Project Lead(s): Pratap Kumar
Issue
There is a large and growing disparity in access to specialist care in urban versus rural areas of countries like Kenya.
With no incentives for specialists to serve outside Nairobi, this disparity is only likely to grow, leaving poor rural patients facing huge barriers to access specialist care.
Solution
The project sought to enable remote second-opinion consultations with volunteer specialists, and to provide patients with information on locally available resources, thus empowering them to access appropriate care.
Health-E-Net’s second opinion program, ‘Ushauri wa Pili’ (UwP), offers patients in Kenya easy access to specialist medical opinions via an electronic platform.
Operations focused on primary healthcare facilities in Nairobi’s urban slums, as well as individual patients in and near Nairobi.
The project involved the development of a web-based solution for conducting remote medical consultations.
The platform performs three major functions:
1. Provides a user-friendly interface for nurses to create and structure an electronic medical record
2. Provides an intuitive interface for remote specialists to review a medical record
3. Uses the documented medical record to form the basis of a phone consultation.
Each remote consultation delivered by Health-E-Net involved the following stages:
1. Lead generation (directly or via partners)
2. Initial patient contact (to determine suitability for remote consultation and history-taking)
3. Data digitization and entry into the platform (including data retrieval)
4. Identification of specialists and sharing of case record
5. Phone consultation and specialist report.
Outcome
There were 20 phone consultations held in the 34 cases documented on the platform, ranging from neurology and neurosurgery to rheumatology and otorhinolaryngology.
Of the remaining 14 cases, 5 are ongoing cases and, in 9 cases, a phone consultation was not achieved, usually because of lack of data needed for the consultation.
Health-E-Net was successful in creating a volunteer network of over 70 specialist doctors globally. They include retired specialists, diaspora doctors, doctors participating in medical missions, and consultants and trainees in global health residency programs.
In November 2015, Health-E-Net was awarded a grant of GBP 250,000 ($505,032 CAD) from the UK Department For International Development’s County Innovation Challenge Fund to extend the remote consultation service into Turkana, to support maternal and newborn health.
They have been granted a Utility Model Certificate (similar to a patent) for the technology in Kenya and a Patent Cooperation Treaty (PCT) application has been filed.
The platform continues to be developed, with the latest phase of development including the creation of a tablet-based version of the platform, real-time chat functionality and built-in VOIP (voice over Internet Protocol) calling.
These improvements are expected to make the platform a truly mobile health application that can be deployed in remote settings at very low cost, compared to traditional telemedicine.