How to leapfrog in healthcare system

Last week, one of my relatives contracted the coronavirus. It started like a normal flu and progressed into a cough, then a headache and chest pain. At that point, a decision was made to call a doctor.

The doctor said since he was coughing, it was wise to bring him to hospital for a chest scan and also have his oxygen levels checked. The scan showed a progressing infection in the lungs. The oxygen levels were at 91 percent, which is considered borderline.

He was admitted to the hospital for close monitoring.

The young man turned to me and asked why hospitals have all these gadgets doctors were tinkering with. “I could have given them most of this information,” he said, as he pulled his mobile phone to show me his oxygen levels, heart rate and temperature. All the readings were similar.

The admission procedure took five hours. First, we had to deal with unreceptive staff at the reception who took their sweet time. This was followed by a run around to find the admitting doctor to fill the insurance form, then the validation from the health insurance and a confirmation of bed availability.

All these activities were unnecessary if the healthcare system is decentralised. Our health systems doesn’t have to evolve like it happened in other countries. It is possible to leverage technology and truly leapfrog. This is how the developing world can provide healthcare for all. Let me explain.

New affordable and simplified diagnostics equipment with advanced technologies is widely available to enable emerging economies to leapfrog. Some of this equipment uses batteries and can be deployed anywhere and is changing healthcare especially in remote places. Many applications have been developed on the mobile platforms with great accuracy and can be used for e-health in rural areas.

For example, there is a handheld lung ultrasound that is being used as a fast and effective alternative to X-Ray and CT scan, particularly with Covid-19 patients. There is also a smaller but effective Virtual Reality passive 3D-stereo monitor for planning surgery or training surgeons and it gives more precise visualisation of patient-specific anatomy. It also has a 3D imaging for X-ray, CT, and MRI.

With such advancement in technology, the thousands of nurses, clinical officers and doctors unemployed today could find work in micro diagnostics and hence lower the cost of healthcare in current centralised and sometimes monopoly in diagnosis. A midwife in the remotest place could use a hand-held ultrasound tool to tell the position of an unborn child instead of using crude methods. What other option does Africa have for tackling child mortality other than new technological tools?

With all the vital signs now on the mobile, the triage doesn’t have to be in a central place. New ways of passing the information to doctors — for interpretation of data and decision-making — has to be devised. Such interventions would automatically create a vibrant e-health system for remote areas that will decongest hospitals. Further, health workers will be optimally utilised since location won’t matter.

In my view, a radiologist in Kenya, for example, should provide services throughout the continent especially in countries with fewer health workers. Some unemployed nurses and clinical officers can be deployed in virtually every village to provide support for patients who may not be digitally literate while intensifying digital literacy for every citizen.

As new diagnostic innovations emerge, rich countries will dump legacy equipment into developing countries when indeed we can leapfrog and begin using this emerging industry 4.0 health diagnostic tools. Our main problem is that the rate at which new technology diffuses into our space is far too slow that we are often taken advantage of.

Many public broadcasters, for example, are on their deathbed due to poor investment judgment in out-of-date technologies.

Let’s not make similar mistakes in healthcare investment.