Online patient portals that integrate financial and clinical data have been around for a while in many of the developed countries. These portals offer immediate access to patient information, reduce the cost of care and eliminate penalties such as re-admissions.
According to the recent Patient Portals in Africa analysis by Frost & Sullivan, African healthcare providers are gradually beginning to recognise the convenience and cost benefits of adopting such portals, and uptake is expected to increase. However, there remains a lack of urgency in implementing them.
Puseletso Mompei is the new business director of SA firm CenHealth, which operates one such portal. It portal hosts patient data for doctors but also allows patients to provide accurate facts on their medical history electronically, reducing errors and misdiagnosis.
‘Patients generally don’t have in their possession solid, reliable health data about themselves or loved ones,’ says Mompei.
‘In instances where patients do have some information, it is usually on various pieces of paper, which are easily lost or destroyed.
‘CenHealth allows users to upload copies of X-rays, scans and any other images to their account, keeping it safe from the elements and retaining their integrity. This saves the patient the costs of repeating scans and tests.’
Tackling affordability is central to CenHealth’s vision. The platform does not require upfront investment from users, and provides the ability to store, manage and share health records – an option many individuals and health practitioners did not previously have.
‘The advent of smartphones and mobile medical devices and apps means that consumers and their healthcare providers do not require PCs and servers. At CenHealth, we put your health in your hands by providing you with a plug-and-play platform that is simple to use and easy to access,’ she says.
According to Mompei, electronic solutions present a massive opportunity to improve the health sector in Africa. The digitisation of information has the potential to introduce efficiency, seamless integration, accuracy and cut costs.
‘Today, health information is still predominantly held in paper format, making it expensive and complex to consolidate and draw intelligence from. Electronic solutions enable sharing of information, which is crucial for combining or aggregating healthcare data.
‘Various activities such as national budgeting and planning – as well as disease outbreak management – depend on reliable data, which in Africa has been limited but with technology, are more feasible.
‘Technology can revolutionise the way healthcare is experienced by the patient, and allow for collaboration of health practitioners across geography, teams and disciplines,’ says Mompei.
The digitisation of information has the potential to introduce efficiency, seamless integration, accuracy and cut costs
Etienne van Wyk, healthcare manager at Frost & Sullivan Africa, agrees that e-health has the potential to impact both access to and the cost of services. ‘In Africa more people have access to mobile networks than to water and electricity,’ he says.
‘This in turn makes e-health solutions immensely scalable, which will naturally drive down the cost. With a growing penetration of mobile devices in Africa, access to products and services will be greatly impacted as well.’
Finding sustainable business models has been a problem but this is gradually changing as healthcare providers and users realise the need and, through mobile, gain the ability to participate in this new way of providing healthcare.
According to van Wyk: ‘Healthcare is becoming increasingly consumer driven and solutions that aim to be disruptive will need to engage consumers directly. This is where the true value lies, and all the big tech companies are trying to get ahead in this space.’
SmartPrac is a healthcare practice management system where practitioners can access a pay-per-use cloud platform to simplify the running of their practices. It allows for scheduling of SMS reminders; storing of comprehensive patient records and treatment notes; invoicing; medical-aid billing; account and stock management; and financial reporting.
Mushambi Mutuma of SmartPrac feels e-health has a bright future in Africa given the failings of healthcare systems across the continent, which are too weak or under-resourced to adequately address the high burden of diseases and demand.
‘Our healthcare systems don’t have the capacity to match the scale of its problems and core issues like primary access to care. Technology and electronic solutions can offer a bevy of answers to the challenges on the ground,’ says Mutuma. ‘This includes enhanced monitoring and evaluation; improved service delivery; training and upskilling of healthcare workers; and improved diagnostics and treatment.’
Furthermore, technology can assist with resource management and improving the management of stock and shortages thereof. Through digital health records and mobile health, healthcare in Africa can now be streamlined and optimised.
Yet this is not something that can be handled entirely by the private sector – the assistance of the public sector is also required. This was demonstrated by the reaction to the Ebola outbreak in West Africa, where the two sectors joined hands to roll-out solutions to assist in spreading information about the threat.
The International Telecommunication Union launched a free mobile application in partnership with operators to facilitate co-ordination among organisations responding to the Ebola crisis and offer the public access to the latest news from official sources.
In Ghana, Vodafone and voice messaging firm Kirusa partnered with government to launch the Ebola Public Health Project, disseminating content on the outbreak to subscribers for free.
Away from Ebola, Ghanaian startup mPedigree, which uses mobile phones to secure pharmaceutical products against counterfeiting, partnered with the Uganda National Bureau of Standards and USAID for programmes in the East African country.
‘From a government standpoint, e-health does not succeed without the necessary legislation, national implementation and scalability’
Mompei says that there has been much innovation in recent years from the private sector but though some solutions can be used privately by individuals, areas such as maternal health, chronic disease, epidemiology and public health require government participation to have an impact. She says that partnerships are ‘crucial for scaling private innovations to populations, as is the pooling of resources’.
Mutuma agrees that the onus for e-health success lies on private companies and government equally. ‘For private companies, there is a need for innovation and the design and development of products and solutions that connect areas with limited resources and infrastructure. More companies need to focus on problem solving on the ground and in the doctor’s room.
‘From a government standpoint, e-health does not succeed without the necessary legislation, national implementation and scalability. Right now there is not a uniform healthcare system approach in South Africa or a clear template for technology integration.
‘Without government-led establishment and improvement of infrastructure, private companies will always be limited with their range.’
With partnerships such as this starting to become established, and governments and healthcare providers waking up to the possibilities in e-health, there is great potential for companies operating in this space.
Van Wyk says the opportunity for investors is ‘immense’ as Africa offers both a tremendous burden of disease as well as scalability in numbers.
‘The continent also has the potential to leapfrog a lot of technology, due to the growing use of mobile devices that have become a critical part of daily life, with people using them as a primary means of communication as well as for economic transactions,’ he says.
Max Pichulik, co-founder of Impact Amplifier, which has recently launched the Enterprise Elevator e-health accelerator programme in SA with a number of other partners, says investors are attracted by the large potential impact of e-health, primarily serving the emerging middle class in Africa.
‘The impact potential in the public health system is massive, and the private sector will increasingly play an important role with the underserved population,’ says Pichulik.
‘From a mobile perspective, we are seeing a lot of movement in home-based care shifting across to being managed by mobile technology. Whether that’s tracking visits, treatment, patient records or referrals. There is an industry forming here in m-health.’
Pichulik says that entrepreneurs trying to play a role in the public health system must be patient, and have the wisdom to perhaps not start with that market segment initially but rather grow over time.
While Van Wyk agrees that the opportunity is not without risk, adding that there is much competition, especially with the likes of Google, Apple, Microsoft and IBM turning their attention to healthcare. However, he adds, the potential definitely exists.
‘How big is the economic opportunity in e-health? I cannot say but assumedly, much bigger than we think,’ he says. ‘I believe we are on the brink of many game-changing technologies that will become available in the next few years.’
