Frank Verbeke

Using Togaf for Building a National Implementation Strategy for E-Health Services and Technologies in Burundi

In order to better align existing and future ICT implementations in the health domain with the strategic options defined by the National Plan for Health Development, the Ministry of Health (MoH) of Burundi initiated in 2014 the development of a national e-health enterprise architecture based on the TOGAF methodology. A first part of the development cycle consisted of a detailed analysis of regulatory documents and strategic plans related to the Burundian health system. In a second part, semi-structured interviews were organized with a representative sample of relevant MoH health structures. The study demonstrated the donor driven unequal distribution of hardware equipment over health administration components and health facilities. Internet connectivity remains problematic and few health oriented business applications found their way to the Burundian health system. Paper based instruments remain predominant in Burundi’s health administration. The study also identified a series of problems introduced by the uncoordinated development of health ICT in Burundi such as the lack of standardization, data security risks, varying data quality, inadequate ICT infrastructures, an unregulated e-health sector and insufficient human capacity. The results confirm the challenging situation of the Burundian health information system but they also expose a number of bright spots that provide hope for the future: a political will to reclaim MoH leadership in the health information management domain, the readiness to develop e-health education and training programs and the opportunity to capitalize the experiences with DHIS2 deployment, results based financing monitoring and hospital information management systems implementation.

Strengthening Community Attributes in the OpenClinic GA Open Source Collaboration: an Analysis of Prevailing Practices and Thoughts from Internet Blogs

In order to reach the objective of making the OpenClinic GA open source hospital information management system a broadly backed sustainable collaborative project, a community needs to be created around it. Since not much was found in scientific literature about creating, growing and maintaining open source communities, we searched the internet to learn from the experiences of open source users all over the world. The community attributes (i) feeling of belonging, (ii) social capital, (iii) belief, (iv) shared processes and (v) communication were identified from literature and served as a guidance for tagging and structuring the massive amount of information we got from open source community related internet blogs. The blog analysis provided useful practical tips for implementing the high level characteristics of effective open source communities. To generate a feeling of belonging, users and developers must be approached personally, the community needs a formal way to deal with conflicts and each member must have a fair chance to participate, whatever his skills and expertise are. People often contribute to an open source project in order to get some recognition. They can get this social capital through rewarding, but also through constructive feedback when they make mistakes. Both ways are important to show people they are considered to be contributors to a serious project. To keep contributing, people must believe in the community. Therefore, it has to be a well-functioning, welcoming place. To create this, we must be aware of the importance of shared processes to run such a community. Reasonable access policies and leadership are very important in this. Finally a solid communication strategy is necessary to bind all of these elements together. It must be kept in mind that users and contributors may live and work in different continents. There are lots of virtual communication tools cope with that, but one should not underestimate the importance of face-to-face meetings.

ICT-Enabled Universal Health Coverage Monitoring and Evaluation in Sub-Saharan Health Facilities: Study in 8 Reference Hospitals of Rwanda, Burundi, the Democratic Republic of Congo and Mali

UHC (Universal Health Coverage) is at the center of the Sustainable Development Agenda. In this study, the authors made an evaluation of the indicators allowing quantification of the impact of health coverage schemes on patients, applied in 4 sub-Saharan Africa countries: Rwanda, Burundi, the DRC (Democratic Republic of Congo) and Mali. After an analysis of potential health coverage indicators, the most relevant ones were calculated on the basis of patient administrative and health insurance data, collected via OpenClinic GA, an HIMS (health information management system) used in 8 sub-Saharan hospitals during the period 2010-2016. The results show that the PHSC (patient health services coverage) rate is highest (81.5%-92.7%) in the 2 hospitals of Rwanda and in 2 hospitals of Burundi (37.7%-77.7%). The PHSP (patient health service payment) rate as the proportion of costs paid by the patient versus total health service costs is below the 25% threshold recommended by WHO only for the 2 hospitals in Rwanda. The POOP (patient out-of-pocket) payment is below the threshold of 180USD per patient per year for all hospitals. The HIEXs (health insurance expenditures) are funded by the university private insurance (86% of expenses covered) in 2 university teaching hospitals in DRC, by CBHI (community based health insurance) (69%) in 2 hospitals in Rwanda, by the free care policy (77%) in 2 hospitals in Burundi and by the SHI (social health insurance) (100%) in the 2 hospitals in Mali. PHSC in the 8 reference hospitals reflects the national trend towards UHC in each country. With this study, we demonstrate the possibility to assess the degree of UHC in developing countries, by a methodology based on indicators calculated via information extraction from routine data in electronic health records.

Building а National Clinical Data Warehouse

Turkey has created an e-health vision along with the Health Transformation Program. In this framework, standard coding systems such as standard definitions of the institutions, databank of healthcare providers, standard disease, drug and medical supplies classifications have been developed and a national clinical data warehouse (Health-NET) was established. Health-NET is an integrated, safe, fast and expandable health information system which aims to improve efficiency and quality of health services by collecting all kinds of data produced in the health institutions in line with the standards and generating information adequate for all stakeholders of the collected data.

The Application of PEST Analysis to the Creation of the Profile of na IT Product Designed to Activate and Support Senior Citizens in Poland

The purpose of the paper is to create a profile of an IT product, using IT tools to collect and to analyse information and enable communication between elderly people to support and activate them. PEST Analysis method was used to determine different factors of influence on the domain of elderly people activation and support Having evaluated the factors and defined the product characteristics, the Authors focused on defining the profile of the IT product by referring the aforementioned characteristics to the structure of the product in the marketing understanding thereof.

Interoperability Within E-Health Arena

Integrated care that starts with patients taking care for their health, that includes truly multidisciplinary team approach to treating patients’ conditions and that utilizes enormous existing common knowledge in an efficient way, is one big step towards increasing healthcare provisioning quality while in the same time having healthcare cost under control. The foundation of the integrated care is timely availability of comprehensive information for all stakeholders within healthcare processes independent on their location and information system or application they use. The absolute precondition for this is ability of different IT systems / applications to exchange and display information in a way that is not only comprehensible to all stakeholders but also means the same to all of them. This ability is called interoperability. In this paper, overview of different interoperability aspects for electronic healthcare records / personal healthcare records is given. The main standards / initiatives are explained along with some challenges and possible way forward. Index Terms — Electronic Healthcare Record, Personal Healthcare Record, interoperability EN 13606, openEHR, archetype, HL7 CDA, IHE

Suggestions for the Elicitation of Seniors Involvement in ICT and Socially Innovative Solutions to Tackle IT

Human-computer interaction (HCI) issues for older people are extremely important in the light of the rapidly ageing population in developed countries. In addition, technology offers great potential for this age group, but it will be only useful if it can be used effectively by its target users. We will therefore examine how HCI can address the needs and situations of this increasing older population and how their involvement can be maximized in order to support participation and empowerment. In recent years, HCI technologies have manifested their potential to enhance the autonomy and quality of the life of elderly people, through boosting the elicitation of seniors. This paper is describing a methodology and challenges that will support healthcare professionals’ action in the further effective usage of systems based on HCI.

Big data in Neurosurgery - Intelligent Support for Brain Tumor Consilium

A brain tumor occurs when abnormal cells form within the brain. Medical imaging plays a central role in the diagnosis of brain tumors. When a brain tumor is diagnosed, a medical team will be formed (consilium) to assess the treatment options presented by the leading surgeon to the patient and his/her family. Using historical evidence-based healthcare data and information directly extracted from images to categorize them may support to increase decision for treatment of patient with brain tumor. Due to its complexity, cancer care is increasingly being dependent on multidisciplinary tumor consilium. That is why it is very important to avoid emotional and quick decisions done by members of consilium. Few studies have investigated how best to organize and run consilium in order to facilitates important decision about patient therapy. We developed and evaluated a multiparametric approach designed to improve the consilium ability to reach treatment decisions. In particular the use of discriminative classification methods such as support vector machines and the use of local brain image meta-data were empirically shown to be important building blocks as support for therapy assign. For efficient classification we used fast SVM classifier with new kernel method.

Eb@le-Santé: Networked Electronic Health Records in Academic Hospitals in RDC

The Eb@le-Sante EuropAid project (2009-2012) is a partnership between Belgian and Congolese (RDC) institutions. The main aim is to improve health care in RDC via electronic records [4] [5] [7] and educative medical teleconferencing [1]. Therefore we equip four academic hospitals with a server providing medical software, linked workstations in a local area network at the hospital and interconnections to the academic network Eb@le that interconnects seven universities in the country. The project also aims at educating local teams towards both technical and medical autonomy. Currently, the main equipment in the four locations (the university teaching hospitals of Kinshasa, Lubumbashi, Bukavu and Kisangani) is installed and the local teams have started recording medical patient records. The project’s methodology aims at solid registration of complete patient records, resulting in high quality data, improving the care of the patient and, enabling swift reporting [10][11] and data-mining for research on anonymous epidemiological data. Moreover, correct and adequate administrative data become available to the hospital management and teleconsulting/tele-education components complete the package.

Notable e-Health Developments

The field of information and communication technologies (ICT) in health care, now called e-health, is coming to maturity. This is demonstrated by several “real world” accomplishments that will hopefully demonstrate the benefits of ICT in health for all those involved, not the least society and the patients at large. In this article, we will highlight the technical and the profession-specific building blocks, on which e-health applications are based, give a few examples of typical realizations and discuss the evolving political context.