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Tag Archive for: telemedicine

National Framework for mHealth: Ethiopia

Ethiopia is at a pivotal moment in its efforts to improve the health status of its people and move the country into a new phase of social and economic development. The country’s massive Health Extension Program (HEP) program has placed over 34,000 community health workers in 14,000 health posts in less than 8 years. Now, health authorities are exploring ways to improve the program with mobile solutions.

Sponsored by The Bill & Melinda Gates Foundation, Vital Wave Consulting authored the “mHealth in Ethiopia: Strategies for a new Framework” report for the Ethiopian Ministry of Health. The report offers a framework for addressing specific information, communication and inventory management issues with mHealth interventions.

Download the report by clicking the link below – and let us know what you think in the comments!

Initiative:

Evidence Commons

Maternal Newborn mHealth

April 10, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Qualcomm’s Wireless Reach mHealth Project to Improve Cardiovascular Disease in Resource Scarce China

Qualcomm’s Wireless Reach™ initiative, the strategic initiative of the wireless chipset manufacturer, has partnered with Life Care Networks and the Community Health Association of China to start a mHealth project focused on improving prevention and care of cardiovascular diseases (CVD) in rural China. The project, Wireless Heart Health, was launched back in September in community health clinics in three provinces (Shandong, Anhui, and Sichuan) and one municipality (Chongqing).

Photo Credit: Qualcomm

In the past, most mHealth projects in rural areas have focused on acute diseases. These diseases are easier to handle via treatment and/or prevention, which allows for numerous mHealth interventions including appointment and pill reminders as well as data collection and information dissemination. But chronic diseases are becoming a larger public health issue in rapidly developing countries. Within China, CVD is the leading cause of death. By leveraging mobile technology to reach the rural community clinics, patients and health workers in rural areas can be connected directly with trained medical personnel in an urban area. While this type of connection is common in many countries (see MTN CareConnect in South Africa), the level of technology sophistication in this project allows for more in-depth data to be gathered and transferred to trained doctors.

Project Details

Life Care Networks developed a cardiovascular monitoring system that uses China Telecom’s 3G network to send heart data to cardiac specialists, who can provide rapid patient feedback. The system includes an electrocardiogram (ECG) senor on a smartphone, electronic medical record software, and workstations at the community clinics. The ECG-enabled smartphone has a gold rim around the outside part of it which is the senor. The patient simply holds the top and bottom of the phone in order for it to read their heart data. The medical records software is web-based and includes all past data collected in the clinic. This allows for both the community health workers and the doctors in the call center to have access to historical data in order to provide better care to the patients.

Within the project, the community health clinics are connected via the 3G network directly to cardiac specialists in the Beijing Life Care Networks Call Center. Using the ECG sensor along with the software and workstations, the patient data is sent to the call center and allows for real-time feedback either by SMS or voice. The call center is open 24-hours a day, and their services range from monitoring and diagnosis to treatment and referral. Referrals are especially important in these clinics as the clinic staff often do not have the knowledge and expertise to treat complicated cardiovascular issues. Because the smartphone sends the patient information directly to a trained doctor, it allows for referrals to happen swiftly, cutting down the time it usually takes. Also the smartphones are available for patients to rent in order to monitor their cardiovascular information.

Partnership Model

By leveraging a partnership model, Wireless Reach has been able to expand many services into rural or resource scarce areas by working with both for-profit and nonprofit organizations. With the Wireless Heart Health project, Life Care Networks is a for-profit company that has a commercially available ECG monitoring service as well as products and services for personal care. They offer different levels of service, depending on the needs and desires of their clients. The other project partner, the Community Health Association of China, is a nonprofit organization that supports the efforts of the Ministry of Health in helping to strengthen the Community Health Clinics throughout China.

Wireless Reach’s partnership model does not only include bringing together for-profits and nonprofits to strategically work together. An important aspect of all Qualcomm’s Wireless Reach projects is that they tie directly to government policies and initiatives. For example, this project addresses one of the specific issues outlined in the recent 2009 Chinese Health Care Reform, which focuses on strengthening the country’s grassroots medical institutions to provide equitable health care for all citizens.By partnering with Community Health Association of China, Qualcomm is able to engage in a project that supports the Chinese government’s efforts to develop a primary health care system.

Sustainability and Scale

Another important aspect of Wireless Reach projects is the goal for them to sustain as well as reach scale. In some cases, the project and its products/services become commercialized. In other cases, they have been sustained by the relevant country’s government. Since this project is only months old, the long-term model has not been decided yet. But there is a plan to create sustainability in the short-term and answers the age old question of “who pays?” In the model, patients are charged a small fee to its patients to rent the specialized phone. This allows the clinics to generate revenue and creates incentives to actively use the products and services.

Current Results

As mentioned before, each of Qualcomm’s Wireless Reach projects are focused on reaching sustainability and increasing scale. For this project, Wireless Reach is focused on gathering information and creating best practices in order to keep the project sustainable and eventually scale up. New impact data has recently been received and ranges from September 2011 to the end of January.

46 community health clinic doctors have been trained on how to use the system.
A total of 1033 patients have participated in the project.
These patients have sent 2172 pieces ECG data.
Out of that data, 513 pieces were identified as abnormal.
Out of all of the patient participants, 208 were screened for serious cardiovascular conditions and referred to higher-level clinics for further evaluation and testing.

Wireless Heart Health is an interesting example of how creating strategic partnerships, utilizing current technology and infrastructure (both telecommunications and health), and tying the project goals to current government policies can create a sustainable and scalable mobile health model.

Please also find below a video of the project:

View More Qualcomm Videos

February 17, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Weaving eHealth Into the Fabric of the African Health System

The 4th Afrihealth Conference, held in Nairobi, Kenya on Nov. 30 and Dec. 1, broadened the debate on the adoption of Telemedicine, mHealth and eHealth in Africa, and brought attention to the need to integrate and mainstream eHealth into the continent’s health system.

The theme of the conference was “consolidating the gains of technological innovation in healthcare through effective management,” and some debate sparked on what direction to take eHealth in Africa.

According to Science and Development Network reporter Maina Waruru, experts attending the conference argued that “a focus on high-tech healthcare solutions could come at the expense of basic prevention such as access to clean water and sanitation, good nutrition and hygiene, and health education.” Since 80 percent of illnesses in Africa stem from preventable infectious diseases, this focus on high-tech is a move in the “wrong direction.”

But the potential for using ICTs to continue to improve basic healthcare in Africa is great, and a focus should be on ensuring that appropriate technology is utilized and effectively delivered.

One concern attendees brought up was the lack of a legal framework to determine what qualifies a person to work as an “e-health” professional. E-health is often practiced by non-professionals such as ICT technicians and nurses, and many countries have not established what qualifications are needed to be certified as a professional.

In addition, physicians in many countries are of an older generation and received their degrees before the ICT explosion. Many are not comfortable with situations where they consult with patients remotely, without actually being in the room with them.

Image from Dr. Kwankam's powerpoint presentation at Afrihealth conference

From Dr. Kwankam's presentation at Afrihealth 2011 conference

To address some of these issues, Shariq Khoja, the coordinator of the e-health program at Aga Khan University, has suggested that laws should be put into place to “accommodate and mainstream [e-health].” According to Dr. Yunkap Kwankam of the International Society for Telemedicine and eHealth, “for eHealth to take root and thrive…it must itself be transformed…we must weave eHealth into the fabric of the health system.”

Dr. Kwankam claims that Africans can benefit from technology changes by effectively managing it and charting a course for ICT in health through an organized eHealth profession, national eHealth policies and strategies, and addressing large eHealth challenges, such as scaling up eHealth interventions.

Dr. Kwankam and other experts’ presentations from the conference are now available.

December 7, 2011/by actualize

Agriculture, Health, Originally posted on the GBI Portal

AfriHealth Conference, Nairobi, 30 November – 1 December 2011

AITEC announces expert speaker line-up for AfriHealth Conference, Nairobi, 30 November – 1 December 2011

OPENING PLENARY

Consolidating the gains of technological innovation in healthcare through effective management

Professor Yunkap Kwankam, Executive Director, International Society for Telemedicine & eHealth (ISfTeH), Switzerland

Aiming for a more integrated approach in healthcare delivery at national and local levels

Dr Katherine Getao, Head of eGovernment, Office of the President, Kenya

The economics of eHealth

Professor Maurice Mars, Head, Department of Telehealth, University of KwaZulu-Natal & President, South African Telemedicine Association

Ericsson’s mHealth Solutions – use cases and success criteria to enhance healthcare delivery

Rainer Herzog, Head of Strategy & Business Development mHealth & eHealth, Ericsson

mHealth: Turning hype into delivery

mHealth reaches puberty: Hype & hyperventilation

Bright Simons, Founder, mPedigree, Ghana

Using mobile telephony as an innovative communication channel for family planning

Bas Hoefman, Text to Change, Kenya

mHealth and the required ecosystem in East Africa

John Kieti, mLab, Kenya

PLENARY 2

An overview of latest worldwide trends in telemedicine

Frank Lievens, Board Member & Secretary, International Society for Telemedicine & eHealth, Belgium

Addressing the fragile environment of e-health in resource-limited settings

Dr Christoph Larsen, synaLinQ, Vietnam & Kenya

Accessing funding for healthcare initiatives in Africa

Ken Nwosu, eHealth Ontario & McMaster University MSc eHealth Programme, Canada

Pharmaceutical management

Anti-counterfeit systems for pharmaceuticals

David Svarrer, CEO, Digital Age Institute, Kenya

Using IT for improved pharmaceutical care delivery in developing countries: A case study of Benin

Dr Thierry Oscar Edoh,University of Bonn & German Federal Army University of Munich, Germany

Case Studies 2

A Multilingual Expert System for Ubiquitous Diseases Diagnosis (MESUDD)

Dr John Oladosu, Lecturer, Ladoke Akintola University of Technology, Nigeria

Community-based eHealth promotion for safe motherhood- A case study from Khyber Pakhtoonkhwa, Pakistan

Dr Shariq Khoja, Director AKDN eHealth Resource Centre, Aga Khan University, Kenya

Business models for effective service delivery: Rural Health Systems

Changing African healthcare through private sector technology innovations

Steve Landman, CEO, Carego International, Kenya & USA

Leveraging telehealth to improve child maternal health

Iboun Sylla, Business Development Manager, Texas Instruments, USA

National e-health policy development: The Commonwealth approach

Dr Sylvia Anie, Director, Social Transformation Programmes Division, Commonwealth Secretariat, UK, and Dr Adesina Iluyemi and Tom Jones^,Directors, TinTree International eHealth and Consultants, Commonwealth Secretariat, UK

PANEL DISCUSSION

What are the best practice achievements that can be replicated across the continent?

MODERATOR

Professor Yunkap Kwankam, Executive Director, International Society for Telemedicine & eHealth (ISfTeH), Switzerland

PANEL MEMBERS

Lucy Fulgence Silas, Country Director for Tanzania, D-Tree International

Dr Moretlo Molefi, MD, Telemedicine Africa, South Africa

Dr Catherine Omaswa, Chairperson, National eHealth Committee, Uganda

Dr Wuleta Lemma, Director, Tulane Technical Assistant Program (TUTAP) Ethiopia

WORKSHOP 1

Open source healthcare information systems

Nurhizam Safie, United Nations University, International Institute of Global Health (UNU-IIGH), Faculty of Medicine, National University of Malaysia

Open Source health information systems offer an alternative to proprietary healthcare information systems. Currently, most developing countries have a tight financial budget for their healthcare services and cannot afford the high cost of licence fees imposed by proprietary healthcare information system providers. Therefore, open source healthcare information systems are an attractive alternative to be introduced in the healthcare services of developing countries. By using open source healthcare information systems, the healthcare providers such as hospitals and clinics can improve the efficiency of services, reduce licensing and maintenance costs in managing information systems, as well as catering for future scaleability and growth.

Among the available open source healthcare information systems, MEDICAL has been chosen for this workshop because MEDICAL is a multi-user, highly scaleable and centralised system which provides the following functionality:

Electronic Medical Record (EMR)
Hospital Information System (HIS)
Health Information System

This workshop is intended for users who want to get a better introductory functional understanding of MEDICAL. The workshop offers a thorough knowledge in usability and understanding of two critical modules, namely Patient Management and Financial Management.

Objectives

Having attended this workshop, participants should be able to:

Understand the concept of open source health information systems.
Understand the functional concepts of MEDICAL modules, namely Patient Management and Financial Management.
Understand the development concepts and architecture of MEDICAL.
Workshop Content

Introduction to MEDICAL and Basic Settings

Introduction to MEDICAL: Vision and Mission
Architecture: Supported operating systems, databases & ERPs
The modular concept framework
The MEDICAL development environment.
Introduction to Sourceforge and SVN
Introduction to Transifex: The translation and localization portal

Patient Management

Patient registration
Emergency department /ambulatory
Outpatient/In-patient
Admission, discharge & transfer (ADT)
Appointment & scheduling
Resource scheduling
Medical record management
Report & statistics

Financial Management

Charging, billing & invoicing
General ledgers
Accounts receivable/payable
Cash book management
Reporting

WORKSHOP 2

Using theCasemix system for health finance management

Prof Dr Syed Aljunid, Professor of Health Economics and Senior Research Fellow, UN University International Institute for Global Health, Faculty of Medicine, National University of Malaysia

This workshop is designed to introduce participants to the Casemix system for enhancement in quality and efficiency of healthcare services . Casemix experts from the UN University International Institute for Global Health will share their experience in implementing Casemix systems in a number of developing countries globally. The workshop will provide an overview of Casemix, its evolution from the first version introduced in the 1980s by Professor Robert Fetter from Yale University, to the present day where the system has been implemented in more than one hundred countries worldwide. Minimum dataset requirements for Casemix systems will be discussed in detail, including requirements for diagnoses and procedures coding using the ICD classification system. Benefits of using Casemix as a prospective provider payment mechanism under social health insurance programmes will be presented in this workshop. Software currently available to support implementation of Casemix system will be demonstrated including the recently launched the UNU-CBG Casemix Grouper, a universal, dynamic and advanced grouper software. Proposed plan for implementation of Casemix system under the UNU-IIGH programme will be presented in this Workshop.

Workshop Objectives:

At the end of the workshop, participants should be able to:

Understand the concept of the Casemix system
Appreciate the role of Casemix in enhancing quality and efficiency of healthcare services.
Design the basic minimum dataset package for Casemix Implementation.
Have basic knowledge on the use of UNU-CBG Casemix Grouper

Workshop Content:

Casemix:: An introduction
Minimum Dataset for the Casemix system
Supporting software for Casemix
Implementation of Casemix in developing countries for health financing

To register as a delegate, log on to www.aitecafrica.com or email info@aitecafrica.com

September 28, 2011/by actualize

Agriculture, Health, Originally posted on the GBI Portal

How to convey the new WHO Mental Health Intervention Guide to workers in the field?

On paper? Online? On smartphone apps? Via SMS or voice?

This 89 pages mhGAP-IG is issued in 2010 and now available in several languages. The guide consists of decision trees for the most important psychiatric conditions.

1. Use of paper versions:

Reading: Additional shipping and transport costs can be a hurdle in low and middle income countries (LMIC). One can download the guide from the WHO website, but then one faces the high costs of (color) print and copies.

Training: Face2face trainings seem the most ideal option, but the in most LMIC there is a shortage of health tutors. And a face2face training necessitates the movement of the health worker away from the field, which interrupts the delivery of services and is expensive.

2. With the internet/desktop/laptop:

Reading: Distribution on CDs is cheap. Online reading offers also the use of go-to tabs, notes storage, information charts and a find-utility. The main disadvantages of internet/computer is the constant need of a computer nearby and standby, which is a rarity in most LMIC.

Training: Beside the benefits of no travel and no interruption of the daily work, the internet gives health workers also the opportunity to study on own pace and preferred time.

3. With mobile apps on smartphones:

Reading: Smartphones can have a high added value for previously unconnected people. Smartphone prizes drop and they are growing in popularity in LMIC. The guide can be read on an app.

Training: Education via a smartphone apps offers the same benefits as the internet learning, like nice attractive tools and designs. The extra advantages are the pocket format; easy taking it with you.

4. With mobile phones (no wireless internet):

Reading: Service in developing countries will rely heavily on text messaging and voice in the years ahead. One can convey parts of the guide by SMS or voice, piece by piece, or certain parts on request. One can even run an automated SMS reply manager.

Training: Conducting a training in the mhGAP-IG solely by mobile phones is possible, but only an option of one really can’t reach the health worker via another channel.

Conclusions and recommendations:

-Not one of the 4 distribution channels is the best of all, so create materials in all 4

-Concert international and implement what’s most suitable on a local level

-Connect and cooperate with innovators in LMIC

-Look for creative funding channels, including NGOs and telecom providers

-Learn, lend and copy from other health fields, which are a long way ahead in technical innovations.

Full article with links and examples on the in2mentalhealth website

September 20, 2011/by actualize

Health, Health Systems, Originally posted on the GBI Portal

New telemedicine center in Nigeria aims to keep patients at home

A new telemedicine center opened last month in Lagos, Nigeria with the purpose of providing healthcare to local Nigerians. Designated as the Glo-Telemedicine Center, located on Victoria Island in Lagos, this center is a product of the collaboration between Nigeria’s Global Resources and Projects and healthcare providers in India, U.S., Egypt and other countries.

Photo Credit: Onche Odeh

The center is designed to minimize transportation concerns for Nigerians, especially those in isolated areas, to bring them expert healthcare from abroad. According to the executive officer of Global Resources Dr. Wale Alabi, “the Glo-Telemedicine Centre would bridge the gap between the poor and good health services by creating a simless [sic: seamless] communication between them and those with the expertise and facilities to help them.”

Dr. Alabi cited the high prevalence of Nigerians using life savings, and even taking out crippling loans to travel to foreign countries seeking expert healthcare. Dr. Alabi also claimed that over 60% of those who go abroad for services can get those same services in Nigeria, but often go abroad due to incorrect diagnoses.

The center will be used as a medical tool to reduce medical costs and substantially increase range of access to patients. The center is designed to offer specialty treatments to Nigerians at a low cost. It will also offer Continuing Medical Education to health professionals as a means to keep them informed of latest trends in health services.

The center’s capabilities are dependent on broadband fiber optics supplied by a Nigerian Telecommunication firm called Globacom. Their services take advantage of advances in ICT to transmit text, sound, video, image and other information from one location to another location.

Telemedicine is an application of medicine that takes advantage of electronic communications to transfer information from one location to another, often between health provider and patient, or between two health providers. Dr. Alabi noted that the success of telemedicine in African countries such as Kenya and Ghana is “transforming those countries.”

Similarly, Dr Alabi hopes the center will ultimately transform the way Nigerians think about accessing healthcare. However, this is not the first telemedicine project in Nigeria. Several years ago, the Nigerian government through the ministries of science and technology and health, commissioned a pilot telemedicine project that used satellite-based technologies. That project, called the NigComSat-1 Telemedicine pilot, was labeled impractical due to high costs and inapplicability. The Glo-Telemedicine center however, took note and addressed those issues, which is why it is now fully operational to Nigerians.

June 14, 2011/by actualize

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