|Plenary session PL05, Wednesday, April 21 2010, 9:00-10:30, Room 2|
|Chair(s): Najeeb Al-Shorbaji, Director, Knowledge Management and Sharing, World Health Organization, Switzerland, Jean-Michel Gaspoz, Professor and Head, Department of Community Medicine and Primary Care, Geneva University Hospitals, Switzerland|
|De-Isolating Care Professionals in Sub-Saharan Africa Using the Internet|
|Antoine Geissbühler, MD Director, Medical Informatics Division, Geneva University Hospitals, Switzerland|
|mHealth: Bridging the Health Divide|
|Krishnan Ganapathy, President, Apollo Telemedicine Networking Foundation; President Elect, Telemedicine Society of India|
|Capacity Building in eHealth and Health Informatics in Developing Countries|
|Don Detmer, President and Chief Executive Officer of the American Medical Informatics Association, USA|
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The benefits of Information Technology (IT) in healthcare are creating "boundless opportunities in a borderless world", according to speaker Dr. Ganapathy. Access to healthcare and support for care professionals in remote rural areas is being transformed by the internet and telecommunications. Resources are being better utilised as the need for physical mobility of equipment, care providers and patients is minimised.
This plenary session was chaired by Jean-Michel Gaspoz, as Najeeb Al-Shorbaji from the World Health Organization (WHO) was unable to attend. The main theme running throughout the session was how to overcome physical distance and lack of access to healthcare with the assistance of IT. The presenters spoke of IT being beneficial not only to the patients in remote areas of developing countries, but also to healthcare professionals practicing in such areas. The first two presenters focused on their experiences of providing access to quality healthcare for patients in rural areas and access to information to the practitioners themselves.
The goal of IT intervention in healthcare is to support care professionals wherever they are located in the world, said Antoine Geissbuhler, MD, Geneva University Hospitals. The key is to move information rather than the patients or the care professionals. The density of care professionals is very low in some areas of the world, such as Sub-Saharan Africa and Southeast Asia. The case studies of Niger and Mali were presented where de-isolation of care professionals has been implemented (professionally and socially).
These case studies were the brainchild of the RAFT network, a project run by “people of goodwill and enthusiasm”. The RAFT network consists of 30 local collaborators and a team of five collaborators in Geneva. The project started in 2001 and is now active in 15+ countries, mainly in French-speaking Africa. The network is mostly deployed in reference hospitals and in some remote sites. People in Africa now produce 75% of the content on the network. The project is still in its initial stages and more sophisticated tools are needed for it to become more robust and sustainable. Current developments in RAFT include: industrialising its deployment in district hospitals; evaluating new diagnostic tools coupled with remote support; moving towards certifying capacity development; and teaming up for the implementation of public health and clinical information systems.
Dr. Krishnan Ganapathy, gave an impassioned and energetic presentation on how a humble phone inside your pocket can be a tool to save lives. Mhealth, or mobile health, is a useful tool not only in developed countries, but also in developing countries. The speaker quoted Dr. Muhammed Yunus, “The quickest way to get rid of poverty is to provide everyone with a mobile phone”. Today’s mantra should be “anytime, anyone and anywhere”. Dr. Ganapathy mentioned three advantages of mHealth: a better utilisation of limited resources, a reduced burden on tertiary hospitals and allowing patients to remain in their communities. MHealth will make a huge difference to healthcare access, as 80% of the world’s population has mobile phone coverage potential. Literacy is not necessary at all in mHealth; images are all that are needed. The only limit is your imagination.
Following the presentation, the Chair asked Dr. Ganapathy the all-important question, “Who is paying for mhealth in India?” Dr. Ganapathy replied that insurance companies must cover the bill for the mhealth network in India. People must be encouraged to take up mhealth.
The last speaker was Dr. Don Detmer, CEO of the American Medical Informatics Association (AIMA). His presentation mainly dealt with the human capacity side of ehealth development. He identified three major themes in medical informatics: identify and support local health experts locally as well as worldwide, formalise partnerships with others and build a collaborative AMIA global partnership programme for health informatics. He spoke of moving “from silos to systems”, creating “healthy individuals and populations”. The components for his vision of an ehealth workforce are: Human factors, Information, Communication and Technology (HICT). The degree of change would be more difficult as you moved from technology to human factors. Dr. Detmar introduced Health Informatics Building Blocks (HIBBS) and mentioned that three prototypes are currently being created. Finally, he concluded by saying that a useful vision now exists, but many things still need to be done. These include creating an adequate IT infrastructure, evolving healthcare processes and taking a fresh view of the education of healthcare workers.
Finally, a very important question was addressed to all three speakers during Q&A about appropriate behaviour and the ethical framework of ehealth. Dr. Detmer said that this was a very important question, as culture is a relevant challenge today. He said “the patient is the individual in North American/European culture, while the patient is the family in Asia, Africa and south Europe”. According to Mr. Geissbuhler, it is very important to bridge language barriers and to understand the socio-economic context of the particular country involved. Finally, Dr. Ganapathy commented that breaking the face-to-face paradigm of medical care is not easy, but the past decade has shown considerable improvement in this area.