1. Towards Personal Connected Health in SA
eHealth AFRO, Oct 2017
Dr Peter Benjamin

2. Vision of Personal Connected Health for NHI
South Africans are empowered to take care of their own health and access appropriate health services through personal connected health.
1. Support individuals, families and communities improve their own health
2. Accessible health services (DOH in NHI)
Use personal mobile tech (94%) – Next stage of mHealth
Respect to all work on eHealth & telemedicine for diagnosis, treatment, informatics, health system efficiencies

3. WHO definition of health
“State of complete physical, mental, and social well being, and not merely the absence of disease or infirmity”

4. Health is more than healthcare

5. Service & linkage to care Outside health-service
Buildng blocks to PCH
Service & linkage to care
Outside health-service
Integration of services
Policy & coordination
 Coherent national PCH in foundation of NHI

6. Digital Health for Health system Telemedicine eHealth HIS
Links to but separate from HIS
Digital Health for Health system
Telemedicine
eHealth
HIS
Point-of-care

7. Vision of Personal Connected Health for NHI
Health Field
Program area
A1. MomConnect expansion
Maternal health
Service & linkage to care
A2. Health information for all (Wikihealth 100 x 100)
Health promotion
Outside health-service
A3. Personal diagnostics linking to healthcare
A4. Service-access to support survivors of gender-based violence
Female health & violence
A5. Integrated health app
All (initial focus on MCH)
Integration of services
A6. Assessment of all patient-facing digital health services
All
Policy & coordination
A7. Last mile of PMTCT
A8. Smoking cessation “StopSMS”
Health promotion
Respect to all work on eHealth & telemedicine for diagnosis, treatment, informatics, health system efficiencies

8. Testing: Usage of health information when accessible
Health Information for all
Testing: Usage of health information when accessible
WikiHealth 100 x 100
100 most important health issues as approved Wikipedia-style articles
100 languages
Mobile as way to link
Develop in SA languages, available

9. Testing: Usage of personal diagnostic tools
Personal diagnostics
Testing: Usage of personal diagnostic tools
Hypertension serious issue in pregnancy (pre-eclampsia etc)
Blood pressure monitor: via App?
In facilities, high-risk women with smartphones
Daily SMS encouraging test; record data
Respond as indicated
Trial

10. Test: Use of mobile for individual and community response to crisis
Gender-based violence
Test: Use of mobile for individual and community response to crisis
Link to care servics after attack
Notifications to friends
Mapping of services
SMS messaging follow-ing

11. lth, South Africa

12. Test: New model for Health System interaction with population
Next steps for MomConnect
Test: New model for Health System interaction with population
WhatsApp/text interaction
Link to care, Integrated with Road To Health Booklet, continuum of care
One integrated helpdesk for all SA DOH

13. Vision of Personal Connected Health for NHI
B1. Pre-emptive health
H promotion
Outside health-service
B2. Supporting community mobilization on social determinant
B3. Health as a human right
All
Patient empowerment
B4. Community ambulance
Emergency
Linkage to care
B5. Adherence support: diabetes
Non-Comm diseases
Service & linkage to care
B6. Medical callcentre
Emergency linkage to care
B7. Innovation framework for new health content and services
Policy & innovation
B8. Policy for integrated personal connected health
Policy & coordination
B0. Pre-loaded on smart phones
All (initial MCH)
Integration and innovation
Respect to all work on eHealth & telemedicine for diagnosis, treatment, informatics, health system efficiencies

14. Partnership towards PCH
A partnership to plan, implement and evaluate projects; support policy developments and build a community of practice in South Africa to realise the vision of Personal Connected Health for all in SA by 2022.
Led by DOH (Ministerial Advisory Committee eHealth)
Collaboration of health implementers, NGOs, private sector, suppliers of digital health systems, researchers, donors and other related organisations.
Respect to all work on eHealth & telemedicine for diagnosis, treatment, informatics, health system efficiencies

15. EFFECTIVE COVERAGE INTERVENTION OF KNOWN EFFICACY Thanks to:
Alain Labrique, JHU
Jo Y, Labrique AB et al. In Press 2013

16. EFFECTIVE COVERAGE INTERVENTION OF KNOWN EFFICACY
mHEALTH: A Health Systems Catalyst
EFFECTIVE
COVERAGE
POOR DEMAND FOR SERVICES
DRUG OR SUPPLY STOCKOUT
FAILURE TO FOLLOW GUIDELINES
INTERVENTION
OF KNOWN EFFICACY
Thanks to:
Alain Labrique, JHU
Jo Y, Labrique AB et al. In Press 2013

17. DETERMINANT LAYERS OF UHC
And begin to align mHealth strategies with the post-2015 agenda to achieve universal health access (Labrique & Mehl, 2015)
DETERMINANT LAYERS OF UHC
mHealth Strategies
COST
Financial Coverage H H
Mobile financial transactions
Decision support, POC diagnostics, Telemedicine, Reminders, Incentives
Persistent electronic health records, Provider- to-provider communication, Work planning, Reminders
Behaviour change communication (BCC), Incentives
Hotlines, Client mobile apps, Client information content subscriptions
Human resource management, Provider training, Telemedicine
Supply management, Counterfeit prevention
Client registration, Electronic medical records, Unique identifiers, Data collection and reporting, Screening tools, Civil registration and vital events
QUALITY
Effective Coverage G G
DEMAND
Continuous Coverage F F
Contact Coverage E
Accessibility of health facilities E
SUPPLY
TARGET: universal effective coverage of health interventions of known efficacy D
Availability of human resources C D
Availability of commodities and equipment B C B
AVAILABLITY
Accountability coverage A A
Target population
Total population
Current gap in determinant performance
Illustrative mHealth strategies to close performance gaps
Minimum performance of supply determinant

18. technologically boring”
“These tools don’t get
socially interesting
until they’re
technologically boring”
(Clay Shirky, 2010)
© Cell-Life 2010 18