    De nombreux participants ont été surpris par l'ampleur des défis identifiés en matière de cybersanté lors du Forum. Ils ont appréhendés les mesures pour y faire face dans leurs politiques de santé en ligne, les stratégies et les plans de mise en œuvre. Les pays doivent allouer des ressources pour mettre en place les facilitateurs (leaders, champions) de cybersanté pour les surmonter. Il y’a plusieurs façons de le faire, et ils tournent autour de l'intégration et de l’interopérabilité des outils, le tout sou le leadership des facilitateurs de cybersanté. Acfee, en intégrant les nouvelles informations sur la cybersanté, consigne dans son programme de de renforcement de la cybersanté en Afrique : des cours, des modèles de leadership, des services de renforcement de capacité des hommes, et des conseils sur mesure, qu’il va fournir pour les pays et les projets. Un exemple de l'échelle et des domaines d’application de la cybersanté se trouve dans le diagramme suivant :

    Dans le schéma ci-dessus on a seulement la moitié des défis identifiés par le Forum. D'un autre schéma consigné dans le rapport du forum on retient la classification suivante des défis : • Stratégies • Capacité • Relations avec les fournisseurs • Durabilité • Performance de la cybersanté • Informatique de santé • Analyses de rentabilité • Réalisation des avantages • Réglementation et gouvernance • Approvisionnement • Formation médicale initiale et continue • Echelle du pays.

    Pour faire face à ce vaste éventail de défis de santé en ligne a besoin d'un ensemble d'étapes et de processus bien planifié. L’équipe de chercheurs et d’évaluateurs d’Acfee, spécialistes en cybersanté fournissent quelques suggestions à ce propos en préconisant des mesures.

    Certains succès en matière de cybersanté ont montré que les défis peuvent être relevés dans les projets de cybersanté. Le succès exige que la séquence soit réaliste et correct, que les mesures pour y faire face, sont efficaces, et que le leadership est du bon type pour réussir.

    Ces mesures sont: 1. Identifier les défis en matière de cybersanté spécifiques dans les stratégies de cybersanté et de santé 2. Élaborer des plans d'atténuation des risques afin de suivre leur impact et leur signification 3. Sélectionnez les défis pertinents pour chaque projet dans la stratégie de cybersanté 4. Sélectionnez la séquence nécessaire pour maximiser les avantages de succès de la cybersanté 5. Concevoir les mesures nécessaires pour faire face efficacement 6. Allouer des ressources nécessaires pour les mettre en œuvre les projets de cybersanté. Dans le cadre de l'évaluation des risques et d'atténuation des difficultés, il est essentiel que les pays et les fournisseurs soient clairs sur les défis qu’ils adressent. Ils en ont besoin pour le succès et pour maximiser les avantages au bénéfice des programmes ou projets de cybersanté.

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    See article in english. 

  • Rapport du forum africain de telesante axe sur les vies sauvees

    L’Afrique a bien connu les problèmes et les priorités de santé. Pour la réussite de la télésanté, il est essentiel que cela aide à faire face aux priorités d'abord. C'est dans ce contexte stratégique que le Centre Africain pour l'Excellence de la Télésanté (Acfee) commence à partir de la mise en place des politiques, stratégies et programmes de télésanté.

    Le dialogue avec ses Conseillers consultatifs et ses partenaires de l'industrie au Forum eHealth africain (AEF) a identifié les priorités de santé qui incluent deux objectifs primordiaux:

    Prévenir les décès évitables, Améliorer la santé et la productivité.

    Ces ci lient à d'autres priorités. L'un est d'améliorer l'écart de mortalité grandissant parce que les femmes vivent plus longtemps que les hommes. La télésanté aussi a besoin de fournir de l'aide à plus de personnes, en particulier:

    Les enfants, pour répondre aux besoins de plus de 50% des enfants dans les 35 prochaines années prévues par l'UNICEF; Le taux élevé de fécondité et un nombre croissant de femmes en âge de procréer, ce qui entraîne la naissance de deux milliards de bébés en Afrique au cours des 35 prochaines années ; Le doublement de la population du continent, et les moins de 18 ans augmenteront la population des deux tiers à près d'un milliard.

    Le résultat sera une immense augmentation de la demande en soins de santé et d'éducation découlant de ces données démographiques. Ils sont décrits dans « Promotion de la télésanté en Afrique", le rapport du premier sommet de la télésanté africaine de Acfee. Vous pouvez accéder à ce rapport sur l'onglet de gauche de la page d'accueil de eHNA. Il contient un schéma montrant le large éventail des priorités en matière de santé dont la télésanté doit y contribuer.

    L'importance relative de celles-ci diffère d'un pays à un autre et, certains auront d'autres priorités supplémentaires. Des liens explicites avec les plans de télésanté sont nécessaires pour établir les priorités et les projets de télésanté de manière à aider les pays à atteindre leurs objectifs de santé.

    Ces-ci ne fournissent pas du tout des avantages immédiats, mais les projets doivent s’inscrire dans une séquence qui potentialise la durabilité, le passage à grande échelle, à moyen et long terme pour un gain de santé. Une liste de contrôle comprend:

    Un accès élargi aux services de santé de la reproduction, Une plus grande responsabilisation des citoyens sur leur santé, Une meilleure santé maternelle et infantile, y compris un meilleur suivi de la grossesse et les soins prénataux et postnataux, L'amélioration de la santé des populations rurales, Rencontrer d'autres OMD et SDG, Poursuite des progrès sur les maladies infectieuses, Poursuite des améliorations portant sur les maladies transmissibles (MT) avec plus d'actions soutenues, Augmentation des améliorations dans la lutte contre les maladies non transmissibles (MNT) avec de nouvelles actions soutenues, Les services de traumatologie pour face à la demande croissante, Action de prévention des maladies, y compris la réduction de l'obésité, Meilleures ripostes aux épidémies, y compris son élargissement et l'amélioration de la e-Surveillance, Enregistrement civile plus fort ainsi que les systèmes de l'état civil.

    Ce sont les priorités de taille pour les systèmes de santé aux ressources limitées de l'Afrique. Il est essentiel que la télésanté abordable et efficace joue pleinement son rôle.

  • AeF: how can suppliers help countries before procurement?

    In July, the African eHealth Forum (AeF) reviewed the role of suppliers in helping countries with their eHealth ideas and strategies. The reverse’s needed too, so countries can help suppliers with a better understanding of countries’ needs, constraints and challenges. These relationships are valuable to both sides, but need to be transparent, available to all suppliers and not cut across procurement. 

    Models from countries in other continents, like the USA and Europe don’t fit Africa. One factor is that the difference between African countries is considerable. This makes it demanding for suppliers to have a common theme for their contributions. It makes it difficult for countries to combine into common groups,

    The African Centre for eHealth Excellence’s (Acfee) approach to finding an achievable fit’s set out oin its AeF report Advancing eHealth in Africa sets out one way of achieving it, build on the AeF model. It sees suppliers being part of capacity building. Constructive relationships at the time of strategies and well before procurement are sophisticated, so the AeF sees the need to develop eHealth leadership as a prerequisite. It’ll also help to create links with similar African countries and eHealth leaders.

    This can’t be created from scratch. It needs to grow organically around specific, realistic, sustainable, affordable and timely eHealth strategies and plans.

  • AeF: Africa's eHealth solutions are specific

    Too many simultaneous or large-scale eHealth solutions increase the risks of delay and unfulfilled benefits. It’s encouraging that the African eHealth Forum identified a fairly narrow band. It’s consistent with the African Centre for eHealth Excellence’s (Acfee) approach to finding an achievable fit to eHealth priorities. The AeF report Advancing eHealth in Africa sets out more details.

    It isn’t surprising that the range isn’t wide, with the tight sustainability and affordability constraints of African countries. The band includes:

    Integrate health information and management information systems Sharing data between health workers and health and healthcare organisations EHRs, which can incorporate patient and medical records mHealth, which extends across a wide range of health conditions eSurveillance, given increased emphasis by the WHO   Telemedicine, which can include telemonitoring Supply chain management District Health Information System (DHIS) 2 ICT collaboration eLearning for a wide range of health workers, including eHealth and professional training. 

    Each of these carries different levels and relationships of risk and reward. EHRs can be seen as the Himalayas of eHealth. When they’re successful, the benefits are spectacular. Reaching this view is laden with risks, and not everyone achieves them, and in a few cases, they have to be abandoned.

    Other types of eHealth are lower risk, but the benefits are lower too. Reporting and management eHealth has perhaps the lowest risks and offer few benefits for patients, carers, communities and health workers, hence the need for a balance of investment between eHealth at points of care and management reporting. 

    Recent experience for Africa is that eSurveillance investment needs strengthening to achieve greater rewards. The investment risk is quite high, but the risks of insufficient investment are higher. eSureveillance’s priority is increasing. After the Ebola epidemic, it’s a must.

  • AeF: eHealth challenges are massive

    Challenges, is a nice way of describing inhibitors, and eHealth’s full of them. In Africa, they’re pervasive and hard to remove. Ignoring them doesn’t work. They won’t go away.

    There are many different types of eHealth. The potential to improve health and healthcare is considerable. The probability they will is problematic. It’s helpful to spread out an array of contributions before delving into the details. This strategic context is the African Centre for eHealth Excellence’s (Acfee) approach to finding a good fit to eHealth priorities.

    Acfee’s dialogue with its Advisory Board and industry partners at the African eHealth Forum (AeF) identified an enormous range of eHealth challenges, more than 60 of them. The AeF report Advancing eHealth in Africa sets out more details.

    Africa’s eHealth challenges are the critical theme to emerge from the 2015 Forum. Its scale and scope exceed eHealth’s other facets, and it’s essential that countries identify and fix these alongside and before eHealth investment. Countries need to ask several questions. What are our relative priorities? How do we decide? How do we fix them? When do we fix them? 

    A simple picture shows how the challenges are broader than other eHealth topics. It’s an illustrative measure of their relative scale and importance.

     

    Many participants were surprised at the scale of the eHealth challenges identified in the Forum. They include measures to deal with them in their eHealth policies, strategies and implementation plans. Countries need to allocate resources to put in place the eHealth enablers to overcome them. There are several ways to do this, and they revolve around integrating and timing eHealth enablers and eHealth applications.

    Acfee’s incorporating the new information on eHealth challenges into its eHealth curriculum and courses, eHealth leadership models and human eHealth capacity services, and preparing bespoke advice to countries and projects to provide them.

    An example of the scale is in the diagram.

     

    It’s only about half the number of challenges identified by the Forum. Another diagram’s in the AeF report along with a classification of:

    Strategies Capacity Relationships with suppliers              Sustainability eHealth performance Health informatics Business cases Benefits realisation Regulation and governance Procurement Medical education Country scale.

    Dealing with this extensive range of eHealth challenges needs a set of steps. Acfee’s earlier research and evaluations of eHealth provides some suggestions. Successful eHealth has shown that the challenges can be addressed in sequence alongside eHealth projects. Success requires that the sequence is right, the measures to deal with them are effective, and that eHealth leadership is of the right type to succeed. Steps are:

    Identify specific eHealth challenges in eHealth strategy Develop risk mitigation plans to track their impact and significance Select the challenges relevant for each eHealth project in the strategy Select the sequence needed for maximised benefits from successful eHealth Design the measures needed to deal with effectively Allocate resources to them Implement them alongside the eHealth project.

    As part of the risk assessment and mitigation, it’s essential that countries and suppliers are clear about the challenges that need fixing for success and maximised benefits. While countries are often clear about the eHealth challenges face, it’s vital the vendors are too.

     

  • AeF: eHealth contributions are wide-ranging

    There are many different types of eHealth. The potential to improve health and healthcare is considerable. The probability they will is problematic. It’s helpful to spread out an array of contributions before delving into the details. This strategic context is the African Centre for eHealth Excellence (Acfee) approach to finding a good fit to eHealth priorities.

    Acfee’s dialogue with its Advisory Board and industry partners at the African eHealth Forum (AeF) identified eHealth contributions. The AeF report Advancing eHealth in Africa sets out more details. You can access the report from the left tab on eHNA Home page.

    Investing in eHealth needs links to health and healthcare. It should seek to identify the impact of various types of eHealth in integrating and co-ordinating health and healthcare information for patients, carers, communities, health workers, managers and policy-makers. A diagrammatic summary from the AeF report shows the range of contributions.

    A starting point can be adopting appropriate themes from the following range of eHealth contributions with the aim to make eHealth a pillar of health system strengthening:

    Have an overarching goal to provide personalised and responsive healthcare for all Provide real-time and better quality data patients, families, carers, communities and health workers Share data between health workers and health and healthcare organisations Improve diagnostic abilities in primary health care Provide access to patient records for authorised patients and health workers Quantifying impact adequately, both in business cases and monitoring and evaluation Improve and expand surveillance Provide attendance reminders Support patients, carers, individual health workers and developing virtual healthcare teams Save health workers’ and patients’ and families’ time eLearning for professional training to minimise skills shortage Reduce technical barriers Rationalise routines, such as reporting and follow up Telemedicine for countries that lack specialists and have to refer patients to other countries, such as small countries and small island states Support health information research Develop and improve consistent referral systems and coordination.

    Fitting each of these to a countrys health and healthcare priorities requires a complex assessment model. Their impacts can change over time. A good example’s providing information for research. The short term benefits may be nil, but the long-term ones could be considerable. The case for specific types of research may justify it being pursued.

    The potential of some may be enormous, the probability after adjustment for risks may be modest. African countries need to assess factors like these rigorously before embarking headlong on an investment track. Headlong and investment are two words that are best not used together for eHealth investment.

  • AeF shows healthcare priorities have high level themes

    Africa has well known constraints in its healthcare. Not all priorities can be met within extremely constrained healthcare resources. For successful eHealth, it’s essential that it helps to deal with the high priority ones. It’s this strategic context that the African Centre for eHealth Excellence (Acfee) includes in setting eHealth policies, strategies and programmes.

    The dialogue with its Advisory Board and industry partners at the African eHealth Forum (AeF) identified the healthcare priorities that go beyond goals of health system strengthening. A wide range of integrated initiatives are needed, and eHealth’s role’s outlined the Advancing eHealth in Africa. You can access the report from the left tab on eHNA's Home page.

    Meeting more healthcare priorities needs more and better healthcare. It means improving its current capacity and capability and equipping it to deal with the growth in health needs and demands. There are a few main, longstanding themes, each of which has their own complexities and specific solutions. eHealth’s part of achieving these. It can help to:

    Improve healthcare commitment, quality, cost-effectiveness and efficiency Improve responses to epidemics, including prompt identification and recognition and resource deployment Reach rural communities for both basic and complex healthcare, including better post and ante-natal care Reduce reliance on health services in other countries.

    The diagram shows a summary from the report.

    Behind each of these, there’s a considerable array of changes and transformations needed across a wide range of healthcare activities. Each African country has its own relative healthcare priorities, and these need identifying and linked to specific contributions that various types of eHealth can provide.

  • AeF's report focuses on saving lives

    Africa has well known health problems and priorities. For successful eHealth, it’s essential that it helps to deal with the high priority ones. It’s this strategic context that the African Centre for eHealth Excellence (Acfee) starts from in setting eHealth policies, strategies and programmes.

    The dialogue with its Advisory Board and industry partners at the African eHealth Forum (AeF) identified the health priorities that include two overarching goals:

    Prevent avoidable deaths Improve health and productivity.

    These link to other priorities. One is to improve the widening mortality gap because women are living increasingly longer than men. eHealth also needs to help to provide for more people, especially:

    Children, to meet the needs of 50% more children in the next 35 years forecast by UNICEF High-fertility rates and increasing numbers of women of reproductive age, resulting in the birth of two billion babies in Africa over the next 35 years Doubling of continent’s population, and its under-18 population increasing by two thirds to almost a billion.

    The result will be immensely increased demand on healthcare and education arising from these demographics. These are outlined in Advancing eHealth in Africa, the report of Acfee’s first African eHealth Summit. You can access the report from the left tab on eHNA's Home page. It includes a diagram showing the wide range of health priorities that eHealth has to contribute to.

    The relative emphasis of these will differ between countries, and some will have additional priorities. Explicit links to eHealth plans are needed to set eHealth priorities and projects in a way that helps to meet countries’ health goals. Not all these provide immediate benefits, but projects need setting in a sequence that maximises sustainable, big scale, medium and longer term health gains. A checklist includes:

    Expanded access to reproductive health services, Greater empowerment of citizens over their health Better maternal and child health, including better pregnancy and ante-natal and post-natal care Improved rural populations’ health Meeting other MDG and SDG goals Continuing progress on infectious diseases Continuing improvements dealing within Communicable Diseases (CD) with more sustained action Increasing improvements in dealing with Non-Communicable Diseases (NCD) with new and sustained action Trauma services that cope with increasing demand Action to prevent illness, including reduced obesity Improved responses to epidemics, including expanded and improved eSurveillance Stronger civil registration and vital statistics systems.

    These are daunting priorities for Africa’s resource-constrained health systems. It’s essential that affordable and effective eHealth plays it role in full.