Integrating a Robust E-Health/M-Health Program in our Health Care Delivery System: The Road Ahead

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Have we now embraced the fact that Information and Communication Technology (ICT) is CRITICAL to ECONOMIC DEVELOPMENT, especially now in the fight against EBOLA? I asked this question a few days in the social media (Facebook) and got a lot of responses; all of them pretty much agreeing with me about ICT’s impact on economic development. Obviously, our fight against EBOLA requires the support of three indispensable components: INFORMATION, COMMUNICATION and TECHNOLOGY. INFORMATION (which we have had challenges disseminating) must be properly garnered (from well analyzed data) and COMMUNICATED, using the right TECHNOLOGIES for EFFICIENT and EFFECTIVE decision making and crisis management.

 I have been writing this column for almost eight years and during those years, whenever I mentioned the need for an increased and significant investment in ICTs, I would hear the same old story:  “ICT is not a priority now; our focus is on EDUCATION, HEALTH, AGRICULTURE, ENERGY, ROADS and so on.”

I agree, that the above mentioned are not just are necessities, but the right things to prioritize in a developing country like Liberia. But I had and continue to have qualms with the attitude shown toward and amount of investment placed in ICTs. What have we achieved from all of those things we rightly prioritized? Let’s see: We prioritized Education, and not only did more than 20,000 students fail an entrance examination, but many of our high school graduates can barely read or write a paragraph. We prioritized Health (with 15 doctors for almost 4 Million people), and EBOLA came and give us an unfavorable grade. We prioritized Agriculture, and not only do our folks go to Guinea to BUY PEPPER, I cannot argue that we are even 5% capable of feeding ourselves (I stand corrected).  We prioritized Energy, and today the Liberia Electricity Corporation rations electricity. And then, we prioritized Roads and today, you almost need a Helicopter to visit Gardnersville or the entire Somalia Drive area. But today, in our fight against Ebola, we rely desperately on CELL PHONES, the INTERNET, RADIO Stations, TV, etc.; all part of ICT. And who knows, if we had a Virtual Learning and Training System (VLTS), we could have used video conferencing to train health workers on preventative measures and how to handle Ebola infected patients. That would have saved lives, wouldn’t it?

It is quite clear that we prioritized the right things, but it is also clear we placed very little focus on that which, even the United Nations and other funding partners, refer to as the enabler of economic development. In other words, we did not place much focus on the enabler of all that we had prioritized: ICT. But like my mother always tells me: “TRIALS AND TRIBULATIONS OFTEN COME TO TEACH US A LESSON, STRENGTHEN US, AND MAKE THINGS BETTER FOR THE FUTURE.” I am sure the Ebola contagion has taught us a lesson which will kindle a paradigm shift in our efforts to achieve a better health care delivery system.

The Ebola crisis is a wakeup call for us to revamp our health sector. We should do it collectively and not rely solely on the Ministry of Health and Social Welfare or the Government of Liberia. Our collective approach should involve the paradigm shift I mentioned above which will entail a robust, ubiquitous, aggressive integration and utilization of ICT in the delivery of health services. The amalgam of ICTs and health services is referred to as Electronic Health or e-Health.  The World Health Organization or WHO, provides a better and succinct definition. It defines E-Health as “‘the cost-effective and secure use of information and communication technologies (ICTs) for health and health-related purposes.” The WHO has a unit that “works with partners at the global, regional and country level to promote and strengthen the use of information and communication technologies in health development, from applications in the field to global governance.”

The use of ICTs in health care delivery not only entails fancy health care gadgets, but the development of applications and systems that can bring about improved access to health advice. These applications and systems will  enhance the  quality of care through innovative means including remote consultation, telemedicine and disease surveillance. They will make it possible for policy- and decision-makers to collate and analyze data retrospectively and in real time, to allow for the efficient allocation of scarce resources.

In Liberia, where we have a high mobile penetration, we can combine computers, patient monitors, among several other technology tools, with mobile phones to create opportunities for better health care delivery. We have seen the results of mobile technology which has dramatically changed our culture, and now the way health care is delivered in both urban and rural communities. Simple but effective mobile phones are available and can be used to improve health outcomes. We should investigate, in collaboration and with the support of WHO and other partners, to develop the necessary technologies that include the integration of mobile phones with promising applications. This is also called m-health.

The use of computer applications in health care delivery is not new or uncommon. In the paragraphs below, I discuss some of the health applications being used in other African countries. For example:

In Kenya, a country known for its leadership in mobile phone money transfer, there is a system which enables residents with a mobile phone to upload a locally-developed application that allows them to determine if a doctor or clinic is genuine. By simply sending an SMS, the user is shown up-to-date lists of licensed medical professionals and approved hospitals, starting with those nearest to him or her.

Right here in West Africa, Mali has an e-Health project known as ‘IKON, which enables rural clinics to forward scans and x-rays to specialists for review through ICT connections. These specialists are then able to advise doctors in remote clinics on what treatments should be dispensed.

In Mozambique, SMS reminders and educational messages sent to HIV positive persons, including HIV positive pregnant women, help to improve HIV treatment adherence and prevention of mother to child transmission of HIV.

In Rwanda, a web-based application known as TRACnet, which is accessible both on mobile phones and computers, is used to show data and government HIV indicators from the field. This gives the viewer a comprehensive view of the status, patient load, and drug supply levels of all of the HIV/AIDS programs in Rwanda.

In Uganda, an e-Health solution known as mTrack, tracks medical supplies to clinics in the country.  The Information garnered through mTrack shows health officials what is going on in real time.

In Zambia there is an electronic health record system known as SmartCare. SmartCare stores a person’s data on a pocket-sized plastic card.

After exploring these and many more e-health and m-health solutions, I am convinced that we can investigate, and adopt some of these applications as we begin to revamp our health care delivery system. I think the challenge now is for us ICT professionals to collaborate with policy and decision makers and identify resources necessary to help develop an e-health/m-health program that can be a part of our new and modern health care delivery system. This collective approach can help us build a system that all of us can be responsible for and that will help save our lives. We have learned a lesson that has kindled the need for a paradigm shift in the way our health sector works. EBOLA IS JUST ONE OF THE PLETHORA OF TROPICAL DISEASES in AFRICA, THAT CAN CAUSE DEATH. Let us ensure we do those things that will better the future of Liberia.

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