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ICT for Development e-Health: telemedicine and health information initiatives. ICT4D Lecture 8 Tim Unwin. Outline. The global health agenda E-health Information Delivering practices Examples Global organisations Information and prevention Telemedicine. Health related MDGs.

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Ict for development e health telemedicine and health information initiatives l.jpg

ICT for Developmente-Health: telemedicine and health information initiatives

ICT4D Lecture 8

Tim Unwin


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Outline

  • The global health agenda

  • E-health

    • Information

    • Delivering practices

  • Examples

    • Global organisations

    • Information and prevention

    • Telemedicine

Lecture 8


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Health related MDGs

  • Goal 4: reduce child mortality

    • Target 5: reduce by two-thirds (1990-2015) the under-five mortality rate

  • Goal 5: Improve maternal health

    • Target 6: reduce by three-quarters (1990-2015) the maternal mortality ratio

  • Goal 6: Combat HIV/AIDS, malaria and other diseases

    • Target 7: halted by 2015 and begun to reverse the spread of HIV/AIDS

    • Target 8: halted by 2015 and begun to reverse the incidence of malaria and other major diseases

Lecture 8


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ICTs and the health agendas

  • Three core areas

    • Health management systems

    • Information and prevention

    • Medical practices

  • Key drivers

    • Experiences from north America and Europe

      • Particularly in telemedicine initiatives

    • Pharmaceutical industry: the money in medicine

      • Expanded markets

      • But also a concern to use the potential benefits for greater good

Lecture 8


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ICTs and the health agendas

  • Long experience of ICTs in health

    • Theatre, dance, film, video in health education

    • ‘Traditional’ telemedicine

      • Australian flying doctor service in 1920s

  • Potential of new technologies

    • Very high cost of medical diagnosis equipment

      • Samples and images can be sent digitally

    • Use of consultants contacted by ‘phone/digitally

      • Saves time at a distance

    • Making information relevant and appealing

    • Managing large amounts of data

Lecture 8


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E-health

  • Information

    • Managing health information

      • Hospitals

      • Diseases

      • Maximising health benefits for populations

    • Disseminating information on health care and prevention

      • Health workers

      • General public

  • Delivering medical practices

    • Telemedicine initiatives

Lecture 8


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Global Health Initiatives and ICT

  • World Health Organisation

  • The Global Fund to fight AIDS, Tuberculosis and Malaria

  • Roll Back Malaria

Lecture 8


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  • e-Health initiatives

    • Africa: Health Information Systems (HIS) http://www.afro.who.int/his/index.html

      • But not particularly active

    • South-east Asia

      • Telematics and IT programmes

    • Americas

      • Telemedicine initiatives

  • As yet, mainly pilot schemes

    • Little evidence of ability to deliver initiatives at scale

Lecture 8


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  • The Global Fund http://www.theglobalfund.org/en

    • A financial instrument created in 2002

    • $3 billion committed in 128 countries (Feb 2005)

    • Nothing on ICT or e-Health on site!

Lecture 8


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  • Malaria kills 1 million people a year

  • RBM Partnership

    • Launched in 1998 by WHO, UNICEF, UNDP and World Bank

      • Now has more than 90 partners

  • ICT based work

    • Multimedia online resources

    • http://www.rbm.who.int/cgi-bin/rbm/rbmportal/custom/rbm/home.do

    • Mainly use in information dissemination

Lecture 8


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Information disssemination

  • Soul City, South Africa

  • Imfundo’s support for fight against malaria and HIV/AIDS

Lecture 8


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Soul City South Africa

  • Soul City: Institute for Health and Development Communication http://www.soulcity.org.za

    • A South Africa NGO

    • Established 1992

    • Especial focus on HIV/AIDS

  • Different media

    • Television

      • Six series, each of 13 episodes

    • Radio

      • Six series, each of 45 episodes in 9 languages

    • Print

Lecture 8


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Soul City South Africa

  • Evaluations

    • 47% of people in SA say it is main source of info about HIV/AIDS on TV

    • Strong positive correlation between behaviour and exposure to Soul City

    • Soul City is as well known as Coca Cola in South Africa

    • Materials used in 11 African countries

Lecture 8


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Imfundo support for malaria

  • Imfundo agendas

    • Seeking relevance

    • Tanzania

  • Personal connections

    • Dr. Alasdair Unwin working on malaria in suppport of Tanzanian Ministry of Health

  • CD-ROM on malaria

    • In partnership

    • ICT4D web-solution

    • http://www.gg.rhul.ac.uk/ict4d/Malaria.html

Lecture 8


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Imfundo and the Interactive Health Network - HIV/AIDS

  • Database on digital information on HIV/AIDS

    • Ready access to a wealth of digital materials

    • Searchable by types of user and types of information

    • Users can provide comments on the resources

    • Developed through partnership

    • http://hivaids.digitalbrain.com/hivaids/homepage/home/

Lecture 8


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Delivering medical practices

  • Telemedicine in South Africa

  • Jiva teledoc in India

Satellite link to rural hospital in Mali

www.satexpo.it/en/ news-new.php/3?c=42700

Lecture 8


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Telemedicine in South Africa

  • Telemedicine Research Centre

    • Established by Medical Research Council in 1999

    • Designed to evaluate relevance of international expertise for Africa

    • Findings: telemedicine enables

      • Access to specialist radiologists within hours rather than days

      • Improved diagnosis by community service doctors

      • Local treatment of some patients, thus reduced transfers

      • Reduced professional isolation of doctors in rural areas

Lecture 8


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Telemedicine in South Africa

  • University of Transkei http://telemed.utr.ac.za

    • Open Source telemedicine initiative

    • Web-links

      • Pathology

        • Pathopic (Basel) http://alf3.urz.unibas.ch/pathopic/e/intro.htm

        • Telemedicine

        • Health information

    • Online teaching resources

    • Potential is there

      • But not much evidence of high usage

Lecture 8


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Jiva: sustainable healthcare in rural India

  • Jiva Institute

    • Non-profit Research and Development Institute founded in 1992

      • Health, Education and Social Enterprise

    • Health activities

      • Ayurveda website - the world’s first

        • Holistic, healing science

      • Ayunique - online consulting

      • Teledoc - healthcare for all

      • Ayurbuyer - online store

      • Jiva College of Ayurveda

Lecture 8


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Jiva Teledoc

  • Based in village in Haryana

    • Won World Summit Aware

  • Practice

    • Healthcare workers record diagnostic data

    • Use Java enhanced mobile ‘phones to transmit data

    • Ayurvedic doctors diagnose and prescribe treatment

    • Medicines are then delivered by field workers to patients

    • Costs 70 rupees ($1.50 per consultation)

Lecture 8


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Jiva Teledoc social returns

  • Patients have affordable treatment

  • Women are treated by women

  • Wider healthcare is promoted by field workers

  • Local workers speak local languages

  • Provides some employment in rural areas

Lecture 8


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Conclusions

  • Much is technically feasible

    • High cost end: telemedicine

    • Lower cost: considerable health information

  • Importance of combining multi-functional access points for information

    • The role of Telecentres

  • Yet, the potential of e-Health has still to be realised

    • Why is this?

Lecture 8


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