Integrated Digital Health Systems for everyone

Evolution, just like children´s growth is not linear, but happens in steps. In this evolution, technology has contributed in making these steps much bigger. Some technologies represent a radical improvement in the development path of humanity

One of the most recent examples would be the arrival of the Smartphone and the changes this technology made possible. Changes that become very visible if we travel to the African Continent and observe the changes that happened there during the 2010´s. This technology allowed hundreds of millions of people to make generational jumps in social development in a few short years, radically improving access to banking, ecommerce, and education – to name just a few examples. These changes contributed to the development not only of individuals, but also meant greater equality in the access to opportunities, generation of wealth, improved access to education, health and participation in democracy.

In the healthcare arena, a similarly disruptive technology platform is poised to radically transform access to quality healthcare for hundreds of millions of people. It is more on the “back end” than a smartphone, but the HL7 ® FHIR ® standard and related tech is about to revolutionize medicine all across the continent and the @Nexplain Group is playing a leading role in this process.

So, what is this technology all about? The simplest summary is that it is a Digital Health Record, accessible to all and everywhere. But there is a lot more to it as this article will explain.

Before we get into the details, a quick word on what is behind the emergence of this technology: The HL7® FHIR® platform existed prior to 2020, but it was mostly hidden in clinics and hospitals and of course mostly in the Global North. It was the COVID pandemic that forced an explosion of technological development to improve access to digital health records for all. This is where we come in: the Nexplain Group identified the HL7® FHIR® standards are a key element to building an easy access system to digital healthcare for all, right at the beginning of the pandemic. We invested in development without knowing exactly where it would lead and now we have the ImmuvID ® Platform – Access to Digital Health for all. More about ImmuvID ® in a minute, first, here are some basics:

Access to Digital Healthcare in Africa, challenges and opportunities

Challenges

Less than half of the population in Africa has access to the healthcare they need. This means that more than 600 million people are not receiving basic care.

For obvious reasons donor focus has been on fighting the spread of communicable diseases, but due to a lack of integrated systems, these efforts have largely been in silos.

According to GSMA, good quality, mobile, internet connectivity is still out of reach for almost 70% of the African population. And the cost of mobile connectivity is increasing leading to a growing usage gap: even though more people are being connected the whole time, the equivalent growth in use is declining because of cost

Opportunities

There are two major opportunities:

Digital pioneers: the ability to start (almost) from scratch: This might be the most important characteristic that sets Africa up for explosive growth in digital healthcare: the ability to plan digital architecture on a blank page. Unlike most developed economies in the North, many countries in Africa are at the beginning of their digital journeys meaning that they do not have the frankenstein-like legacy systems that have been developed over the course of the last decades. This leads to the ironic reality that it will be a lot easier for Mauritania to offer the most recent, cutting edge digital access to healthcare to its citizens than Spain, the UK or Germany

The World Bank and African Development Bank estimate that there are some 650 million mobile phone users in Africa, a continent with a population of over 1.3 billion people. According to another recent GSMA report, this is changing very fast now: The mobile market in the region will reach several important milestones over the next five years: half a billion mobile subscribers in 2021, 1 billion mobile connections in 2024 and 50% subscriber penetration by 2025. This means that the ability to use a phone to access digital health records will be secured for most of Africa over the next 3 years. A major breakthrough!

HL7® FHIR®

The HL7® FHIR® (Fast Healthcare Interoperability Resources) standard defines how healthcare information can be exchanged between different computer systems regardless of how it is stored in those systems. It allows healthcare information, including clinical and administrative data, to be available securely to those who have a need to access it, and to those who have the right to do so for the benefit of a patient receiving care. The standards development organization HL7® (Health Level Seven® ) uses a collaborative approach to develop and upgrade FHIR. So, in summary, HL7® FHIR® is the digital framework that allows for a scalable, fully accessible digital healthcare system to be developed

SMART Health Card Standards

SMART Health Cards are verified versions of clinical information, such as vaccination history, test results or digital access to radiological fidnings. They allow you to keep a copy of your important health records on hand and easily share this information with others if you choose. SMART Health Cards contain a secure QR code and may be saved digitally or printed on paper and, of course, on your phone! Again, there are International Technology Standards behind SMART Health Cards, allowing for free and scalable solutions to be developed

ImmuvID ®

ImmuvID is the digital product suite the Nexplain Group developed to make access to Digital Healthcare easy and accessible for all. ImmuvID integrates both the HL7® FHIR® as well as the SMART Health Card standards allowing for mobile access to digital health records from anywhere in the world! And, we have specialized the platform to allow for significant offline functions – very relevant for the realities of healthcare in Africa!

What these new standards and technology like ImmuvID means for Africa

The new technological standards and platforms like ImmuvID means:

Access to almost any part of your health/clinical record, on you phone, allowing you to securely share the data as you wish (most notably – you can share OFFLINE!!)
Healthcare professionals can interact with integrated digital health records from any device and even when they are not connected to the internet. More access to data, more precise information = better care
Administrators have a real time overview of activity in the system because of the integrated and interoperable nature of the standards. This helps to identify challenges before they become problems
Health departments and international organizations have better access to real time data that can be analyzed and mixed with other demographic information in order to identify outbreaks of disease as it happens. This type of intelligence is crucial in fighting communicable disease
The cost of healthcare administration is reduced through the digitization and optimization of processes