Future of Work: Using Health-tech to Realise Health Equity in Africa

How can new digital ways of working in the healthcare sector improve patient outcomes to increase global health equity in the COVID-19 era and beyond?

These were the questions tackled by a panel of globally recognised health-tech experts in a recent webinar for the African healthcare community.

Hosted by BroadReach Group CEO Chris LeGrand, an internationally recognised leader in public health management, the webinar was joined by panellists Dr John Sargent, the World Economic Forum’s 2015 Social Entrepreneur of the Year, health technology innovator and co-founder of BroadReach, Dr Andrew Kambugu, Executive Director at the Infectious Diseases Institute at Makerere University in Uganda and Rochelle Mountany, a senior manager and health industry advisor at Microsoft for Southern Africa and the Middle East.

“Technology can really make transformational progress and get us back on track to reach the Universal Health Coverage goals by 2030,” said LeGrand, who runs BroadReach Group, a global social impact business that harnesses health technology and innovation to improve universal access to quality healthcare through large-scale healthcare programmes in Africa and the USA.

Five key insights were shared on improving health equity through technology:

1. Reactive healthcare wastes precious resources

“Healthcare is often reactive”, says Dr Sargent. “Patients arrive when they are already very sick. These patients are more complex to take care of and therefore more resource-intensive.”

This often happens in settings where resources are already particularly precious and scarce. Health professionals who are reactive normally base their decisions on gut feel as opposed the data at hand.

This leads to hospital administrators spending a lot more time and money on operations, IT and data to get on top of the situation, which is not always a fruitful exercise. Proactivity and prevention are key.

Knowing your community – and the smart use of social determinants of health data – can help health systems get ahead of the curve so that targeted health campaigns can be instituted before a situation escalates, says Dr Sargent.

2. Dashboards are useless to healthcare implementers

Dr Sargent posed this question: “Despite everything the industry is investing in and spending on IT, are we really moving the dial to improve health outcomes? Can we improve health outcomes by investing in more data and analytics? Not necessarily.”

Healthcare managers who oversee complex settings often invest intensively in data, analytics and dashboards. Still, these tactics “mean nothing unless they are a means to an end, and not the end itself.”

That means if dashboards just present a lot of data but can’t deliver critical practical advice and workflows, it means nothing, says Sargent. It must provide healthcare implementers with easy-to-digest, highly relevant, targeted insights to drive their action and offer oversight coordination across the whole system.

3. Data analytics are irrelevant to most healthcare workers

More health data does not mean better insights, and more analytics to interpret more data also does not help most health workers because data analysis is irrelevant to them and the immediate tasks at hand, says Sargent.

“For the executive, operational manager or frontline health worker, if you can deliver them critical advice on workflows and help them collaborate with their colleagues in real-time, then yes data can help them.

But if your answer is, let’s deliver a bunch of dashboards, and let’s train a nurse who has 200 acute patients queuing outside the door to be a data scientist, to click on this button and filter that, then no, more data will not move the dial on outcomes.”

The bottom line is, that the rollout of more pure dashboards simply has not shifted results for healthcare operators in Africa, Asia, Europe, or the United States. It only works for super-users whose job it is to analyse data, not for the healthcare implementers on the ground, at the moment, he says.

What does, however make a real difference on the frontlines is where technology is used to tell healthcare staff in plain English (or natural language) what to do each day by way of simple instructions – linking their workflows with their colleagues’ – empowering them to provide better care in a very practical way.

The Vantage platform, for instance, does this through an integration with Microsoft Teams.

4. Greater patient engagement demands greater mass personalisation

Patients were becoming more active participants in their own health, but this also meant their expectations of healthcare providers were changing, says Mountany.

As the world rapidly digitised over the past year in particular, patients had become used to various industries providing them with personalised digital customer service, and they were now demanding it from the healthcare sector as well.

Achieving meaningful personalisation of customer care at scale meant that better insights needed to be leveraged. This was only possible if various partners across the health and health-tech ecosystems collaborated to improve patient experiences.

This included public-private partnerships and collaborations between large players such as Microsoft and smaller agile partners like Vantage Health Technologies and other innovators worldwide whose collective mission is to improve universal health equity.

5. Reaching the “last mile” of patients requires greater innovation

Speaking from personal, on-the-ground experience as a medical doctor who spent a long time working in a very busy HIV client where he saw up to 400 patients a day and as a seasoned researcher and health executive, Dr Kambugu said it was a monumental challenge to run operations on a paper-based system. Still, the early journey towards digitisation between 2005 and 2012 wasn’t easy either.

He learnt from the experience that to reach the “last mile” of patients, “it was necessary to work smarter and with more innovation to achieve impact and cost-effectiveness”.

Digitising, gaining access to quality data, and then having that data translated into practical workflows and next steps for clinic staff was the only effective way to manage pandemics or achieve the UNAIDS 95-95-95 targets.

These targets entail 95% of people living with HIV knowing their HIV status, 95% of people who know their status receiving treatment and 95% of people on HIV treatment becoming virally suppressed.

It is this insight that drives Dr Kambugu and Uganda’s Infectious Diseases Institute in their research and efforts to innovate and trial new ideas to improve patient and health outcomes, from drone technology to deliver medications and transforming patient experience through voice prompt advice lines to using digital tools to enhance patient-physician interactions.

Some fast facts about global health inequity:

• In high-income countries the life expectancy can be around 80 years, while in low-income countries it can be about 59. (UN)

• Available data indicates that in 2018, only about 16% of South Africans were members of medical aid schemes, with only 10% of Africans belonging to such schemes compared to 73% of whites. This severely impacted access to quality healthcare along racial lines. (Study)

• Pre-pandemic, it was estimated that girls in Lesotho were likely to live 42 years less than those in Japan, and in Sweden, the risk of a woman dying during pregnancy and childbirth was 1 in 17 400, while in Afghanistan, the odds were 1 in 8. (WHO)

• The high-income countries (19% of the global adult population) purchased more than half (54%/ 4.6 billion) of global vaccine doses up until March 2021. Of the remaining doses, 33% were purchased by LMICs (81% of the global adult population) and COVAX purchased 13%. (Source)

• Up until May 2021, only 0.3% of the total vaccines administered globally went to low-income countries. (WHO)

• Up until March, 1 in 4 people in high-income countries had received a coronavirus vaccine, compared with just 1 in more than 500 in low-income countries. (WHO)

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​This story has been published from a wire agency feed without modifications to the text. Only the headline has been changed.