Bellagio — From Bellagio, Italy, AllAfrica's Boakai Fofana blogs on a Rockefeller Foundation conference on how to use information technology to improve access to health care.
Coming from Liberia, where we are struggling to rebuild our public health infrastructure after decades of conflict, I'm finding it stimulating to be amongst a rich diversity of academics and health professionals from around the world who are discussing global health systems. The focus is on how increasing access to the Internet and related technologies can be used to improve health care delivery in developing countries – or what is often called, in the ideas being put forth here, the "Global South."
"Making the eHealth Connection: Global Partnerships, Local Solutions" - taking place at a Rockefeller Foundation conference center in the Italian city of Bellagio, north of Milan - has attracted experts: nurses, professors, engineers and doctors from every corner of the globe. It is, the organizers have said, a forum where donors, governments, industries, researchers and civil society are engaged in an effort to raise the profile of health-care practices supported by electronic processes and communications.
The month-long interaction is subdivided into four weeks, with a shifting group of participants and topics ranging from mobile phones and telemedecine, electronic health record keeping, access to health information and knowledge sharing and the path to interoperability amongst others. These emerging areas of public health interest are spurred by the increasing development and expansion of the Internet, and its potential to facilitate new partnerships and identify promising new areas of work, conference organizers noted.
This week's topics are "Access to Information and Knowledge Sharing", "Health Informatics" and "eHealth Capacity Building". The eHealth world is exploring and experimenting, if not yet expanding, ways by which increased access to connectivity will make it possible to scale up Internet-enabled pilot projects that for example, give health workers online data via hand-held devices.
Monday's keynote speaker highlighted the challenges in sub Saharan Africa, where shortages of trained health professionals are severe and where health outcomes fall far short of the United Nations "Millennium Development Goals" for reducing poverty and improving health by 2015. The crisis is compounded by the lack of health care educators.
In his keynote presentation, Brian Nairn - for eight years, until last month, the Chief Executive Officer of Elsevier Health Sciences - demonstrated ways of "leveraging the power of health information" through information and communications technologies. He argued that rapidly evolving online tools present opportunities that should be seized and made more useful to nurses, doctors, clinicians and other health workers.
"Imagine if we can improve health care delivery by ten percent," he asked. How many children's lives could be saved and how much could the world's health services be improved? He demonstrated how, through video conferencing, complicated health procedures – including surgeries - can be shown to health practitioners via the Internet, thus making skilled instruction accessible to health workers in developing countries. Health professionals far removed from the procedure are able physically to see how complex surgical interventions are performed, rather than only reading text references.
In a video demonstration, Nairn introduced conference participants to online learning tools, where books and other materials are helping to overcome the teacher gap. He stressed that the mobile phone generation in Africa can leap over past methods of health education dissemination.
Participants watched with keen interest and appeared impressed with the possibilities. The eHealth world is exploring and experimenting, if not yet expanding, ways by which increased access to connectivity will make it possible to scale up the pilot projects that give health workers online data via hand-held devices and other Internet-enabled communications technologies.
Many African countries have barely functioning health systems.
Liberia, for instance, has about 100 medical doctors serving almost four million people. Many of the makeshift urban health centers are operated by physician assistants, midwives or less trained personnel. Too often their motive is profit rather than service delivery - selling a "commodity" rather than actually curing the sick. But many patients, especially in countries where illiteracy and unemployment thrive, will seize at anything a "doctor" provides.
Imagine the implications of information and communications technologies in the health field becoming accessible to both patients and health professionals. Imagine alerts on the latest treatment regimes for malaria. Imagine health workers being able to navigate their way through patient records while in the field, or doctors updating prescriptions through emails and mobile phone technology. What a wonderful change that would bring!
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Following the keynote address, participants split into two groups for individual introductions, roundtable discussions and paper presentations. Most attendees are highly credentialed professionals but seem open to all ideas, not just those of recognized authorities. Interactions are warm, and conversations are marked by enthusiasm, zeal for results, and eagerness to effect substantive change in the way public health issues are handled, particularly in the developing world.
Suggestions flowed freely, including expanding distance learning programs, training nurses to be computer literate and providing electronic medical records for health ministries. With the effort and resources being put into a process that could encourage transformative change, I'm hoping this won't turn out to be one of the numerous international conferences that achieve more in talk than in implementation.
