2. Ghana
• Population 24.4 mn
• Enhanced focus on healthcare since 1997 with the
goal to increase the % of population utilizing qualified
health personnel from 30% to 50%
• Physical Infrastructure
– Healthcare Expenditure is 8.3 % of GDP
– Spending by private sector is 48% and public sector is 52%
– 0.9 beds/1,000 population against a world average of 2.61
and WHO norm of 3.9 beds/ 1,000 population
– One third of the population lives 5 kms away from the
nearest health facility
• Health Insurance
– A high 80% of patients visiting private hospital have
coverage
– Claims processing is very lengthy
• Medical Personnel
– 0.1 Physicians per 1,000 against a world average of 1.5
– 1.0 Nurses per 1,000 against world average of 3.3
• Unequal Distribution – the urban versus rural divide
– In rural Ghana, consulting a doctor takes an average of 4
hrs. and costs 8 times more then elf-medication
India
• Population 1,241 mn
• Physical Infrastructure
– Healthcare expenditure 5.1% of GDP
– Spend by private sector is 80% and public sector is 20%
– 0.86 beds/1,000 population
– 1 mn deaths/ yr due to inadequate healthcare facilities
• Health Insurance
– 80% expenditure borne by the patients
– Private Health insurance a mere 3%; State bears 12%
• Medical Personnel
– 1.2 Physician per 1,000 population
– 0.9 Nurses per 1,000 population
• Unequal Distribution – the urban versus rural divide
– Over 700 mn people have no access to specialists care
– 80% of the specialists live and work in urban areas
Healthcare Sector: Challenges
2
3. Common Problems & Growing
3
Population Growth
Ageing Population
RisingHealthcareSpend
Patient
Centric
Integrated
Care
Connected
Healthcare
Standards &
Interoperability
265
40 23 10
848
194 68 30
0
200
400
600
800
1000
2005
2011
NCD (# in ‘000s)
4. Challenges: Priorities are Changing
Improve Patient
Care/Safety/Satisfaction
4
Gain Operational
Efficiencies
Meet Regulatory
Obligations
5. Challenge: IT is more Complex
5
More Integrated Operations
More Networks
More Devices
More Virtualization on Demand
8. eGov Phase II Healthcare Drivers
• Mobile Phone penetration in Ghana is > 100% (number of mobile phones is more than the population
because multi-SIM’ing is common)
• 62% of the disease burden in Ghana is still communicable diseases, maternal and prenatal conditions and
nutrition deficiencies; 31% is NCD and 7% injuries related
Sub-Sharan Africa accounts for 11% of the world’s population yet bears 24% of the global disease
burden and commands < 1% of global health expenditure
Opportunities that can be addressed by ICT
1. Enhance CHPS (Community-based Health
Planning & Services) initiative through mobile
health (mHealth) services
2. Strengthen healthcare Communication system
through ICT to enable faster flow of
information, better governance and effective
decision making
3. Reduce load on institution care through
effective disease prevention and control at
community level
4. Improve access to quality maternal, neonatal
and child care to reduce IMR/ MMR
Examples & Case Studies
Mother & Child
Tracking System
(MCTS)
Outreach Disease
Surveillance
Program (ODSP)
MediPhone
Healthline24x7
Tele-Radiology
8
9. Mediphone is a 24X7 “Doctor on Phone” service for 186 mn Airtel subscribers, backed by
internationally renowned clinical decision support system from Medibank, Australia
MediPhone empowers people to get medical advice over the phone, at the time of their
choice irrespective of location. Running since Nov 2011, the service offers:
• Medical advice including self-care, doctor’s consultation and/or medication
• Accredited medical professionals & doctors to ensure right diagnosis
• Prescription by SMS/ email
• Psychological and Diet Counseling
9
10. 10
Doctor On Phone
Provider Comparison and Evaluation
Health Alerts
Medicine Information
Disease Information
Specialist selection system
Appoint Scheduling
Health Update
First of its kind round the clock, technology enabled,
independent healthcare information services platform,
positioned to transform healthcare by addressing the
basic issues of: • 60,000+ registered home users
• 24x7 Operations across 13 cities
• 150,000 registered healthcare providers
0% 4%
8%
73%
15%
Emergency
Information on diseases
Information on Medicine
Search Select
Symptom to Specialist
11. MCTS Agents, Paramedics and
Doctors calling the beneficiaries
High Risk
Pregnancies
Low Risk
Pregnancies
Monthly call
for high risk
cases.
Total 9 calls.
Mother & Child Beneficiaries receive calls
and reminders as per predefined schedule
Proposed MCTS Call Center- Approach
9 AM – 6 PM Operations
Advanced reminder for
due MCH services
Improved Compliance
Reduced Maternal &
Infant Mortality
Saves Lives!!
MCTS Database of phone number & other
mandatory details for work plan
Information extract of Pregnant women
and children
MCTS Portal
HealthFore CRM
Children
Call at every
ANC visit,
before & after
delivery.
Total of 5 calls.
2 calls for
OPV/DPT and 1
call for
Measles.
Total of 3 calls
Healthcare professionals/
Hospitals/ CHC etc.
11
12. Screening conducted at PHCs
Patient Details capture – EMR
ID generation
Samples processed at Gujarat
Laboratories (Partner)
Cards and Reports Issued to
PHC
Reporting Dashboards
Spot Test
Issue of Appropriate Card
Outreach Disease Surveillance
Sickle Cell Screening
12
13. INTERNET
Billing Diagnostic Test
Performed by Technician
SRL Radiologist 1
SRL Radiologist …
SRL Radiologist 2
Guwahati Central Data
Center
TechnicianTeleradiology Image
server
Patient
Tele-Radiology
13
Objective: Use ICT to overcome
lack of staff and expertise in
providing Radiology services
Scope: Tele-radiology services in
11 district hospitals, with
centralized reporting
Across 11 Regional Diagnostic Centers covering 14.9 mn citizens in State of Assam
15. • Healthcare segment is complex business and an important part
of every country’s economy
• Medical industry has seen path breaking innovations both in
the area of medical procedures as well as medical equipment
• Common Problems and Challenges loom in healthcare across
the world primarily to do with lack of accessibility, affordability
and awareness
• ICT and mHealth integrated with traditional care methods are
the only way to bridge the growing healthcare divide
• Standardization and Inter-operability, security and privacy are
going to play a critical role in adoption of patient-centric
integrated healthcare
15
To Summarize
