Vodafone PowerTalks

Kampala Serena HotelMarch 31, 2016

You’re Welcome!

Vodafone PowerTalks

Uganda’s eHealth Situation

Vodafone PowerTalks

Vodafone PowerTalks

CASE STUDY: Driving Health Impact with Mobile Tools by LivingGoods

© Alfred Wise, Country Director, Living Goods Uganda.

Stealing from Avon to Serve the PoorCollaborating with BRAC under the BRAC-Living Goods

Partnership

Driving Health Impact with

Mobile Tools

Living Goods: addressing key challenges in community healthQuality and performance

management

Health worker incentives and

motivation

In-stock supply chain

Vodafone PowerTalks

Women, Health & Ict

© Bonita Beatrice Nanziri, Founder AfriGal Tech

This Is Me…

HELLOO…….

Bonita Nanziri

Founder Afrigal Tech

WOMEN

HEALTH

&

ICT

3.4 Billion Women in the World...

HEALTHY

WOMEN;

HEALTHY

WORLD!!

ICT – What’s the big deal??

Reduce administrative

costs

Increase qualityof care and efficiency

Increase patient security and data

protection

enable entirely new modes of

care

Reduce operating costs of clinical

services

ICT

& WOMEN’S

HEALTH

Technology EvolutionUSSD Applications, Mobile Applications (Android, IOS)

Increased EfficiencyPlanning ahead & Multi-tasking

OpportunitiesNGOs, Tech Start-ups, Online &

Offline campaigns

Increased Life ExpectancyDiagnosis and Prevention Based

Technologies

Decision SupportResearch forums, calendars,

online doctors

Partner SupportIn long distance relationships; chat-rooms Skype, Google+, Whatsapp

Community SupportDiscussion forums, blogs, help

lines

WHAT IS BEING DONE IN

UGANDA??

Margaret Nanyombi, Jackline Namanda, Esther Ndagire, Pauline Nairuba & Bridget Mendoza (not pictured)

BV KITAn application that allows women to

self-test for bacterial vaginosis

WINSENGAA smartphone-based ultrasound

alternative.

Cipher256 Pioneer Team (2012)

Afrigal Tech Pioneer Team (2015)

MDEXAn application that helps people

test for sickle cells

THE CANDLE HAS

BEEN LIT…

SOME WILL FOLLOW THE

LIGHT…

SOME WILL DIM THE

LIGHT…

BUT………..

THERE ARE THOSE

THAT WILL ALWAYS

WORK TO KEEP THE

CANDLE LIGHT

BRIGHT!!!

Vodafone PowerTalks

Kampala Serena HotelMarch 31, 2016

CASE STUDY: Electronic Health (Dental) Records at The Dental Studio

© Dr. Okello Aliker, The Dental Studio, Uganda

Changed more than ever-before in last

century

Move from curative to cosmetic care

Infection control and cosmetic dentistry

has spurred modernization of practice

infrastructure

© Dr. Okello Aliker, The Dental Studio, Uganda

© Dr. Okello Aliker, The Dental Studio, Uganda

Before Cosmetic Makeover After Cosmetic Makeover

© Dr. Okello Aliker, The Dental Studio, Uganda

Before Cosmetic Makeover After Cosmetic Makeover

1980s > Outside to inside the practice

1990s > Administration to clinical applications

2000s > Clinical records and x-rays

2010s > CAD/CAM and Mobile applications

© Dr. Okello Aliker, The Dental Studio, Uganda

Technology increasingly pervasive

Rise of the patient as a consumer and

determiner of own health

Medical record ownership

Medical tourism and mobile lifestyles

© Dr. Okello Aliker, The Dental Studio, Uganda

Digital photos and x-rays

Electronic health records

Medical-legal documentation

CAD/CAM outsourcing dental crowns

© Dr. Okello Aliker, The Dental Studio, Uganda

“Medical errors are responsible for injury in

as many as 1 out of every 25 hospital

patients….estimated 48,000-98,000

patients die from medical errors each

year. Errors…estimated to cost…$17 to

$29 billion each year.”

Source: Agency for Healthcare Research and Quality, US DHHS

© Dr. Okello Aliker, The Dental Studio, Uganda

© Dr. Okello Aliker, The Dental Studio, Uganda

© Dr. Okello Aliker, The Dental Studio, Uganda

© Dr. Okello Aliker, The Dental Studio, Uganda

© Dr. Okello Aliker, The Dental Studio, Uganda

© Dr. Okello Aliker, The Dental Studio, Uganda

© Dr. Okello Aliker, The Dental Studio, Uganda

© Dr. Okello Aliker, The Dental Studio, Uganda

© Dr. Okello Aliker, The Dental Studio, Uganda

Before Cosmetic Makeover After Cosmetic Makeover

Patient safety

Doctor peace of mind

Cost and time savings

Product consistency

Leverage customer relationships © Dr. Okello Aliker, The Dental Studio, Uganda

Cloud-based

Interactive

Mobile application

Cashless payments

3D printing

Relationship based

© Dr. Okello Aliker, The Dental Studio, Uganda

Okello Aliker

Dental Studio Uganda

@OkelloAliker

@dentalstudioug

© Dr. Okello Aliker, The Dental Studio, Uganda

© Dr. Okello Aliker, The Dental Studio, Uganda

Vodafone PowerTalks

CASE STUDY: mVaccination and E-

learning

© Nathan Wasolo , Route to Market Lead, GSK Uganda

An overview of mVaccination

and e-learning

Nathan Wasolo

ICT’s Impact on healthcare

1. Improving the functioning of healthcare systems

• Information systems: patient records, tracking disease prevalence,

monitoring drug supplies, re-ordering system and billing

2. Improving healthcare delivery

• Telemedicine: consultations for remote locations

• E-learning

3. Improving communication around health

• Social mobilization for health campaigns

• Information dissemination during disease outbreaks

78

GSK’s involvement locally

1. mVaccination in Mozambique

2. E-learning in Uganda

79

mVacciNation Strategy and Structure

80

mVacciNation Strategy

81

Phase 1: One Year Pilot in Mozambique aims to support EPI to:

1. Increase demand for vaccines and reduce non-compliance to vaccine

regimens

2. Improve coverage and reduce inequalities in coverage through better

informed management of EPI systems and resources

3. Mitigate the effects of supply constraints through improved stock visibility

4. Reduce safety risks associated with ineffective cold chain through increased

monitoring

5. Improve quality of administrative coverage data by replacing paper-based

systems at point of service delivery

Phase 2: Develop scale up and replication plan through leveraged support from

GAVI and USAID

GOAL: To transform access to vaccines in developing countries through use of

mobile technologies and with the support of key global stakeholders.

Partner Commitments

82

1. GSK and Vodafone MOU

a. Signed December 2012

b. 50/50 Partnership Agreement

c. £143,000+ committed each

2. USAID and GAVI funded Randomized Controlled Trial

a. Agreed 2013

b. $1.2 million committed by USAID

c. $300,000 committed by GAVI

d. Some funds, ~$75,000 each, committed by GSK and

Vodafone

mVacciNation Flow: Vaccination Tracking

Caregivers bring

children to the

clinic for

vaccination.

The vaccination

nurse completes

the vaccination

The vaccination

event is

captured on a

smart phone

Data is

synchronized

with the Cloud

(servers hosted

in-country)

Caregivers

receive a

reminder to

return for the

next vaccination

START

mVacciNation Outputs

84

Output Data – October 2015

85

Through 5 pre-pilot facilities launched in January 2014

• 35,000+ unique children registered

• 55,000+ vaccination visits captured

• 110,383+ immunizations captured (by antigen)

• 4,151+ stock updates performed (average of 3 per week per

clinic)

• 1,582 + temperature updates received

•https://vimeo.com/grosvenorfilm/review/141187648/e7fdccb1c0

Password: gsk

*A few clinics have not been providing regular updates which the team is working on

with the provincial and national MOH

Supporting the Training of Frontline Health Workers

The 20% Reinvestment Programme:

The Challenge

87

A chronic shortage of trained health workers in the world’s least developed countries.

In Uganda, the maternal and child mortality is 435 deaths per 100,000 live births with just 20,165 midwives and nurses serving a population of 33million people creating a ratio of 1:1,1818 creating a shortfall of the

recommended health staffing levels of 1: 439.

The Solution

88

• Train and upgrade midwives to diploma level using eLearning approach to improve health of rural and disadvantaged populations in Uganda.

• Launched in Feb 2010, we are now in second phase of the project:

Phase 1: 2011-2014Phase 2: 2015-2020

About the Project

Project Goal: To train midwives to a diploma (registered) level more rapidly to improve the health care of the rural-based and disadvantaged populations in Uganda.

Project Objectives:

• Design, test and implement a feasible eLearning solution.

• Build the capacity of Amref Health Africa in Uganda Country Office, Human Resources Directorates, ministries of Education and Sports, Health and Uganda Nursing Council.

• Use results to influence policy and replicate the programmes in Uganda and beyond.

Project Partners

Key Achievements

91

• 56 midwives graduated. 217 continue with studies, expected to graduate in May

2015 and May 2016.

• 12 nursing training schools supported to manage eLearning programmes and

provide computers.

• 150 tutors/clinical instructors/mentors trained in ICT skills and distance

education approach.

• 10 eCentres established around the country to increase access to reading

materials for student midwives.

• 22 course units of the midwifery diploma programme revised and converted to

eContent

• Development of Distance Education (DE) guidelines for eLearning. Will also act as blueprint for any nursing school interested in providing eLearning programme.

• Train 1000 enrolled midwives to registered diploma level.

• Train 960 tutors/clinical instructors.

• Conduct research to improve policy and Maternal and Neonatal Health programming.

• Train 300 mentors.

• Increase the number of eLearning implementing schools across

Uganda to 13.

Future Plans

92

Thank You!

Vodafone PowerTalks

CASE STUDY: Biometric Medical Scheme Management by Smart Applications

© Judy Mugoya, Country Manager Smart Applications

Corporate Philosophy

Our Purpose

● Creating a society of healthy people through easier, simpler

and faster access to healthcare

Our Objective

● To provide secure hassle free access to healthcare services

everywhere anytime

Our Pillars

Ethical – Responsible, Reliable, Secure

Accessible – Have Reach, Responsive, Efficient

Smart – Cutting Edge, Relevant, Adaptive

You – We understand You, We are about You

● We do this by making processes easy, fast and secure

98

Challenges in Managed Healthcare

99

Fraud

In Africa 40 to 60% of all medical bills are fraudulent.

● Providers pre-issued with membership list and claim forms

– encourage fraud

Impersonation by members at point of service

Justified ‘social medicine’ with sharing of photo cards

● Inability to manage membership & cancellations

Treatment over scope and limit of benefits purchased

No control on member benefit management in scheme period

100

Scheme Processes (Current/ Non Smart)

The Smart Solution

102

Smart Features

Contactless Microprocessor Smart Card

Smart data transmission equipment(delivery at best effort)Smart card and fingerprint

readers at point of service

103

Smart Journey

104

Smart Solution

● Efficient Member Management

Rules on benefits & benefit limits are managed

electronically

Member Cancellations and Activations are done remotely

● Smart Access

Control over access to only allowed service providers

● Online Controls and Management Information

Smart tools for real time reports on utilization

Reports on scheme indicators/trends for decision making

105

Technology and Managed Healthcare Convergence

HEALTHCARE MANAGER

Electronic Automated Scheme Processes & E-Data

Member Identification at point of Service

Biometric Smart cards

Scheme BenefitsManaged Via Smart Solution

E- Invoices & E-ClaimsElectronic Capture & Submission

Electronic Claims Submission

Electronic Claims processingE- Reconciliation &

E- Settlement

Automated & Electronic Feedback on Outcomes

Administrators & MSPsas partners

The Smart System:

107

Smart footprint in Africa

● Activate and install Smart system in requested

facilities

Smart footprint in East Africa is

379 - Uganda

1,978 - Kenya

379 - Rwanda

47 - South Sudan

Growing presence in Tanzania and Zambia

108

Value add service

● Web Integration

A web based Smart DIY Portal

Seamless access to the medical cover information through web platform

● Mobile application

Smart USSD mobile access capability (testing phase)

Members access their medical statements, balances and as well as the members’ utilization.

● Cross border servicing

Member access medical services in hospital installed with the Smart system across the East Africa region

Automatic conversion of member benefits into local currency for billing

109

Value add service

● Smart Price Control

Enforces pre-agreed prices (per scheme/category)

Electronic Billing by treatment type - consultation,

medication, procedures, labs

● Co-pay enhancements

Copay amount or percentage

Multi-point copay per visit

110

DrugsPrescription, dosage

ProceduresPrescription, dosage, change in treatment plan Diagnosis

ICD10 codesPast diagnosesCo-morbidities

DemographicsAgeGenderOthers

HospitalizationHospitalization eventsDays in hospitalHospitalization type: Inpatient, outpatient, ER

Un-structured dataEHR/EMRPhysician’s summaryTextual information

Patient features

Next Steps in E- HealthSMART CARD

DrugsPrescription, dosage

ProceduresPrescription, dosage, change in treatment plan

DiagnosisICD10 codesPast diagnosesCo-morbidities

DemographicsAgeGenderOthers

HospitalizationHospitalization eventsDays in hospitalHospitalization type: Inpatient, outpatient, ER

Un-structured dataEHR/EMRPhysician’s summaryTextual information

Patient features

Next Steps in E- HealthSMART CARD

113

Smart Clientele15

114

Smart Presence15

Smart Applications International Ltd.P.O. Box: 57776 - 00200, Nairobi, KenyaTel: 254 20 320 6000Cel: +254 733 320 600, +254 718 222 000 Email: info@smartapplicationsgroup.com

Smart Applications International (Uganda) Ltd.Nakawa Business Park Block A 3rd FloorPlot 3-5 Port Bell Road, P.O. Box 33947, KampalaTel: (+256) 312 555 300, 414 257 070, 703 251 525 Email: Info.ug@smartapplicationsgroup.com

Smart Applications International (South Sudan) Ltd. Tong Ping, Next To USA Residence, Plot 51 Off Airport Road, P.O. Box 113 JubaTel: +211 977 901 720, +211 977 786 081 Email: Info.ss@smartapplicationsgroup.com

Smart Applications International (Tanzania) Ltd. Mikocheni B Plot 154, Bima StreetP.O. Box 7966, Dar Es Salaam, TanzaniaTel: +255 22 278 1226Email: Info.tz@smartapplicationsgroup.com

Smart Applications International (Rwanda) Ltd.B.P 6019 Kigali, Rwanda Plot 164 Ruganwa, Kg 688 Street, Kamutwa Village, Kacyiru Sector, Gasabo District. Kigali CityTel: +250 787 780 027Email: Info.rw@smartapplicationsgroup.com

Smart Applications International (Zambia) Ltd. A501 Northgate Gardens, NAPSA Complex P.O Box 31355, Lusaka, ZambiaTel: +260 961 256 489Email: info.za@smartapplicationsgroup.com

Enjoy a healthy and happy

life with hassle free access to healthcare

service the Smart way.

115

Q & A

Thank You

Vodafone PowerTalks

CASE STUDY: Wellness & Internet of Things

© Oswald Jumira, Executive Head Strategy & Partnerships Cumii

A thing, in the Internet of Things, can be a vehicle with a tracking device or person with a heart monitor implant or an automobile that has in built sensors to alert the driver when tire pressure is low …or any other natural or man object that can be assigned an IP address and provided with the ability to transfer data over a network.

"Internet of Things" phrase to describe a system where the Internet is connected to the physical world via ubiquitous sensors

So far, the Internet of Things has been most closely associated with machine to machine (M2M) communication in the transport, manufacturing, power, oil and gas utilities. Products with M2M communication capabilities are often referred to as being smart!

IoT is our DNA

CUMii current markets presence

CUMii to Target markets 2016-2017

Ghana Nigeria Myanmar

Egypt

South Sudan

Angola

Namibia

South Africa, LesothoSwaziland

Mozambique

Tanzania

Ethiopia

Kenya

Burundi

Rwanda

DRC

Botswana

Zambia

Zimbabwe

Malawi

Our Presence

Our Partners

Wellness Prevention Diagnosis Treatment

Monitoring

Emergency Response

Healthcare Practitioner Support

Disease Surveillance

Healthcare Administration

Solutions Across The Patient Pathway

CUMii Health Strategy

Wellness & Prevention

Health Tips

Diagnosis Dial a Doc

Chronic Disease Management

Blood pressure, Blood glucose home monitoring

Disease Surveillance Infectious Disease Reader

Hospital Patient Vital Signs Management

Connected Hospital Grade Devices

CUMii Health Solutions

Market Analysis

• Chronic conditions such as diabetes and heart disease will overtake

infectious diseases as the major causes of illness in Africa by 2025

• Up to 80% of diabetics remains undiognosed.

• The current model increases the costs of healthcare for individuals

and health funders due to the higher levels of hospitalisation and

unnecessary doctor’s visits

• With awareness millions of life will be saved

• Hypertension is now common in high density areas, especially

amongst older people suffering from diabetes and obesity, but the

rates of awareness, treatment, and control are extremely low

• According to a study done in Uganda, more than a quarter of the

adult population had hypertension but awareness and control was

very low.

• The same applies to people with diabetes where 50% of estimated

number of people with diabetes are undiagnosed and most are

probably unaware of the condition.

Measurement Value

Estimated No. of people with diabetes

693,200

Estimated No. people with hypertension

560,000

Hospitals are witnessing increasing rates of diabetes and hypertension. This creates a potential market for monitoring devices

National Health Strategic Plan is focusing on NCDs and CUMii health platform which retains data and provides analytics, will be a good fit for its strategy

1

2

3Insurance companies are constantly looking for ways to reduce medical payouts to clients with servere medical conditions which can be proactively prevented.

• Users with chronic diseases such as diabetes and hypertension will incur more cost, about

58% more, in treating the condition when it’s severe

Market Key Drivers

My CUMii Health

Notification of Testing Reminder

Doctor

Dial –a-Doc Relative

Patient

CUMiiHealth Wellness Ecosystem

Health Tips

“Creates a Social Network around patients health through linking patient to Doctor, Family and Friends”

Blood Glucose and Blood Pressure Home Monitoring

• Collect patient vital signs using accredited connected health device

• Analyse patient data and alert if abnormalities or no reading detected

• Information can be seen by Doctor / Clinic / Family in addition to end-user

CUMii Connected Health Platform

Optional forwarding of patient data to

Doctor / Family etc.

Data sent to user

Device data sent to platform (cloud-

based)

CUMii Wellness Mobile App

Devices

Wider Ecosystem

CUMii Wellness Platform

Patients

Health Providers

Ministry of Health

Caregivers

Health Insurers

Benefits to Users

• The subscription benefits are:

o Connected home health device (blood pressure or blood glucose monitor)

o Automated upload and storage of data from the connected device to the cloud

o Access to patient record by the patient’s doctor who can remotely monitor progress

o Access to health alerts by a nominated relative (e.g. reminders to test)

o Daily health tips package (manage diabetes tips and/or manage your blood pressure tips)

o One monthly call from a Dial-a-Doc to discuss condition

o 5 free testing strips per month for diabetes customers

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