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eHealth and Telemedicine in Nigeria
Introduction
According to WHO report, in Nigeria life expectancy dropped from 53.8
years for females and 52.6 years for males in 1991 to 46 years for
females and 45years for males in 2004. The infant mortality rate(IMR)
rose from 87.2 per 1,000 live births in 1990 to 104 in 2004. The
maternal mortality ratio of 800 per 100,000 live births is one of the
highest in the world.
The disability adjusted life expectancy (DALE) of 38.3 years ranks 187
in the WHO report. There is thus an urgent need to support the health
system with adequately trained personnel and medical facilities in order
to improve the quality of healthcare.
Important causes of morbidity and mortality in Nigeria include malaria,
TB, malnutrition, HIV/AIDS , parasitic infestations, typhoid fever,
pneumonia, complications of pregnancies and deliveries, hypertension and
diabetes mellitus. Others include strokes, cancers, sickle cell disease
and accidents, coronary artery disease and pulmonary arterial embolism,
amongst others. eHealth has a crucial role to play in the diagnosis and
management of these conditions and related complications.
The Nigerian health care system is presently characterized by inadequate
infrastructures and lack of basic amenities. The federal government has
commenced refurbishment of some of the teaching hospitals. Most of the
existing health services are inaccessible to the vulnerable group
especially the poor and people living in rural and underdeveloped areas.
What is e-Health?
eHealth is a relatively new term in health care practice and one of the
most rapidly growing areas in health and ICT today. The term encompasses
a range of services that involve health care and information technology
supported by electronic processes and communication. It involves the use
of information and communication technology(ICT) to improve patient
care.
The World Health Organization defines eHealth as ‘the cost-effective and
secure use of information and communications technologies(ICT) in
support of health and health- related fields, including health-care
services, health surveillance, health literature , and health education,
knowledge and research’.(WHO 2005).
Eysenbach G, a world-renowned eHealth expert defines eHealth as ‘an
emerging field in the intersection of medical informatics, public health
and business , referring to health services and information delivered or
enhanced through the Internet and related technologies. In a broader
sense, the term characterizes not only a technical development, but also
a state –of-mind, a way of thinking, an attitude, and a commitment for
networked, global thinking, to improve health care locally, regionally,
and worldwide by using information and communication
technology’.(Eysenbach, 2001).
What is Telemedicine?
Telemedicine involves the use of medical information transferred from
one site to another through electronic communications to improve
patient’s health care including diagnosis and treatment.
Telemedicine may be as simple as two medical professionals discussing a
case over the telephone, or as advanced as using video teleconferencing
systems.
Two forms of e-Health/Telemedicine
eHealth occurs in two forms which include synchronous or ‘real time’
communications and asynchronous or ‘store and forward’ communications.
Synchronous eHealth requires a communication link between two or more
parties that allows a real-time interaction to occur. Synchronous
telemedicine may use video-conferencing equipment with attachment of
peripheral devices which aid in interactive examinations. For instance,
a tele-stethoscope(eStethoscope) allows the consulting physician in
remote location to listen to the patient’s heartbeat and lungs, a
tele-ophthalmoscope(eOphthalmoscope) and tele-otoscope(eOtoscope) allow
a remote physician to examine a patient’s eyes and ears respectively.
Asynchronous eHealth involves the acquisition and transmission of
patient’s medical data such as radiological studies, laboratory results
and biomonitoring information to a physician at a convenient time for
assessment offline. A digital image is taken using a digital
camera(‘stored’) and then sent (‘forwarded’) to another location.
Asynchronous eHealth doesn’t require the parties to be present at the
same time.
Applications of e-Health Technologies.
There are clinical and non-clinical uses of eHealth technologies.
Clinical Applications of eHealth technologies(Telemedicine) include:
Clinical eHealth Clinical services consisting of remote patient
evaluation, treatment and monitoring by digital equipment. These include
specialist referral services, primary remote diagnostic visits and
remote patient monitoring.
Specialist referral services: involve a general medical practitioner in
a remote location consulting a specialist or a specialist consulting
another specialist for second opinion. This may involve a patient being
evaluated by a specialist over a live, remote consult or the
transmission of diagnostic images and/or video along with patient data
to a specialist for viewing later.
Almost 50 different medical subspecialties have successfully used
telemedicine. Radiology through the use of teleradiology continues to
make the greatest use of telemedicine with patients’ radiological images
from remote sites interpreted by Radiologists. Other applications of
telemedicine include telecardiology, telepathology, teledermatology and
telepsychiatry amongst others.
Teleradiology is the electronic transmission of patient radiological
images from one location to another for the interpretation and / or
consultation. Teleradiology allow prompt interpretation of radiologic
examinations and give greater access to consultations and improved
continuing medical education.
Primary Remote Diagnostic Visits: whereby devices examine a patient and
a connected physician residing in another location virtually examines
and treats a patient. This can play a crucial role in a developing
country like Nigeria with shortage of health care professionals.
Remote patient monitoring : devices remotely collect and send data from
homebound patients to a monitoring station for interpretation. The data
may include patient’s vital signs, ECG and blood glucose. Such services
can supplement the use of home visiting nurses .
e-Prescriptions : It replaces handwritten paper orders by doctors. It
allows physicians to use a computer or a personal digital assistant(PDA)
to electronically transmit a prescription to a pharmacy selected by the
patient. After placing the electronic order, the system checks for the
patient’s drug history including allergies, interactions with other
prescriptions and whether the drug is covered by the patient’s insurance
by searching the pharmacy and health plan databases. The e-prescription
is convenient to pharmacies due to automatic creation and storage of
electronic records of the prescription. The e-prescription improves drug
safety by decreasing the amount of prescription errors and subsequently
reduces avoidable health care costs.
e- Medical Records(EMR): The collection, storage, indexing,
communication and access to patient data. It enables easy communication
of patient data between health care providers and a greater access to a
wide variety of the patient’s comprehensive health information. The
health care provider can access this data to get more complete
information of the patient’s health in elective and emergency cases.
Evidence Based Medicine: This system provides medical information on
appropriate treatment under certain patient conditions. It enables the
healthcare professional to determine whether a patient’s diagnosis and
management are in line with current medical research.
Virtual healthcare teams: They consist of teams of health care providers
who collaborate and share medical information on patients for intramural
care, through electronic equipment like videoconferencing equipment.
Other clinical applications of eHealth include health advice by
telephone in emergent cases (teletriage) and advice on prevention of
diseases, and promotion of good health by patient monitoring and
follow-up.
By
Dr Osbert
Egiebor, MD, FAAP, FACR.
Dr Egiebor is a Nigerian
Physician practicing in the United States of America. He performs
regular voluntary medical missions in Nigeria.
He is actively involved in the establishment of Lincoln Advanced
Radiology & Diagnostic Medical Centre in Benin City, Nigeria. The
project is being undertaken by Nigerian Physicians in the United States
in order to improve the standard of healthcare and medical education in
Nigeria. The centre will serve as a teaching facility for Nigerian
Physicians and medical students.
Careers & Jobs at Lincoln Advanced Radiology & Diagnostic World class
Centre
What
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COMMENTS
for "eHealth
and Telemedicine in Nigeria":
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April 16, 2008
Olutunji
in Lagos says:
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Welcome to what has been missing in black Africa.. the power of
Information shared. There are bodies of knowledge that need to
go from personal property to shared resource for the improvement
of our lives.
Thank you Doctor.
|
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April 3, 2008
Zainab Al from Kaduna says:
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Thank you Doctor for sharing this exciting and useful
information on applying technology to improve healthcare. And
please spread your tentacles all over Nigeria and Africa. We
need more of such from our people in the diaspora.
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Click for Nigeria's ICT Policy Resources - ICT4D Nigeria
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