HCIT is the beginning and the end for ensuring Health by Yunkap Kwankam, Executive Director, ISfTeH, Switzerland

1. The Great Debate:
Prof. S. Yunkap Kwankam, PhD
Executive Director, International Society for Telemedicine and eHealth
(ISfTeH)
CEO, Global eHealth Consultants, Switzerland
ICT for health not healhcare

2. The most effective way to improve productivity is to improve
health systems
Source: Nicholas C. Petris Center on Health Care
Markets & Consumer Welfare (UC Berkeley),
WHO, A Handbook of Cultural Economics (James
Heilbrun)
Level of HC spending is a function of GDP/capita
regardless of external funding
Healthspendpercapita(2005)
GDP PPP per capita (2005)
10
100
1000
10000
100 1000 10000 100000
R2 = 0.94
Focus of health investments should be on
improving sector productivity

3. 0
50
100
150
200
250
300
100 1000 10000 100000
Variation in health outcomes highlights considerable room for improvement of
inefficient and ineffective health systems
Source: WHOGDP PPP per capita (2005)
Log GDP/Capita (PPP) vs Childhood (<5) Mortality
Childhood(<5)Mortality(per1000)
Country A Country B
Country Y
Country X
Countries with similar health outcomes
but very different profiles
Countries with similar profiles but very
different health outcomes
Effectiveness of health spending widely variable:
Health outcome not tightly linked to income

4. Time lost to paperwork

5. The need for decision support
systems
Current practice depends upon the clinical
decision making capacity and reliability of
autonomous individual practitioners for classes of
problems that routinely exceed the bounds of
unaided human cognition”
Daniel Masys, 2001

6. Countries with a critical shortage of health service
providers (doctors, nurses and midwives)

7. eLearning easing healthcare HR crisis in Kenya
In Kenya, chronic shortage of highly
skilled nurses
Enrolled Nurses (ENs) comprise 70%
of nursing and 45% of the health
workforce in Kenya
• First point of contact for
communities, but are inadequately
skilled to manage new and re-
emerging diseases like HIV/AIDS
PPP led by the Nursing Council of
Kenya (NCK), the African Medical and
Research Foundation (AMREF) and
Accenture to upgrade 22,000 ENs
from ‘enrolled’ to ‘registered’ level
within 5 years via eLearning (distance
education through ICT) methods
Promising progress since start of
program in Sep. 2005
As of Nov. 2006, 3,265 nurses
upgraded
27 colleges and schools participating
including AMREF’s Virtual Nursing
School
Over 100 computer-equipped training
centers set up in 8 provinces,
including remote and marginalized
districts
eLearning can reach goal w/in next
decade versus >200 years w/ traditional
classroom methods
0
5
10
15
20
25
2005
2007
2009
2011
2013
2015
2225
(K)
•~2,800 ENs upgraded/yr
•Cum. cost ~ $2.5M
•~$114/nurse
22,000 ENs to upgrade
•~100 ENs
upgraded/yr
•Cum. cost ~ $50M
•~$2,273/nurse
eLearning vs. traditional methods for
upgrading ENs
Traditional classroom method
eLearning
Results do not just represent dramatic cost and time improvements over
status quo, they are nearly impossible without use of ICT
Source: Source: WHO, AMREF website

8. Social determinants of health
WHO Commission report
Improve daily living
conditions
Tackle the inequitable
distribution of power, wealth
and resources
“Reducing health inequities is, for
the Commission on Social
Determinants of Health, an ethical
imperative. Social injustice is killing
people on a grand scale.”

9. Digital health: a two-edged sword?
“More people have access to a
mobile phone than to clean water,
electricity or tooth brushes” Closing
the gap in Health Equity through Technology,
Alliance for Health Promotion in collaboration
with the ITU, WHO and the Global Health
Programme at the Graduate Institute, Geneva
Nov. 16, 2015
“As advances in technology redefine
the ways people, systems and
information interact, resource-poor
communities are often excluded.” Fong
& Harris; WHO Bul. 2015;93:438-438A
The difference matters

10. Digital Health: doing the right thing right
10
DIGITAL HEALTH = OPPORTUNITIES
Not simply digitizing analog concepts – but transforming them
Every activity that is performed in the health sector can benefit from judicious
use of ICT
FOUNDATION
Social determinants of health
BASIC TENETS
Health is produced in the home and repaired in institutions (Francis
Omaswa)
Greatest opportunities for ICT in health lie not in curing diseases but in
producing health

11. Thank You
11
ykwankam@gehcs.com
ykwankam@isfteh.net