of the many problems hindering HealthCare digitization in Nigeria

Categories Health Technology, Thoughts

“Things may come to those who wait, but only the things left by those who hustle.” -Abraham Lincoln.

Permit me to substitute the word “work” for “hustle” in the above quote. I often wonder if we have to play catch up in everything while dwelling on things that other developed nations have or are already successfully moving away from. I believe that if we work in the right direction, our transition from the “catch-up” phase to the “racing-with” phase will be seamless and faster than we might have ever thought. In this short article, I will be highlighting three issues which I think are presently militating against development in the HealthCare-IT space especially as regards its adoption and benefits.

I focus on HealthCare-IT not only because I am a trained medical professional but because I have worked with some of them as a Software Developer. In addition, I have also gathered experience over the years while working on CareMedica and other HealthCare-IT solutions. Currently, there are a number of indigenous solutions in the HealthCare-IT space covering several issues such as maternal health, blood bank, health insurance, personal health records. I am of the opinion that existing solutions need to be maximized while more solutions need to be created. There are several factors militating against the actualization of a progressive digitized healthcare, some of these factors will be highlighted in this paper with the hope that it will spur discussion that will lead to a change in the status quo.

Digitization of HealthCare has its advantages and drawbacks. I am however of the opinion that the advantages far outweigh whatever disadvantages that presently exist. Some of which have been discussed extensively in this overview. I will look at these issues from the perspective of a healthcare service provider’s problem.

Will / Expertise?

Digitization of medical activities depends heavily on the computer literacy level of the service providers. A larger percentage of the few healthcare organizations I have been privileged to come across and work within the past are chaired or owned mostly by mostly owned by persons from older generations who are wary of fully embracing digitization. With the majority of the private healthcare service providers being controlled by this set of people, the chance of successfully implementing any form of digital approach might remain very minimal as some even term it “Laziness”. It is hoped that in the nearest future when younger people who are more open to information technology become key players in the healthcare sector, there will be a positive change in trends.

In few cases, we have had to rework the general user experience of CareMedica before and after initial deployment based on user’s preference but I must still mention it that the lack of will of an average healthcare worker to adopt the digital approach to his/her work cannot be overemphasized. This is more so because a “notable” percentage still view it as a way to reduce the importance of their task(s) rather than viewing it as a viable means to improve their productivity. The reluctance to adopt digitization is due to their lack of expertise, un-readiness to learn a modern way of doing things and the misconceived notion that their jobs are threatened by the process. It is therefore obvious that to digitize any healthcare set up, both top-level management and employees must be sensitized about the advantages of the process in order to ensure that misconceptions do not discourage adoption.

an observation chart sample (via CareMedica)

Any organization seeking to digitize must at a preliminary stage, consider these issues so as not to waste limited resources that might be committed to the process as this can frustrate the solution provider and hinder implementation.

To prepare employees for the digitization process Healthcare organizations can organize related training(s) for their employee or where convenient encourage and sponsor them seek external training within a stipulated. The human resource management department may also factor in and prioritize computer literacy with a set proficiency level in its subsequent recruiting criteria. While some Heads of HealthCare setup have shown a great commitment towards going completely paperless, I will also advise that digitization can be best achieved gradually in stages. This will members of the organization a chance to become familiar with and increase expertise in the new approach.

Infrastructure.

The core infrastructural requirements for the successful digitization of any healthcare setup is a reliable computer network and “POWER”. Epileptic power supply remains a recurring issue in Nigeria. To bypass this problem, a few healthcare setups are adopting alternative renewable energy options at a great cost. Owing to the increased costs incurred by providers from having it rely on alternative sources of power, one may argue that the growth of the healthcare digitization market may be stalled owing to the high cost of maintenance. A company seeking to be digitized must first address her power issues before starting the digitization process as resources will be greatly wasted if this issue is not resolved early. The cost of setting up a computer network is arguably the easiest in the whole healthcare digitization process as its mode and type are always more of a function of preference and capital provided by the organization and less of the solution’s requirements.

As has been stated, setting up a computer network is very easy as it can be scaled up to the desired level at any point in time when deemed necessary. The cost of setting up a renewable source of energy can, however, be very expensive but that seems like the only feasible option at the moment for any healthcare so as to avoid any issue in terms of availability and reliability.

Policy Implementation?

The vision of the National Health ICT Strategic Framework (2015–2020) vision statement read thus “By 2020, health ICT will help enable and deliver universal health coverage in Nigeria.” While the 2014 National Health Act states that:

(1) The Federal Ministry of Health shall facilitate and coordinate the establishment, implementation and maintenance by State Ministries, Local Government Health Authorities and the private health sector of the health information systems at national, state and local government levels in order to create a comprehensive National Health Management Information System.

(2) The Minister may, for the purpose of creating, maintaining or adapting databases within the national health information system desired in subsection (1), of this section prescribe categories or kinds of data for submission and collection and the manner and format in which and by whom the data is to be compiled or collated and shall be submitted to the Federal Ministry of Health.

Also,

(1) All private health care providers shall:-

(a) establish and maintain a health information system as part of the national health information system as specified under section 35(1) of this Bill; and

(b) ensure compliance with the provision of sub-section (1)(a) as a condition necessary for the grant or renewal of the Certificate of Standards.

There is currently no data documenting the implementation of the road-map and the act which should serve as the backbone of the digitization process. Despite these challenges, I will love to encourage all our medical professional bodies to continually demand the full implementation of the Health Act as well as other supporting policies deemed fit to move digitized healthcare in the right direction.