Blockchain and eHealth are a perfect match. Countries of the East African Community namely Tanzania, Uganda, Rwanda, Kenya, South Sudan and Rwanda have set a goal of pursuing telemedicine and eHealth in general as one of the principal pillars of the long-term respective healthcare strategies. This is commendable for a whole number of practical realities.
The Kenya Experience
In Kenya, the government, with the support of the United Nations system in the country is spearheading the Sustainable Development Goals (SDGs) Partnership Platform. The platform is envisioned to be a vehicle for driving public-private collaboration and innovations for realisation of what has been dubbed as the country’s ‘Vision2030’ and SDG goals.
Key objectives for the country’s health policy 2014 – 2030 which underpin Vision2030 are:
- Elimination of communicable conditions
- Halt and reverse the rising burden of non-communicable conditions
- Reduce the burden of violence and injuries
- Provide essential healthcare
- Minimise exposure to health risk factors
- Strengthen collaboration with private and other health-related sectors
In 2009, Rwanda launched the Integrated Health Systems Strengthening Project (IHSSP). Prior to this, the multiple systems used to gather, aggregate and analyse the information were rather rudimentary and, crucially, they were not interoperable. In fact, the system was not even web-based. Data aggregation involved each of the country’s 450 Health Centres entering their information in local databases and each month sending a flash drive with the information to one of the 40 district hospitals. The hospitals then imported the data and used the same system to send district data to the central level.
IHSSP in collaboration with the Ministry of Health built the Rwandan Health Management Information System (R-HMIS). The system was rolled out nationally in 2012. Using DHIS-2, a free and customisable web-based software platform, the system allows Health Centres to enter their information directly into the national database and view charts and graphs showing trends in their data over time.
The system is a vast improvement at a public health level and is commendable. However, this still leaves the individual patient facing the same old challenges. Rwanda has been at the forefront in actively seeking to exploit technology in a bid to improve healthcare delivery. It is the first African country to register, launch and promote the use of an artificial intelligence (AI) system as a digital healthcare provider. Babyl Rwanda has proved very popular in a country with a severe shortage of medical personnel, a situation found in every country in the region. A lot more can be done to build on this in efforts to improve both access and quality of healthcare and blockchain technology holds that promise
Tanzania has had a 5 year eHealth strategy which was launched in 2013 and this is due to conclude later in 2018. The strategy had modest ambitions, a reflection of the time of its conception and the overall healthcare strategy. ICT was seen as a vehicle to streamline and improve administrative processes (e.g., in planning and reporting) and for establishing electronic patient files. TeleHealth was envisioned as a way of communicating with the population mainly through web portals but also for the possible use of SMS text messages. ICT was also seen as having a role in teaching, training and communicating with professionals in the health and social welfare sector.
A successor strategy is on its way. This gives policymakers the opportunity to be a lot bolder and put blockchain technology at the centre of the new strategy. Many of the challenges that healthcare services face can be alleviated to a significant degree with the embrace and deployment of this technology. This holds the key to delivery of a better quality, cheaper and more accessible service to people including those who are geographically remote.
Telehealth forms one of the central planks of the current national Health Sector Strategic Plan (HSSP-IV; 2015 – 2020).
With all these countries striving to deliver good quality, accessible and equitable healthcare to their people, blockchain technology provides a golden opportunity to realise those ambitions. Indead, blockchain and ehealth are a perfect match.