• Telemedicine
  • Computer aided detection for TB (CAD4TB) installed across Ghana

    A target of sustainable development goals (SDGs) is to end tuberculosis (TB) globally by 2030.  Effective prevention, detection and treatment is necessary to achieve this goal.  Ghana is in the global high burden list for TB, but is tackling this burden using eHealth innovations. 

    In collaboration with Delft Imaging Systems, they have successfully installed 51 X-ray systems in facilities, containers and TB screening mobile clinics across the country.  These mobile X-ray systems are self sustainable, employing solar technology to power them, even in the remotest of locations.  All X-ray systems have been equipped with computer aided detection (CAD4TB) software that makes use of machine learning to detect TB in X-rays.  Additionally, tele-radiology technology is used to interlink all images to a central platform that allows healthcare providers across connected facilities and units to access images.

    The innovation allows healthcare providers to screen up to 200 images per day.  When the images reveal a high CAD4TB score, patients are referred for the standard and more expensive GeneExpert tests.  This makes detecting TB in poorer communities very effective. 

    It is eHealth innovations like this that will strengthen health systems in Ghana and other African countries, while still being conservative of the constrained health budgets in Africa.

  • Telehealth providers have five trends

    As Africa’s mHealth initiatives move on, opportunities to include telehealth are expanding. Options for health systems can follow five provider trends. MDLIVE has described these in Wellness Gone Wireless:Top 5 Trends Driving Telehealth in 2018, available from Fierce Markets. 

    The trends are: 

    Expansion of cloud-based smartphone technology and health and wellness wearables, creating more engaged consumersAI innovation enabling more refined data analytics and personalised patients’ experiencesReduced reliance on reimbursement models, expanding providers and patients populationsConsumer satisfaction driving more demand and lower costsDisciplined focus on data security, driving increased consumer confidence and suppliers’ oversight. 

    Removing barriers to access telemedicine’s part of these trends. It can improve healthcare quality and removes geographic limitations on access. It’s becoming easier to match providers to community needs.

    These are encouraging signs for Africa’s telehealth priorities.

  • Ghana prioritises telemedicine for universal health coverage

    The Novartis Foundation and the Ghana Health Service have announced the successful integration and scale-up of a pilot telemedicine programme started in the Ashanti Region in 2011.  Full national coverage of telemedicine services is expected to be possible by 2019. 

    The telemedicine programme strengthens healthcare capacity by empowering community health workers, while also improving the quality of their care.  Additionally, this avoids unnecessary referrals, thereby reducing transport costs for patients. 

    Community health workers make use of mobile technology to connect to health professionals and specialists via a tele-consultation centre.  Doctors, nurses and midwives in the tele-consultation centres instruct community health workers and advise on the treatment of their patients, particularly in emergency care. 

    The success of the telemedicine model has prompted Ghana Health Service to implement the programme across the nation as part of its national e-health strategy to improve healthcare delivery.  With sustained government leadership, this initiative could transform healthcare for years to come.

  • Ghana will have a national telemedicine service next year

    Pilotitis become a phenomenon a few years ago as scaling-up eHealth pilots became too challenging. Good scale-up news is the recent  telemedicine initiative by Ghana Health Service and The Novartis Foundation, They’ve announced the successful integration and scale-up of a telemedicine service. National coverage’s planned for 2019. 

    The 24-hour telemedicine service uses mHealth for community health workers to consult specialist health professionals at teleconsultation centres on a range of health topics, including emergencies. It builds from the telemedicine pilot started in 2011 in the Ashanti Region’s Amansie West District.

    An important lesson for other African countries’s the timescale. Seven years may seem like a long time, but eHealth does take time to come to fruition. Over the period, telemedicine has encountered some specific changes. mHealth opportunities have replaced conventional conferencing technology, now obsolete and looking a bit clumsy and chunky.

    Ghana may have set a standard for other African countries to follow. It represents a considerable technological achievement in modernising and transforming healthcare. 

  • New telehealth code of practice's out

    As their mutual cycles evolve, telehealth’s developments lead onto updated codes of practice. Telehealth Global has released the 2018/19 International Code of Practice for Telehealth Services, updated be the Telehealth Quality Group (TQG). Its perspective’s consumer and service users, and deals with: 

    Remote consultationsActivity monitoringTelecare and social alarms (PRS)Vital signs monitoringmHealthVirtual coachingIncorporates ISO/TS 13131: Health Informatics – Quality Planning Guidelines for Telehealth Services.

    Interoperability (IOp) and cyber-security are given more emphasis. Enhancing telehealth’s IOp  can improve its fitness for purpose. Consistent data between hubs and remote centres, and people’s devices in their homes is the goal. It’s seen as offering greater choice. 

    Better cyber-security’s needed to ensure more trust. It means effective cyber-security needs reaffirming, leading on to action to strengthen defences.

    Demonstrating telehealth’s performance is important too. More openness means that performance measures and achievements are required to be honestly and openly displayed on service websites. These can lead to greater accountability. 

    As Africa expands its telehealth programmes, and the role mHealth plays in them, TQG’s updated code provides a sound foundation to build from. Using the IOp and cyber-security perspectives can direct projects towards better performance for Africans.

     

  • Telehealth reduces risk in chronically ill patients

    As the number of patients with chronic conditions increases, telehealth’s role might become more important to meet their needs. A study in the Journal of Medical Internet Research (JMIR) by a team in Alicante, Spain, evaluated telemedicine’s impact of adopting new care models that provide more home supervision. It found it appears useful to improve targeted disease control and reduce resource use. These are to important findings for Africa’s health systems and their eHealth strategies. 

    Target diseases were one, or more of, diabetes, hypertension, heart failure and Chronic Obstructive Pulmonary Disease (COPD).The study’s objective was to evaluate ValCrònic telemonitoring’s impact on patients with these long-term conditions who are at high risk for hospital readmissions and Emergency Department (ED) visits. It compared before and after effectiveness after a year of primary care monitoring.

    Using the Community Assessment Risk Screening Tool, 521 patients used a tablet to self-report relevant health information. It’s automatically entered into their eHealth record for consultation.

    Compared with the year before ValCrònic, there were significant reductions in: 

    Weight, down from 82 kg before to 80 kgThe proportion of people with high systolic blood pressure,36% to 33%High diastolic blood pressure, 14% to 8%Haemoglobin, 36% to 20%Patients attending primary care emergency services in, 13% to 6%Hospital ED visits, 19% to 13%Hospital admissions due to an emergency,20% to 14%Disease exacerbations, 10% to 8%.

    Taken as a group of measures, an important finding seems to be that they’ve all moved in the same direction. The team’s overall conclusion’ that ValCrònic has positive benefits for high risk patients and healthcare by reducing hospital readmissions and ED visits. It supports equivalent investment by Africa’s health systems.

     

  • Conférence internationale sur la télésanté et la télémédecine au Maroc

    Casablanca, la case blanche poumon économique du Maroc moderne, est célèbre pour beaucoup de choses, y compris la diversité architecturale des bâtiments (célèbre mosquée Hassan II), de l'art déco à la modernité traditionnelle. Cette semaine, c'est l'architecture numérique de la santé qui est à l’honneur. C'est là qu’à lieu la 22ème conférence internationale sur la télémédecine et la télésanté, qui débute aujourd'hui avec un vaste programme technique. Je suis heureux d'être présent, avec Dr Sean Broomhead, Président d'Acfee, et de nombreux collègues et amis de toute l'Afrique.

    Les objectifs de la conférence sont de présenter des expériences pratiques et des résultats de recherche dans le domaine des solutions de télémédecine et de télésanté, et de fournir aux professionnels de la santé, aux représentants de l'industrie, aux décideurs politiques, aux chercheurs et aux scientifiques et de nouveaux concepts et idées en télémédecine, en télésanté et en santé électronique.

    MeHealth 2017 réunit les membres de la Société marocaine de télémédecine et de télésanté (MSfTeH), de la Société internationale de télémédecine et de télésanté (IsTeH) et un large éventail d'autres institutions et organisations locales et internationales impliquées dans le développement et la mise en œuvre de la télémédecine.

    La conférence MeHealth 2017 de Casablanca, la 22ème conférence internationale de l’ISfTeH veut présenter des expériences pratiques et des résultats de recherche dans le domaine de la télémédecine et des solutions eHealth, et fournir des opportunités aux prestataires de soins, des représentants de l'industrie, des décideurs, des chercheurs et des scientifiques de se rencontrer et discuter des projets en cours, de la recherche et des nouveaux concepts et idées en télémédecine, en télésanté et en santé mentale.

    L'utilisation des technologies de télémédecine et de télésanté représente une réelle opportunité d'améliorer la qualité de vie des patients et de réduire les coûts de santé. Cependant, il fait face à d'importants défis liés à la propriété des données et à la vie privée des patients, à l'engagement du professionnel de santé, à l'adhésion du patient, à l'intégration dans les soins courants, aux aspects financiers et de remboursement.

    Les conférenciers comprennent des intervenants de classe mondiale comme:

    Prof. Francesco SicurelloDr. Najeeb Al ShorbajiPeter J. TonellatoM. Abdarrhman AnneDr. Zakiuddin AhmedLuis FalconProf. Maurice Mars

    Les sessions parallèles couvrent les thématiques suivantes:

    Santé numériqueTélémédecine en AfriqueGNU SantéInformation médicaleBioinformatique Casablanca est également célèbre pour le film de 1942 portant le même nom et son célèbre Rick's Café. Alors que le café original était sur un plateau de tournage hollywoodien, un entrepreneur marocain a depuis créé le véritable Rick's Café à Casablanca. Le restaurant est logé dans un grand bâtiment traditionnel marocain construit en 1930. Nous vous invitons à le découvrir.

  • eHealth and Telemedicine meeting kicks off in Morocco

    Casablanca, Morocco is famous for many things, including diverse building architecture, from Art Deco to modern. This week it’s a digital health architecture attraction. It is the venue for the 22nd International conference on Telemedicine and eHealth, which kicks off today with an extensive technical programme. I am happy to be attending, along with Acfee Director Dr Ousmane Ly and many colleagues and friends from across Africa.

    The goals of the conference are to present practical experiences and research results in the field of Telemedicine and eHealth solutions, and to provide opportunities for healthcare providers, industry representatives, policy makers, researchers and scientists to meet and share and discuss current projects, research, and new concepts and ideas in Telemedicine, Telehealth and m/eHealth.

    MeHealth 2017 brings together members of the Moroccan Society for Telemedicine & eHealth (MSfTeH), the International Society for Telemedicine & eHealth (IsTeH) and a wide range of other local and international institutions and organizations who are involved in Telemedicine/eHealth development and implementation.

    Speakers include:

    Prof. Francesco SicurelloDr. Najeeb Al ShorbajiPeter J. TonellatoMr. Abdarrhman AnneDr. Zakiuddin AhmedLuis FalconProf. Maurice Mars

    Satellite workshops cover:

    Digital HealthTelemedicine in AfricaGNU HealthMedical InformationNA Student Symposium BioinformaticsStartathon: Innovation in Telemedicine and eHealth. Casablanca is also famous for the 1942 film and its infamous Rick’s Café. While the original café was a Hollywood film set, an enterprising entrepreneur has since created a real Rick’s Café in Casablanca. The restaurant is housed in a traditional Moroccan grand mansion built in 1930. I look forward to checking it out. 
  • Telehealth may increase healthcare demand

    Telehealth, using telephones and including telemedicine, can benefit patients, health workers and healthcare organisations. One probable benefit is reducing reliance on GP and Emergency Department (ED) visits with virtual visits, so reducing healthcare costs. Another’s convenience for patients. It seems that can patients’ convenience’s reducing healthcare benefits, a case of supply led demand. 

    A study in Health Affairs,  Direct-To-Consumer Telehealth May Increase Access To Care But Does Not Decrease Spending, found that the convenience of telehealth services for patients may mean they solve access issues long before they bend healthcare’s cost curve.  It may be these much shorter waiting times and earlier utilisation may increase healthcare spending.

    The research team analysed over 300,000 patients’ commercial claims data spending for acute respiratory illnesses. Data extended over three years. About 12% of telehealth visits replaced visits to other providers. Some 88% was new utilisation with shorter waiting times. Net annual spending on acute respiratory illness services increased by $45 for each telehealth user. 

    eHNA reported on a similar outcome for an eVisit service. The findings seem reinforce each other. Africa’s eHealth programme should include the probability of the phenomenon in their telehealth business cases so additional healthcare resources that may be required can be planned too.

  • eHealth Group offers a telehealth paradigm shift

    About a third of African countries invest in telehealth, identified by the WHO and Global Observatory for eHealth in their 2015 survey. Since then, eHealth Group, based in South Africa, has leapfrogged telehealth’s technology and its supply side. 

    Its lineage goes back to the Da Vinci Robotic Surgery. This enabled eHealth Group to incorporate the ideas, principles and techniques into its robotic telehealth services. Instead of a link between a patient and a healthcare professional, eHealth Group’s robots and products enable healthcare professionals to deal directly and easily with several patients in wards, ICUs and communities.

    At its core are:

    Direct access to a wide range of clinical data about patientsExplicit, precise and clear images of patientsIts own excellent, global telecommunication network. An example is where doctors can have two screens.

    The picture shows a doctor accessing a patient’s view and PACS side by side. It’s an efficient and effective use of his time and benefits patients directly.

    South Africa’s eHealth Group provides services across Africa. It’s part of a global network, operating in over 30 countries, across 20 specialties in over a thousand hospitals and over 4,000 medical specialists available online. About 70% of US telestroke hospitals in the USA use eHealth Group’s services, up from 30% four years ago. 

    There’s a wide product range extending from tablets to sophisticated robots that provide high quality telehealth. Alongside the products, eHealth Group provides a service range including access to advice from a network of medical specialists, specialists who can provide direct patient care, and training. 

    Elliot Sack and some of his robots from eHealth Group will be at eHealthAfro 2017 on 2 to 4 October in Johannesburg. His presentation will reveal the paradigm shift that can make a difference to Africa’s health and healthcare. eHNA has more to report on it.