Information and communication technology (ICT) is no longer just bits and bytes; it has become a tool to scale the world to greater heights. Various sectors have embraced it as a tool driving development, the health sector inclusive.

During the African Health Forum of the World Health Organisation that was held last month, e-health was one of the topics discussed.

e-health is the use of ICT to provide and support healthcare service delivery.

Edith Munyana, the health network and systems administrator specialist at the Ministry of Health, explains that e-health is a broad matter which encompasses different aspects, ranging from patients having online access to medical services to doctors carrying out operations through online platforms.

Rwanda has embraced the use of digital health with the Ministry digitalising systems such as Rwanda health management information system, a tool used in validation and analysis of statistical data tailored to integrate health information management activities. There is also the electronic logistic management information system which provides an effective and sustainable supply chain system for medicines and other health commodities, among others.

Forms of e-health

e-health encompasses a number of sub-domains including, electronic medical records, telemedicine, mobile health (mHealth), health IT systems and virtual healthcare.

Dr Fidel Rubagumya, the Founder of Rwanda Children’s Cancer Relief, defines electronic medical records as a digital version that contains a patient’s medical history.

When a patient is referred, for example from Butaro Cancer Centre to King Faisal Hospital, and everything that was recorded at Butaro is lost and the doctors have to start from zero. This he says affects the subsequent treatment. However, with this system all this can be improved upon, he says.

Munyana says telemedicine is where healthcare professionals diagnose and treat patients in multiple locations by means of telecommunications technology.

"Ability to carry out telemedicine consultations between district and referral hospitals has helped reduce the number of patients that are transferred from district to referral hospitals and outside Rwanda.”

With health IT systems, health portals help to disseminate health information to promote healthy behaviour in patients.

Munyana says the trend of e-health has picked momentum as more service providers and patients come aboard.

In regards to electronic medical records, there are 12 hospitals with registration and billing modules and 340 health facilities with one module of EMR (HIV package). Also there are 15 sites with facilities of telemedicine, says Munyana.

ICT as a tool for quality healthcare

Andrew Rugege, the director, International Telecommunication Union (ITU) for Africa, says ICT is a tool capable of accelerating the provision of excellent health services to citizens.

He says there is a lot of work to be done not only in Rwanda but all over Africa in terms of e-health development.

"The slow progress is allover Africa but we are going to double our effort. Our aim is to simplify access to e-health services and make it as simple and as cheap as possible such that even the person deep down in the village can access it,” Rugege says.

Rubagumya, however adds that, in as much as we are building hospitals and other infrastructure there are still a few specialised doctors.

"e-health can be used with the use of video-conferencing or tele-videos, among others, to optmise the few specialists we have to help guide general practitioners to diagnose and treat complex cases,” he says.

Challenges

Munyana says the cost of advanced e-health infrastructure, for example, telemedicine infrastructure, plus the accessibility challenge in remote areas is still an obstacle.

Rugege says the different e-health initiatives in place pose a challenge without proper coordination.

"We found that many countries don’t have strategies and policies on e-health. More awareness is needed on this matter for policy makers and leaders to be able to make fitting strategies and policies and also do capacity building for health workers,” he says.

Way forward

Munyana says to overcome these challenges there is need to mobilise funds to increase the number of health facilities to be connected and also to work with local governments and stakeholders to avail internet facilities in remote health facilities.

Rugege points out that the International Telecommunication Union agreed to do a joint initiative called "be healthy be mobile”, to accelerate Sustainable Development Goals.

"The initiative has three sides; the first one is digital health leaders to help develop policies; the second is digital health platform for the different initiatives; and the third is access and sustainability.

"The initiative will help build a common platform for e-health services by bringing them into one framework. We shall also do resource mobilisation to ease access to devices used in accessing these services,” he says.

Jean-Philbert Nsengimana, the Minister of Youth and ICT, says with the right type of investment, e-health will be on the right track.

"Something has been done both on the level of public health and on the consumer’s side. There are several start-ups providing different services such as Babylon health Rwanda, and I think that’s where most of the focus needs to be to improve our healthcare services,” he says.

"The use of ICT in health is very important, more so in prevention, reducing the cost of healthcare by cutting unnecessary travel expenses in search of quality medical services.”