By: Darren Wilkins, MS, MBA MIS-
(DWilkins@WilkinsSystems.Com)
CCNA, MCP, MCDST, Security+, A+, Network+, Server+, Linux+, FTCE-Computer Science
As a kid, my siblings and I vacationed in Weasua, Gbarpolu County, where my father owned his diamond mining business. In those days, whenever we got sick, we would have to cut short our vacation and fly back to Monrovia because the local clinic did not have the equipment to treat our illnesses. In 2007, while in Haiti on a study of that country’s telecommunications industry, I developed a slight stomach illness which led me to the nearest clinic. While at the clinic I was instantly reminded of the clinic in Weasua which I had visited several years ago. But what was seemingly different about the Haitian rural clinic was that it had several portable electronic devices which I immediately recognized. I discovered subsequently that those devices were part of a telemedicine (the use of ICT to provide clinical care at a distance) program which had been initiated by a group of foreign health workers. At that point, thoughts of being sent back to the United States had evaded my mind since the telemedicine program was set up to prevent unnecessary travels to the main city for illnesses that were considered minor. As I expected, the nurse did her preliminary diagnosis, entered the results into a handheld computer, and sent the information to the main hospital in Port au Prince (the capitol of Haiti). In about two hours, a courier entered with a delivery which happened to be my prescription. By evening time that day, I was discharged and sent back to work with my team. That experience is the basis on which today’s article was written. I will discuss the injection of ICT in the health sector by implementing a telemedicine program, especially in rural areas. Although I firmly believe that the appropriate telemedicine applications can improve the health sector and save more lives, there are many aspects of the health system that require a shift in paradigm in order to provide viable healthcare.
While the number of doctors may be growing in Liberia, health workers, especially nurses who serve the rural population are isolated from specialists’ support, up-to-date information, and opportunities to exchange experiences with colleagues. This situation presents the same situation with which I was faced in Weasua several years ago. As our partners (NGOs and other organizations) make available their resources (helicopters, vehicles, etc), the unavailability of the much needed technology to facilitate healthcare in rural areas presents a challenge for nurses and other healthcare workers. With telemedicine, some of these challenges can be alleviated and lot of lives could be saved because information will be shared effectively and promptly. So, what is telemedicine?
Telemedicine is the use of telecommunication technologies to provide healthcare services over long distances and can be used to improve healthcare as well as enhance economic development in a developing country like Liberia. It allows physicians to provide consultations, collect and share uniform laboratory data and medical records to provide health care. The introduction and implementation of telemedicine technologies in Liberia has the potential to change the course of healthcare delivery, especially in the rural areas. Telemedicine will allow doctors at the John F. Kennedy hospital to be able to diagnose and treat a patient in remote areas like Weasua or Yekepa without having the patient visit the main hospital in Monrovia. This can be done in real time! It is ideal for a counter-response to the threat of national disasters by ensuring that real-time medical care is available to victims of disasters despite the location.
With Liberia at such critical stage in the recovery process, the implementation of a national telemedicine program will provide a solution for the scarcity of a specialist, the lack of an effective media of communications, as well as provide up-to-date information and education for health workers. Telemedicine allows doctors to perform several tasks remotely and seamlessly; tasks which in the past, required patients’ visits to hospitals in the main cities costing them huge sums of money for transportation. Pregnant women will also benefit from this because doctors will be able to perform fetal monitoring remotely and consult health care workers to examine “prospective” mothers in order to keep apprised of their pregnancies. This will save a lot of babies as well as the “prospective” mothers. Telemedicine can make a difference in how healthcare delivery to the poor in implemented. Statistically, rural areas have been listed as those areas with high population and the poorest of citizens. If we implement a national telemedicine program that can reach that population, we will greatly improve our healthcare system.
Telemedicine has been successful in several African countries including Nigeria, Ghana, South Africa, Niger, Guinea, Tanzania, Kenya, just to name but a few. I am absolutely confident that telemedicine will work well in Liberia because of our booming mobile telecommunications industry which has changed the way Liberians communicate. GSM technology has brought affordable and easy access mobile phone access hence, facilitating any initiative to implement telemedicine. WIMAX can enable video conferencing and high speed broadband connections will allow the use of interactive media that will allow doctors and health workers provide quality health care for all Liberians.
It must be noted that the success of telemedicine in Liberia does not fall solely in the hands of the government. The initiative must involve all stakeholders otherwise the benefits will never be reaped. There must be an effective partnership among all stakeholders to ensure the success of this endeavor. Furthermore, there may be fears about the costs of telemedicine but what is more important; the lives of our citizens or a few dollars that might most likely end up in the wrong pockets?
Another issue that needs to be addressed is the education of health workers to enable them to provide better care for their patients. Nurses, who along with teachers are my most revered professionals, must be given the best education and tools to keep up-to-date on the changes that are occurring in the health field. New technologies continue to change the way things are done, hence they need to have access to current information relating to their profession. Also, apart from having nurses attend “nursing schools or colleges” our health system should provide technologies that give them access to the internet from where they can gain a wealth of information and resources to better themselves as well as connect, collaborate, and communicate with other health workers in the global community. Below are a few of the approaches I would suggest to the health care authorities:
- Allow nurses to travel to Western countries so that they will attend training programs and bring back some of the best practices of their profession and spread it across the health care spectrum.
- Give nurses PDAs (Personal Data Assistants) containing up-to-date basic reference materials as part of their continuing medical education.
- Provide all necessary technologies to healthcare professionals so that they are informed about trends in healthcare and the practical impact, positive or negative, that new standards, technologies, and products will have.
- Provide access to Email, chat, and instant messaging to healthcare workers. These tools can be used on PDA’s (i.e. Palm Pilot). Email, chat, instant messaging and now video conferencing are very economical solutions to support healthcare in remote areas because of their store and foreword functionality. All of these tools are very user-friendly and they can be found in the Open Source environment which is free or obtained as COTS (Commercial Off-The-Shelf) solutions. They allow the sending of e-mail attachments such as image files, thereby permitting a form of low cost telemedicine. Video conferencing can also be done in a low cost way by using the appropriate application with cheap hardware (Webcam). SKYPE is an excellent tool that is ideal for health workers. Its video conferencing features are great for communications between doctors in the main city and nurses in the rural areas.
- Extend broadband capacity to villages. This has to be done through or in collaboration with LIBTELCO
- Purchase vehicles that are equipped with telemedicine technologies to be used for to travel to rural areas and to help train rural health workers while also providing health services
- Setup an HIV AIDS helpline to allow individuals report illnesses anonymously. Some individuals, for the fear of disgrace, may not want to publicly report their illnesses. If a medium for anonymous reporting is established, cases will be reported and hopefully, there will be a decrease in the number of Liberians dying from the disease.
Now, while I advocate the use of ICT to improve our healthcare system, we should not be tempted to emulate Western healthcare system which is no doubt different than ours. Without considering the sustainability aspect, telemedicine could have a negative impact on the continuity of the system. And unless we understand the technological and cultural readiness our country and its health care practitioners, embarking on this initiative will be fruitless and may even cause more problems
The advent of ICTs has unleashed new opportunities for the delivery of health services. Yet, despite these new opportunities, the Liberian healthcare sector is still faced with several challenges in meeting the healthcare requirements of residents in rural areas of the country. Some of the challenges are little or no access to emergency treatment in rural areas, inadequate information dissemination, inadequate infrastructure, to name but a few. With so many inadequacies coupled with increased demand for improved health care delivery, telemedicine applications tend to be the ideal solution to address the challenges of healthcare delivery in Liberia. I know my critics will say that I am proffering solutions that have the reconstruction of basic facilities as a prerequisite for implementation. But I disagree with them all the time because their idea of the construction of basic facilities do not subsume the use of creative energies to identify and pioneer new and innovative solutions to problems that we have experienced from before the time I was born. Liberia needs visionaries; people who can think outside the box; people can dare to explore the unfamiliar for the betterment of the country. Liberia does not need individuals who espouse the status quo because it benefits them. We are in a new world, with new ideas and new ways of thinking. My philosophy which has been buttressed by demands from my employers is that there is always a solution to a problem. You just have to be creative and willing to explore the unfamiliar. That’s how new innovations emerge!
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