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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

ICT for Developmente-Health: telemedicine and health information initiatives

ICT4D Lecture 8

Tim Unwin

outline
Outline
  • The global health agenda
  • E-health
    • Information
    • Delivering practices
  • Examples
    • Global organisations
    • Information and prevention
    • Telemedicine

Lecture 8

health related mdgs
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

icts and the health agendas
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

icts and the health agendas5
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

e health
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

global health initiatives and ict
Global Health Initiatives and ICT
  • World Health Organisation
  • The Global Fund to fight AIDS, Tuberculosis and Malaria
  • Roll Back Malaria

Lecture 8

slide8
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

slide9
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

slide10
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

information disssemination
Information disssemination
  • Soul City, South Africa
  • Imfundo’s support for fight against malaria and HIV/AIDS

Lecture 8

soul city south africa
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

soul city south africa13
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

imfundo support for malaria
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

imfundo and the interactive health network hiv aids
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

delivering medical practices
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

telemedicine in south africa
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

telemedicine in south africa18
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

jiva sustainable healthcare in rural india
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

jiva teledoc
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

jiva teledoc social returns
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

conclusions
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