Advice from the late W C Fields, an American comedian, was to “Always carry a flagon of whiskey in case of snakebite and furthermore always carry a small snake.” Dr James L. Madara, Executive Vice President and CEO at the American Medical Association (AMA) has invoked snake and other metaphors with other creatures as imagery for bad eHealth. In his AMA address, he says it’s vital to separate “The digital snake oil from the useful--and potentially magnificent--digital tools.” Snake oil’s quack medicine and remedies, and the equivalent has no place in eHealth . It’s essential advice for Africa’s health systems.
Achieving it needs action to It ferret out and quell the undesirable “digital dystopia” that doesn’t improve health, healthcare or make it more efficient. Dr Madara says examples are:
- Ineffective EHRs
- mHealth apps of questionable quality
- Tools often fail to enrich the doctor-patient relationship
- Tools that need more time, not less.
He sees these as an increasing challenge that needs tackling. His examples of good investments are robotic surgery and telemedicine. These provide camouflage for poor eHealth that are “Appearing in disguise among these positive products are other digital so-called advancements that don't have an appropriate evidence base, or that just don't work that well.” The AMA’s separating the useful tools from the “digital noise” and working with vendors and federal regulatory agencies to apply the findings.
How can Africa’s health systems replicate this essential and unending task? They’ll need:
- A new eHealth role for each countries’ medical, nursing and pharmacist associations
- Developed and applied eHealth regulation
- Doctors and other health workers knowledge embedded in eHealth solutions
- Adapt eHealth tools to variations in practices
- eHealth evidence databases
- Applying findings in eHealth strategies, plans and procurements.
Acfee’s eHealth evaluation database has examples of good and bad eHealth. Some of the bad eHealth is partly due to weak or inappropriate eHealth leadership, procurement, project management, benefits realisation and financing methods. Inadequacies in these limit the benefits of good eHealth, so need adding to the list of actions for Africa’s eHealth.
These activities need resourcing. It’s a better investment than coping with the disruption of inappropriate eHealth.