THE TELE-HEALTH REVOLUTION

Medical I.C.T. Construction Incompetence? Negligence? or Un-professional?

ICT Adoption Trends  21.6 million internet users ~53.3% internet penetration (March 2014)  31.8million mobile phone subscribers~78.1%  Drop in SMS use- adoption of more internet instant messaging  Increase in social media consulting and information exchange  41% of medical professionals use mobile phones to seek information for clinical purposes Source: CAK Statistics 2014, Utilization of ICTs for Accessing Health Information by Medical Professionals in Kenya: A Case Study of Kenyatta National Hospital -Journal of Health Informatics in Developing Countries, Dr. George M. Gatero

CPD in Healthcare -Trends  Common practice across all cadres i.e. physicians, dentists, nurses, clinical officers, pharmacists, medical lab techs  Includes both formal/structured and also informal & self directed.  Often regulated and accredited by their respective regulatory bodies (awards CPD points for monitoring).  One of the main factors considered during practice license renewal  Each respective regulatory body have their own CPD guidelines

Sources of Medical Information  Professional colleagues: consultation from colleagues and other medical specialists  Pharmaceutical representatives: research as relates to drugs.  Textbooks and journals: Pocket handbooks are common especially by registrars and interns e.g. BNF  Internet and e-journals: Internet and e-journals also serve as important sources of information for medical doctors. -Medical meetings: valuable source of general medical information. Source: Utilization of ICTs for Accessing Health Information by Medical Professionals in Kenya: A Case Study of Kenyatta National Hospital -Journal of Health Informatics in Developing Countries, Dr. George M. Gatero,2010

HCP Distribution in Kenya (Doctors)  Uneven distribution of doctors in the former 8 provinces:  32% Nairobi (hosts only 8% of the national population),  18% - R.Valley,  14% -Central,  11% - Eastern,  9% - Nyanza,  8% - Coast,  6% - Western,  2% - North Eastern (hosts 6% of the national population)  78.7% of Kenyans living in rural areas have access to less than 21.3% of doctors. (AFHWO-HRH MoH IPPD Date 2009)  Ratio of Doctors to population served in Kenya(2013): 21:100,000 ~ Approx.1: 4762 (WHO standard - 1:600)

KMA Daktari Online  e-learning platform for healthcare workers and the public in general on health issues.  Medical Practitioners and Dentists’ Board (MPDB) requirement for CPD of Medical doctors.  Legal prerequisite for retention in the MPDB register.

Background  Health workers are fundamental to ensuring equitable access to health services and achieving universal health coverage.  Kenya continues to experience a severe health workforce shortage resulting from lack of adequate training and migration (brain drain).

Background  57 countries face critical health workforce shortages  WHO estimates that 2.4 million healthcare workers are needed to meet the Millennium Development Goals(MGDs) set for 2015.

Background  57 countries face critical health workforce shortages  WHO estimates that 2.4 million healthcare workers are needed to meet the Millennium Development Goals(MGDs) set for 2015.

e-Learning  eLearning is used increasingly in health care to support the delivery of learning in outcome-based education.  Broadly speaking, eLearning is considered to be the application and integration of educational technology to the learning process.  eLearning approach is defined as learning with no face-to-face component that relies entirely on the use of eLearning technology and techniques for its delivery

Why Doctors Seek Information?  Backing up prescribing decision (drug administration & effects)  Support the roles and tasks related to teaching and research activities  Maintain their competence throughout their career  To meet the legal requirement for continuous licensing. To improve the management of patients  Provide better patient care service and keep up-to- date with the current trends in medicine  Effective diagnosis hence treatment

Limitations to Information Access  Lack of resource centers and hospital libraries  Lack/few of computers and internet facilities within workplaces  Relevance of internet information to the local context  Lack of local medical reference works in libraries  Lack of general awareness of available information  High costs of subscriptions to journals  Accessibility of information from locations outside the hospitals vis-a-vis their schedule of work

Objectives of Daktari Online The main objective of Daktari Online is to fill the gap of the lack of a reliable and accessible Continuous Professional Development (CPD) tool within the medical fraternity.  Provide a platform for online consultation, reference and publishing of local research/cases  Provide a reliable, localized public online medical education platform  Capacity building of health workers to ensure improved quality of care to the public.

Daktari Online Services Daktari Online (Public) First Aid Symptoms Checker/Drug InteractionDisease ManagementPatient RightsHealthcare Facilities & CentersMedical Financing ServicesMedical Specialists Directory Daktari Online Pro (HCPs) CPD/CMEsReferencesPublicationsEventsTrainingAwareness Campaign

 Help improve understanding of medical conditions, diagnosis, disease, or disability.  Help improve understanding of methods and means to manage multiple aspects of medical condition.  Motivation to comply through effective communication and patient education  Patient Outcomes – Patients more likely to respond well to their treatment plan – fewer complications. Daktari Online (Public)

 Help patients make informed Consent by providing the information they need.  Utilization – More effective use of medical services – fewer unnecessary phone calls and visits.  Satisfaction and referrals – Patients more likely to stay with your practice and refer other patients.  Risk Management – Lower risk of malpractice when patients have realistic expectations

Quality of Content  KMA CPD, Ethics and research committee  Daktari Online editorial board  Accreditation by the MPDB and other regulatory bodies

 Platform development backed up with over 3 years of research of Medical Education in Kenya  Our partnership with Kenya Medical Association with a membership of over 2000 doctors countrywide  Platform for doctors piloted for the 12 months Daktari Online Status

 Over 1000 registered doctors from over 41 different counties representing over 48 different healthcare institutions  Accredited online platform by the medical board to offer online CPD activities  2.5million hits in December 2014 i.e hits by day

Daktari Online Status

Opportunities For Partnership  Platform for sharing of CMES from different CME providers  Implementation of similar CPD program other HCP cadres  Content research and development for the Daktari Online wellness platform for the general public  Publishing opportunity with available peer review

Target HCW Categories Daktari Online Pro (HCP) Physicians (6000)Dentists (700)Nurses (65,000)Clinical Officers (8600)Pharmacists (2000)Medical Lab Technologists Paramedics

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