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Dr. Olajide Joseph Adebola
Society for Telemedicine and eHealth, Nigeria

October 7-11, 2013
CTO Forum , Abuja, Nigeria

Implementing eHealth:
The Nigerian
Experience

1
CTO Forum , Abuja, Nigeria

• Defination
• Implementation of eHealth in Nigeria
• Some of the eHealth initiatives
• Implications for the Cloud
• Drivers for Cloud Computing in
eHealth
• Impact of the Cloud on eHealth
• Conclusion

October 7-11, 2013

Outline

2
CTO Forum , Abuja, Nigeria

• eHealth: the use of ICT for Health
• ICT provide opportunities for individuals,
healthcare providers and administrators to
• obtain information,
• communicate with professionals,
• deliver first-line support especially where
distance is a critical factor and
• promote preventive medicine programmes

October 7-11, 2013

Defination

3
• Efforts to develop telemedicine and eHealth in Nigeria started in
1994.
• Department of Planning, Research and Statistics/FMOH tried to
produce necessary documents for eHealth development and
deployment in 1996.
• FGN first showed commitment to the use of ICT to deliver health
services as explained in the NEEDS document( eHealth seen as a
component of eGovernment)

CTO Forum , Abuja, Nigeria

Approach
• Piecemeal, uncoordinated
• Largely pilots yet to be scaled up
• No comprehensive eHealth national strategy developed yet.
• Efforts made to develop eHealth in Nigeria

October 7-11, 2013

Implementing eHealth in Nigeria so far

4
Some of the eHealth initiatives

• Intel telemedicine/eHealth project between Federal Medical Centre, Bida, and the National
Hospital, Abuja, for critical pediatric care as well as surgical cases.
• FCT eHealth pilot (the FCT eHealth web Portal Initiative) – an online portal that seeks to
manage patient data/statistics and to close any existing gap between primary and secondary
health systems by linking data across health facilities.
• mHealth project with the National Primary Health Care Development Agency (NPHCDA) used
in the Midwives Service Scheme(MSS).
• Mobile Community Based Surveillance (mCBS) project designed to give traditional birth
attendants the ability to report vital MCH events in real time using mobile phones. stitutions –
mobile health unit set up to shuttle across 8 states for a period of 2 months

CTO Forum , Abuja, Nigeria

• A pilot project initiated by the National Space Research and Development Agency (NASRDA) in
collaboration with FMOH in 2007 through provision of services by tertiary in
• India Pan African eHealth Network project at the Universities of Ibadan and Lagos Teaching
Hospitals to help provide trans-border teleconsultation and training of workforce.

October 7-11, 2013

• A pilot project initiated by National eGovernment Strategies Ltd in 2006 to provide teleconsulting
in cardiology with the use of video conferencing equipment and digitalized electrocardiography
machine to Abuja communities.

5
• Made in Nigeria Primary Health Care and Hospital Information System
(MINPHIS) application that keeps patient records and generates various
reports for health management and research purposes.

• Adoption of District Health Information System (DHIS) as a national tool for
reporting aggregate data from the lowest to the highest level.
• Establishment of a national eHealth data/documentation centre to provide
central coordination for national health data/information warehousing and
management and hosting databases for all health programmes of FMoH.
• Lagos State Government’s implementation of eHealth in 13 General
Hospitals in the state enabling the hospitals to practise health care system
supported by electronic processes and telecommunications technology.

CTO Forum , Abuja, Nigeria

• UNICEF supported an mHealth initiative which involves the
implementation of Rapid SMS to track the supply of malaria bed nets as
well as using Rapid SMS to pilot a child nutrition monitoring system

October 7-11, 2013

Some of the eHealth initiatives

6
• There are barriers to scaling up most of the projects to support a larger patient
and care provider base.
• Some of the projects are not running currently or are under- utilized.

• Most of the projects lacked adequate stakeholders’ involvement in all phases from
conception to implementation.
• Most of them are funded in ways that may threaten their sustainability/scalability.
• Most of them have not been evaluated to determine their impact on health
system, patient health outcomes and their cost-effectiveness.
• There is currently no integration of the multiple and wide variety of health
information systems in the country

CTO Forum , Abuja, Nigeria

• eHealth projects implemented so far have merely created small-scale applications
of eHealth that are unable to effectively communicate or share information with
other health systems or across geographies, technologies or programs.

October 7-11, 2013

Lessons learnt from implementation

7
Barriers to eHealth in Nigeria

• Epileptic electric power supply.
• Inadequate government commitment (policy, legislation, funding etc.)
• Lack of/inadequate ICT infrastructure.
• Underfunding of the health sector - little or no funding for eHealth.
• Low awareness of eHealth and its importance.

CTO Forum , Abuja, Nigeria

• Lack of eHealth Legislative Framework.

October 7-11, 2013

• Lack of National eHealth Strategy and Policy.

• Poor attitude to wanting to change the old way of doing things.

• Inadequate human resource capacity.
• Prevalence of cyber crimes.
• Low internet connectivity.

8
CTO Forum , Abuja, Nigeria

October 7-11, 2013

Context for eHealth development

9
Context for eHealth Development
Source: National eHealth Strategy Tool Kit
CTO Forum , Abuja, Nigeria

October 7-11, 2013

Implications for the Cloud

10
CTO Forum , Abuja, Nigeria

October 7-11, 2013

Drivers for Cloud Computing in eHealth

11
12

CTO Forum , Abuja, Nigeria

October 7-11, 2013
CTO Forum , Abuja, Nigeria

• New imperative to secure rapid and reliable transferability of
data between health decision-makers in today’s healthcare
environment
• The need to be able to transfer data reliably 24/7 to effect
optimal care
• Changing demographics , health systems constraints /cost
pressures that demand new effective solutions
• Cost-sustainable
• The nature and impacts of health systems reforms
• The availability of significant experience from other industry
that have adopted the cloud
• The amount of data that health care providers must deal with
is daunting

October 7-11, 2013

Drivers for Cloud Computing
in eHealth

13
CTO Forum , Abuja, Nigeria

• Increased transparency and governance
to health systems
• Security
• Scalability
• Mobility
• Cost Reduction
• Sharing

October 7-11, 2013

Impact of the Cloud on eHealth

14
CTO Forum , Abuja, Nigeria

• Growing expectations, changing demographics,
and resource limitations require wise investment
in eHealth solutions that address major health
needs
• Cloud in eHealth presents new opportunities for
access to quality health care, for all
• Enabling eHealth strategy, policies are required
to ensure that these opportunities are fully
harnessed
• Solutions that are designed and implemented
now must form the foundation (practice and
technology infrastructure) for decades to come

October 7-11, 2013

Conclusion

15
eHealth

October 7-11, 2013
CTO Forum , Abuja, Nigeria

Health is an universal right

eHealth requires a glocal approach
16
CTO Forum , Abuja, Nigeria

October 7-11, 2013

For Our Sakes & Future
Generations

17

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Implementing e health the nigerian experience

  • 1. Dr. Olajide Joseph Adebola Society for Telemedicine and eHealth, Nigeria October 7-11, 2013 CTO Forum , Abuja, Nigeria Implementing eHealth: The Nigerian Experience 1
  • 2. CTO Forum , Abuja, Nigeria • Defination • Implementation of eHealth in Nigeria • Some of the eHealth initiatives • Implications for the Cloud • Drivers for Cloud Computing in eHealth • Impact of the Cloud on eHealth • Conclusion October 7-11, 2013 Outline 2
  • 3. CTO Forum , Abuja, Nigeria • eHealth: the use of ICT for Health • ICT provide opportunities for individuals, healthcare providers and administrators to • obtain information, • communicate with professionals, • deliver first-line support especially where distance is a critical factor and • promote preventive medicine programmes October 7-11, 2013 Defination 3
  • 4. • Efforts to develop telemedicine and eHealth in Nigeria started in 1994. • Department of Planning, Research and Statistics/FMOH tried to produce necessary documents for eHealth development and deployment in 1996. • FGN first showed commitment to the use of ICT to deliver health services as explained in the NEEDS document( eHealth seen as a component of eGovernment) CTO Forum , Abuja, Nigeria Approach • Piecemeal, uncoordinated • Largely pilots yet to be scaled up • No comprehensive eHealth national strategy developed yet. • Efforts made to develop eHealth in Nigeria October 7-11, 2013 Implementing eHealth in Nigeria so far 4
  • 5. Some of the eHealth initiatives • Intel telemedicine/eHealth project between Federal Medical Centre, Bida, and the National Hospital, Abuja, for critical pediatric care as well as surgical cases. • FCT eHealth pilot (the FCT eHealth web Portal Initiative) – an online portal that seeks to manage patient data/statistics and to close any existing gap between primary and secondary health systems by linking data across health facilities. • mHealth project with the National Primary Health Care Development Agency (NPHCDA) used in the Midwives Service Scheme(MSS). • Mobile Community Based Surveillance (mCBS) project designed to give traditional birth attendants the ability to report vital MCH events in real time using mobile phones. stitutions – mobile health unit set up to shuttle across 8 states for a period of 2 months CTO Forum , Abuja, Nigeria • A pilot project initiated by the National Space Research and Development Agency (NASRDA) in collaboration with FMOH in 2007 through provision of services by tertiary in • India Pan African eHealth Network project at the Universities of Ibadan and Lagos Teaching Hospitals to help provide trans-border teleconsultation and training of workforce. October 7-11, 2013 • A pilot project initiated by National eGovernment Strategies Ltd in 2006 to provide teleconsulting in cardiology with the use of video conferencing equipment and digitalized electrocardiography machine to Abuja communities. 5
  • 6. • Made in Nigeria Primary Health Care and Hospital Information System (MINPHIS) application that keeps patient records and generates various reports for health management and research purposes. • Adoption of District Health Information System (DHIS) as a national tool for reporting aggregate data from the lowest to the highest level. • Establishment of a national eHealth data/documentation centre to provide central coordination for national health data/information warehousing and management and hosting databases for all health programmes of FMoH. • Lagos State Government’s implementation of eHealth in 13 General Hospitals in the state enabling the hospitals to practise health care system supported by electronic processes and telecommunications technology. CTO Forum , Abuja, Nigeria • UNICEF supported an mHealth initiative which involves the implementation of Rapid SMS to track the supply of malaria bed nets as well as using Rapid SMS to pilot a child nutrition monitoring system October 7-11, 2013 Some of the eHealth initiatives 6
  • 7. • There are barriers to scaling up most of the projects to support a larger patient and care provider base. • Some of the projects are not running currently or are under- utilized. • Most of the projects lacked adequate stakeholders’ involvement in all phases from conception to implementation. • Most of them are funded in ways that may threaten their sustainability/scalability. • Most of them have not been evaluated to determine their impact on health system, patient health outcomes and their cost-effectiveness. • There is currently no integration of the multiple and wide variety of health information systems in the country CTO Forum , Abuja, Nigeria • eHealth projects implemented so far have merely created small-scale applications of eHealth that are unable to effectively communicate or share information with other health systems or across geographies, technologies or programs. October 7-11, 2013 Lessons learnt from implementation 7
  • 8. Barriers to eHealth in Nigeria • Epileptic electric power supply. • Inadequate government commitment (policy, legislation, funding etc.) • Lack of/inadequate ICT infrastructure. • Underfunding of the health sector - little or no funding for eHealth. • Low awareness of eHealth and its importance. CTO Forum , Abuja, Nigeria • Lack of eHealth Legislative Framework. October 7-11, 2013 • Lack of National eHealth Strategy and Policy. • Poor attitude to wanting to change the old way of doing things. • Inadequate human resource capacity. • Prevalence of cyber crimes. • Low internet connectivity. 8
  • 9. CTO Forum , Abuja, Nigeria October 7-11, 2013 Context for eHealth development 9 Context for eHealth Development Source: National eHealth Strategy Tool Kit
  • 10. CTO Forum , Abuja, Nigeria October 7-11, 2013 Implications for the Cloud 10
  • 11. CTO Forum , Abuja, Nigeria October 7-11, 2013 Drivers for Cloud Computing in eHealth 11
  • 12. 12 CTO Forum , Abuja, Nigeria October 7-11, 2013
  • 13. CTO Forum , Abuja, Nigeria • New imperative to secure rapid and reliable transferability of data between health decision-makers in today’s healthcare environment • The need to be able to transfer data reliably 24/7 to effect optimal care • Changing demographics , health systems constraints /cost pressures that demand new effective solutions • Cost-sustainable • The nature and impacts of health systems reforms • The availability of significant experience from other industry that have adopted the cloud • The amount of data that health care providers must deal with is daunting October 7-11, 2013 Drivers for Cloud Computing in eHealth 13
  • 14. CTO Forum , Abuja, Nigeria • Increased transparency and governance to health systems • Security • Scalability • Mobility • Cost Reduction • Sharing October 7-11, 2013 Impact of the Cloud on eHealth 14
  • 15. CTO Forum , Abuja, Nigeria • Growing expectations, changing demographics, and resource limitations require wise investment in eHealth solutions that address major health needs • Cloud in eHealth presents new opportunities for access to quality health care, for all • Enabling eHealth strategy, policies are required to ensure that these opportunities are fully harnessed • Solutions that are designed and implemented now must form the foundation (practice and technology infrastructure) for decades to come October 7-11, 2013 Conclusion 15
  • 16. eHealth October 7-11, 2013 CTO Forum , Abuja, Nigeria Health is an universal right eHealth requires a glocal approach 16
  • 17. CTO Forum , Abuja, Nigeria October 7-11, 2013 For Our Sakes & Future Generations 17