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HCIT is the beginning and the end for ensuring Health by Yunkap Kwankam


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HCIT is the beginning and the end for ensuring Health by Yunkap Kwankam, Executive Director, ISfTeH, Switzerland

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HCIT is the beginning and the end for ensuring Health by Yunkap Kwankam

  1. 1. The Great Debate: Prof. S. Yunkap Kwankam, PhD Executive Director, International Society for Telemedicine and eHealth (ISfTeH) CEO, Global eHealth Consultants, Switzerland ICT for health not healhcare
  2. 2. The most effective way to improve productivity is to improve health systems Source: Nicholas C. Petris Center on Health Care Markets & Consumer Welfare (UC Berkeley), WHO, A Handbook of Cultural Economics (James Heilbrun) Level of HC spending is a function of GDP/capita regardless of external funding Healthspendpercapita(2005) GDP PPP per capita (2005) 10 100 1000 10000 100 1000 10000 100000 R2 = 0.94 Focus of health investments should be on improving sector productivity
  3. 3. 0 50 100 150 200 250 300 100 1000 10000 100000 Variation in health outcomes highlights considerable room for improvement of inefficient and ineffective health systems Source: WHOGDP PPP per capita (2005) Log GDP/Capita (PPP) vs Childhood (<5) Mortality Childhood(<5)Mortality(per1000) Country A Country B Country Y Country X Countries with similar health outcomes but very different profiles Countries with similar profiles but very different health outcomes Effectiveness of health spending widely variable: Health outcome not tightly linked to income
  4. 4. Time lost to paperwork
  5. 5. The need for decision support systems Current practice depends upon the clinical decision making capacity and reliability of autonomous individual practitioners for classes of problems that routinely exceed the bounds of unaided human cognition” Daniel Masys, 2001
  6. 6. Countries with a critical shortage of health service providers (doctors, nurses and midwives)
  7. 7. eLearning easing healthcare HR crisis in Kenya In Kenya, chronic shortage of highly skilled nurses Enrolled Nurses (ENs) comprise 70% of nursing and 45% of the health workforce in Kenya • First point of contact for communities, but are inadequately skilled to manage new and re- emerging diseases like HIV/AIDS PPP led by the Nursing Council of Kenya (NCK), the African Medical and Research Foundation (AMREF) and Accenture to upgrade 22,000 ENs from ‘enrolled’ to ‘registered’ level within 5 years via eLearning (distance education through ICT) methods Promising progress since start of program in Sep. 2005 As of Nov. 2006, 3,265 nurses upgraded 27 colleges and schools participating including AMREF’s Virtual Nursing School Over 100 computer-equipped training centers set up in 8 provinces, including remote and marginalized districts eLearning can reach goal w/in next decade versus >200 years w/ traditional classroom methods 0 5 10 15 20 25 2005 2007 2009 2011 2013 2015 2225 (K) •~2,800 ENs upgraded/yr •Cum. cost ~ $2.5M •~$114/nurse 22,000 ENs to upgrade •~100 ENs upgraded/yr •Cum. cost ~ $50M •~$2,273/nurse eLearning vs. traditional methods for upgrading ENs Traditional classroom method eLearning Results do not just represent dramatic cost and time improvements over status quo, they are nearly impossible without use of ICT Source: Source: WHO, AMREF website
  8. 8. Social determinants of health WHO Commission report Improve daily living conditions Tackle the inequitable distribution of power, wealth and resources “Reducing health inequities is, for the Commission on Social Determinants of Health, an ethical imperative. Social injustice is killing people on a grand scale.”
  9. 9. Digital health: a two-edged sword? “More people have access to a mobile phone than to clean water, electricity or tooth brushes” Closing the gap in Health Equity through Technology, Alliance for Health Promotion in collaboration with the ITU, WHO and the Global Health Programme at the Graduate Institute, Geneva Nov. 16, 2015 “As advances in technology redefine the ways people, systems and information interact, resource-poor communities are often excluded.” Fong & Harris; WHO Bul. 2015;93:438-438A The difference matters
  10. 10. Digital Health: doing the right thing right 10 DIGITAL HEALTH = OPPORTUNITIES Not simply digitizing analog concepts – but transforming them Every activity that is performed in the health sector can benefit from judicious use of ICT FOUNDATION Social determinants of health BASIC TENETS Health is produced in the home and repaired in institutions (Francis Omaswa) Greatest opportunities for ICT in health lie not in curing diseases but in producing health
  11. 11. Thank You 11