Saturday, May 2, 2009

Why EHR in Africa is so important

Over the last few months, I've been thinking a lot about Africa. Not just in general terms of 'oh wouldn't it be nice to go there' but in more serious terms of 'what can I do to help' as I watched story after story of poor health care, war, and malnourishment. It seems with every breaking news day, the continent that birthed our civilization takes one step closer to mass extinction. As the CEO of a medically focused company, I have continually looked for ways that we could help this beautiful continent, or at least some small sliver of it, move forward and grow and I believe that addressing the health care crisis that grips Africa right now is the best way to do that.

By nearly all accounts, African nations have some of the most devastated and weakest health care systems in the world. Brutal war, civil unrest, AIDS, and a people in near constant movement, have all conspired to bring some countries health care systems to their knees. Doctors, in the areas where there are doctors, often don't have access to the proper drugs, training, or patient information and it's often the case that these healers can do nothing more than provide comfort as thousands of their countrymen die.

Of all the challenges facing medical professionals working in Africa, I believe one of the biggest and most pressing is the access to patient information. When a patients presents themselves for treatment, the doctor must often rely on bits and pieces of the patients memory and weave together some idea of a medical history. If that patient is unconscious, the provider must often take a 'best guess' approach, not knowing anything about allergies, drug reactions, and all those other things that make not killing the patient a little easier. It can be a big job and a heavy weight but these brave doctors face that challenge every single day and, overall, do a remarkable job treating their patients.

But I believe more can be done. Better access to patient information can be achieved even in the most war torn regions of the continent and I believe the answer to the problem is the same one the medical communities in the USA, Europe, and other countries are exploring: electronic health records (EHR).

Using a nationalized EHR system, doctors could immediately look up the entire medical history of any patient presenting themselves and immediately make better decision based on that information. A widespread system would also allow medical professionals to easily share data with their colleagues across town or around the world, and could help them spot developing health trends before they become national epidemics.

Imagine the lives that potentially could have been saved if doctors in some of the highly AIDS ravaged areas could have quickly shared information and tracked the AIDS crisis as it developed. The response from public health would have been quicker and the crisis might not have become so widespread so quickly. The same is true with the recent Malaria outbreaks in places like Zimbabwe where thousands of people were needlessly taken by the disease.

Live could be saved.
Serious illness could be lessened.
Medical education could be improved.

And it doesn't have to cost billions of dollars.

I don't believe most existing EHR systems are right for Africa because they rely too much on things Westerners take for granted like electrical power or network connectivity. To be truly successful, the right solution needs to be unique to the African region. It must live in its environment and work within the limitation and challenges of that environment. It has to be different and it has to add value to the care provided and help doctors make better decisions.

Now is the perfect time for such systems to be deployed. The technology is cheap, labor is available, and there is a growing populace who are increasingly wanting to help in any way they can. The time is definitely right, so why isn't their a bigger interest in EHR in Africa?

Simple: money.

When an EHR vendor in the USA or Europe sells a package, they often make thousands or hundreds of thousands of dollars. That simply isn't realistic in African countries where, many times, international grants need to be obtained just to purchase the technology. If an EHR company isn't also invested in the social aspect of the business, Africa just doesn't make sense.

You won't make money in Africa, you won't have huge profit margins and high support rates. The best you can hope for is to help save a few thousand lives and make a change in the culture you serve.

That takes something more than money. That takes dedication. That takes a sense of social responsibility that extends outside of profit margins.

That takes humanity.