April 24, 2019

DIGITAL HEALTH: M-health to lead positive disruption in health sector

Shehu Badamasi,hospital

Patients, relatives stranded in hospital as health workers strike continues.

•Why digital health contributes $179 billion to global economy

By Juliet Umeh

Access to healthcare in Nigeria and indeed, Africa, still remains a big challenge. For instance, Nigerians pay through the nose to get quality diagnoses and treatments for common ailments. Medical tourism keeps the nation’s economy bleeding.

Penultimate week, President Muhammadu Buhari lamented that Nigeria loses over N400 billion annually to medical tourism and urged stakeholders to join hands to find solution to it.

Addressing participants of the Senior Executive Course, SEC 41 of the National Institute of Policy and Strategic Studies, NIPSS, Buhari said for the good of the country, there must be solutions to issues that could close the gaps in the institutional, legal and policy frameworks for funding universal healthcare delivery.

He persuaded the participants to embark on researches that will examine the experiences of other countries in Africa, Asia, Europe and the Americas in funding universal healthcare delivery and how lessons learnt can benefit the country.

However, stakeholders in the health sector say even if the president’s demands are met, without putting in place relevant technologies that can disrupt the  existing status quo in the health sector, access to healthcare will still be a nightmare.

At a digital health summit recently in Lagos, organised by Premier Medical System, PMS, PharmAccess Foundation and Healthcare Federation of Nigeria, HFN, with theme: Leveraging mobile technology for health: Progress and Challenges, stakeholders lamented the low acceptance of digital technology in the health sector.

Although they agreed that Nigeria’s mobile technology penetration presented a novel opportunity to accelerate progress towards attainment of National Health goals, they, however, regretted that very little progress has been made so far.

For them, in other sectors, including education, banking, entertainment and media, there is a concerted effort towards leveraging technology which has resulted in each of the sectors getting returns for their investments.

They believe the health care professionals need to be more innovative and engender disruption of their sector with mobile health, m-health technology, to forestall the sector going into extinction.

Mobile health is the practice of medicine and public health supported by mobile devices. It deals with using mobile communication devices such as mobile phones, tablet computers and wearable devices such as smart watches, for health services, information, and data collection. The mHealth field has emerged as a sub-segment of eHealth, which deals with the use of information and communication technology, ICT, tools such as computers, mobile phones, communications satellite, patient monitors, among others, for health services and information.

mHealth applications include the use of mobile devices in collecting community and clinical health data, delivery of healthcare information to practitioners, researchers and patients, real-time monitoring of patient vital signs, direct provision of care via mobile telemedicine as well as training and collaboration of health workers.

President of HFN,  Mrs. Clare Omasteye, described digital health as cultural transformation which integrates digital electronics to achieve great outcomes in health care.

She  said  digital health is contributing $179 billion globally and that in the next six years; the market will grow in triple folds to peak at $536 billion.

She quoted statistics from the Global Digital Health as saying that the digital health market is expected to reach $206 billion by 2020, driven particularly by the mobile and wireless health market.

Omasteye described digital innovation as: “The transfer of skills using mhealth such as mobile phone and internet to be able to get highly skilled jobs that are usually done by  highly trained people and pass on to people who are not trained.

“It could change the way people access healthcare. So the traditional venues where people get health care will no longer be the same as they can access it from the comfort of their home.


Innovations in the health sector

According to Omasteye, “today in South Africa, people living with HIV/AIDS do not need to get to the pharmacy to get a drug. They go to an ATM machine, put in the code or prescription and the machine dispenses the antiretroviral drugs.

“Even the fear of buying fake drugs vanishes with mHealth. Today, there are RX systems that are SMS-related. You scratch a box and you send a code somewhere else to authenticate if the drug is genuine. There are also wearable devices like Apple watch to tell you how you slept, what your blood pressure is and what you should do next.

“In phlebotomy – a  process of making an incision in a vein with a needle,  there is a technology akin to torch light, which can be shone and all the veins in the body are seen quickly and clearly.

“With your mobile device, you can have your health record and it also can serve as a glucometer for your blood sugar if you are able to keep the record of your sugar level over a period of time. You send it to your doctor who manages you.

“There is also ECG machine which can work with your phone, it tells you exactly how to place the machine and you send the result back to your doctor.

“There are online pharmacists where a patient doesn’t even need to go to hospital any more. He or she only needs to upload the prescription at, and it helps  pick all orders and sends it to various pharmacists closest to the patient, who will in turn, deliver the drugs,”  she added.

She said few Apps are also helpful such as SaferMum, a tech that connects mothers and give them access to antenatal checkups, immunisation date, information on what they need for their children; SeekMed, that connects patients to online doctor, among others.


Challenges of Nigeria health sector in thinking disruptively

 However, Omasteye noted that a lot of innovations have taken place in Nigeria in the last one year which didn’t cross gestation period: “There were over 200 Medtech innovations in Nigeria. The challenge is that most of them die in the next six months. Now, the health system is so fragmented that there are no hubs and collaborations to enable people think disruptively.”

She also listed other factors to include laws and the regulatory environment that surround digital health; limited funding, poor access to data, no reimbursement system.

Corroborating Omatseye,  Coordinator, Lagos Zone National Health Insurance Scheme, NHIS, Mr. Olufemi Akingbade, said Nigeria is nowhere in implementing mHealth yet.

He, however, noted that digital health is very useful in the sector especially in registration, verification and identification of those to be provided care, but regretted that a lot of doctors are so scared of embracing the technology.


Akingbade said the way out would be to ensure that all mHealth App developers form a hub instead of sitting in silos.

Meanwhile, the General Manager, Lagos State Health Management Agency, LASHA, Dr Olapeju Adenusi, said with the 23 million people in Lagos, the only way to drive health efficiently and effectively is to embrace mhealth.


The position of the ATCON in expanding infrastructure

President, Association of Telecommunications Companies of Nigeria, ATCON, Mr. Olusola, Teniola, said that the key factor in getting mHealth working in Nigeria would be to collaborate with not only the regulators but healthcare practitioners and other stakeholders to ensure an ecosystem that involves everyone.

He said: “We are also engaging the government, Nigerian Communications Commission, NCC, to encourage public-private partnership, PPP, format and we are trying to work with Ministry of Power to improve supply.”

Future of health sector with mhealth

The participants at the event agreed that an innovation such as Artificial Intelligence, AI, has the potential to disrupt treatment planning and drug developments.

With AI, there will be accuracy in predicting and preventing illnesses, diagnosing diseases, making drugs better than they are today and managing health conditions from the comfort of people’s homes.

Virtual reality has also shown four areas in which it can make a change such as in training, it can tell and show you things you can’t see in a classroom, help in pain relief, help in mental and also the management of chronic diseases.

Today, with 3D printing, one can order drugs online, print the drug in one’s home and consume it immediately.

Maybe to imbibe all these cultures in Nigeria, there is need to reorient medical practitioners and disabuse their minds that technology cannot take away their jobs but would rather take away wastages, inefficiency and make them better doctors, pharmacists and medical health providers.