Aga Khan Development Network
eHealth Programme


In an effort to build the capacity of health care professionals, the French Medical Institute for Children offers eLearning sessions on various topics to participants at the Bamyan Provincial Hospital. Over 2,000 health care professionals have been trained since the service initiated in 2010.

Q2 AT A GLANCE


AFGHANISTAN



TELECONSULTATIONS

Total Teleconsultations: 927

Live Teleconsultations: 622

Store-and-Forward Teleconsultations: 305


Live Teleconsultations

In Q2 2016, 622 live teleconsultations were conducted across all sites in Afghanistan compared to 820 teleconsultations in Q2 2015.

The French Medical Institute for Children (FMIC) conducted 150 teleconsultations with Bamyan Provincial Hospital (BPH) and 222 teleconsultations with Faizabad Provincial Hospital (FPH). FMIC also conducted 43 teleconsultations with the Aga Khan University Hospital, Karachi (AKUH, K) in Pakistan and 37 teleconsultations with La Chaîne de l'Espoir in France.

Bashore, Ishkashim and Nusai Comprehensive Health Centres (CHCs) conducted 102 teleconsultations with FPH and 21 teleconsultations with Khorog Oblast General Hospital in Tajikistan.

Twenty teleconsultations were conducted between Bharak District Hospital (BDH) and FPH. Twenty-seven teleconsultations were conducted between Kisham District Hospital (KDH) and FPH.

The graph below exhibits the comparisons from Q2 2015:

*Note: eHealth services did not exist at the site in Q2 2015.


Store-and-Forward Teleconsultations

In Q2 2016, 305 store-and-forward cases were referred across all sites in Afghanistan compared to 285 cases in Q2 2015.

Teleradiology services connect BPH and FPH with FMIC and FMIC with the AKUH, K. Additionally, Bashore, Ishkashim and Nusai CHCs, BDH and KDH avail teleradiology services from FPH. In Q2 2016, 263 teleradiology cases were resolved in comparison to 264 cases in Q2 2015.

Telepathology services connect BPH and FPH with FMIC and Bharak and Kisham District Hospital with FPH. In Q2 2016, 18 telepathology cases were referred for second opinion. FMIC resolved 16 cases while FPH resolved two cases.

Teleopthalmology services connect FMIC with AKUH, K. Twenty-four teleopthalmology cases were referred from FMIC to AKUH, K for diagnosis.

The graph below displays the comparison from Q2 2015.

*Note: eHealth services did not exist at the site in Q2 2015.


eLEARNING

eLearning Sessions: 20

eLearning Participants: 257


eLearning sessions on medical and nursing topics are delivered by FMIC to BPH, FPH, MRH in Afghanistan and Khorog Oblast General Hospital in Tajikistan. FPH also delivers eLearning sessions to Bashore, Ishkashim and Nusai CHCs, BDH and KDH.

In Q2 2016, 257 participants were trained through eLearning sessions delivered by FMIC and FPH in Afghanistan and AKU in Pakistan. FMIC offered 11 sessions to 170 medical and nursing staff at BPH, FPH and MRH. FPH delivered nine sessions benefitting 60 participants at the three CHCs, BDH and KDH. AKU also broadcast one medical conference to FMIC. No sessions were delivered by FMIC to KOGH in Tajikistan.

Under the ongoing Central Asia Health Systems Strengthening eLearning research project, eLearning sessions on Maternal, Neonatal and Child Health topics have initiated for health care professionals. In Q2, the first course was offered, which trained 27 participants at BPH and FPH.

*Note: eHealth services did not exist at the site in Q2 2015.

KYRGYZ REPUBLIC


TELECONSULTATIONS

Total Teleconsultations (Live): 72


Live Teleconsultations

Live teleconsultations are conducted between the Republican Children’s Clinical Hospital in Bishkek and the Naryn Oblast Hospital. In Q2, as part of an initiative by the Naryn Oblast Hospital, Geneva University Hospitals, Switzerland, offered live teleconsultations in Angiology and Cardiology to patients at the Naryn Oblast Hospital. Geneva University Hospitals is not part of the AKDN eHealth Programme; rather the hospital is offering services to patients at the Naryn Oblast Hospital on a need basis. This initiative is funded by the Swiss Government through the Medical Education Reforms Project.

In Q2, 72 teleconsultations were conducted. Of these, 68 teleconsultations were conducted by the Republican Children’s Hospital and four were conducted by Geneva University Hospitals.

In addition to Paediatrics and Obs/Gyn, three new specialities were offered this quarter: Angiology and Cardiology from Geneva University Hospitals and Audiology from the Republican Children’s Clinical Hospital.

Various challenges were encountered during teleconsultation services with Geneva University Hospitals. Due to language barriers, Naryn Oblast Hospital required external facilitators to arrange and conduct the teleconsultation sessions. At the Geneva University Hospital, English and French is spoken, while Russian and Kyrgyz is spoken at the Naryn Oblast Hospital. There was also a difference in medical terminology used at each site. Image quality through Skype was suboptimal, as a result, Scopia, an alternative video conferencing application was used.

More than 50 percent of these cases were primary examination cases. Many patients were coming from other regions without prior triage and teleconsultations were carried out with a tertiary level health specialist, which was not required in many cases. This could be a result of the extensive marketing of eHealth services carried out during Q1.

A trial version of Polycom, video conferencing software, primarily was installed in Naryn Oblast Hospital and the Republican Children’s Clinical Hospital, Bishkek. Sessions were conducted to test the software.

eLEARNING

eLearning Sessions: 7

eLearning Participants: 92


In Q2, seven eLearning sessions were conducted by the Republican Children’s Clinical Hospital and the Kyrgyz State Medical Institute of Continuous Education (KSMICE), benefitting 92 health care professionals at the Naryn Oblast Family Medicine Centre. KSMICE began offering eLearning sessions to the Naryn Oblast Family Medicine Centre in Q2 2016, however, the institute is not part of the AKDN eHealth Programme.

The reason why only seven sessions were offered this quarter is that various in-person professional development courses were organized for health staff at Naryn Oblast Family Medicine Centre by development organizations including Aga Khan Foundation, Kyrgyz Republic and Agency for International Development/Strengthening Partnerships, Results, and Innovations in Nutrition Globally as well as local medical education institutions. Therefore, fewer requests for eLearning sessions were received from the Naryn Oblast Family Medicine Centre. The staff at the KSMICE is on vacation until September. Therefore, eLearning sessions from this site have been discontinued till then. As a result, a lower number of sessions is expected to be conducted in the next quarter.

Apart from routine eHealth activities, the eHealth connection was used to facilitate an online meeting between the focal point of the Republican Children’s Clinical Hospital and the deputy director of Naryn Oblast Family Medicine Centre on periodic health examination of school children. Additionally, the head nurse of the Consultation and Diagnostic Unit of Naryn Oblast Hospital conducted one training session for internal staff in the eHealth room. Thirty-one health professionals were trained in this session.

PAKISTAN


TELECONSULTATIONS

Total Teleconsultations: 95

Live Teleconsultations: 93

Store-and-Forward Teleconsultations: 2


Live Teleconsultations

In Q2, live teleconsultation services in various specialities initiated between Chatorkhand Health Centre and Singal Medical Centre and between Soust Health Centre and Aliabad Extended Family Medicine Centre. Patients coming to the Chatorkhand and Soust health centres can now benefit from live teleconsultation services in addition to store-and-forward services.

During Q2 2016, 93 live teleconsultations were conducted in Pakistan compared to 54 teleconsultations in Q2 2015. Forty-six teleconsultations were conducted between Aga Khan Medical Centre, Gilgit (AKMC, G) and the Aga Khan University Hospital, Karachi (AKUH, K) and 35 teleconsultations were conducted between the Aga Khan Booni Medical Centre (AKBMC) and AKUH, K. Twelve teleconsultations were conducted between AKMC, G and Chatorkhand Health Centre.

The graph below depicts the comparison from Q2 2015.

*Note: Live teleconsultation services did not exist between the sites in Q2 2015.


Store-and-Forward Teleconsultations

In Q2 2016, two store-and-forward teleconsultations were conducted in Gilgit-Baltistan between Soust Health Centre and AKMC, G. During Q2 2015, store-and-forward teleconsultations had been temporarily discontinued at all sites and therefore no cases were referred during this period.


eLEARNING

eLearning Sessions: 5

eLearning Participants: 7


In Q2 2016, the Aga Khan University (AKU) delivered four eLearning sessions which were attended by seven health care providers. One Continuing Medical Education (CME) session was attended by five participants at AKBMC and two at AKMC, G while there were no participants in the other three sessions.

One reason for the lack of attendance is that AKMC, G is not able to receive the eLearning sessions due to the lack of internet connectivity in the mornings.

AKU also offers CME courses to health care professionals at the Bamyan Provincial Hospital and Faizabad Provincial Hospital in Afghanistan. In Q2, one session was delivered.

TAJIKISTAN


TELECONSULTATIONS

Total Teleconsultations: 378

Live Teleconsultations: 169

Store-and-Forward Teleconsultations: 209


Live Teleconsultations

In Q2 2016, 169 live teleconsultations took place across the eHealth sites. 124 teleconsultations took place between Khorog Oblast General Hospital (KOGH) and the three district hospitals, with Roshan District Hospital (RDH) referring 42 cases, Darwaz District Hospital (DDH) referring 41 cases and Ishkashim District Hospital (IDH) referring 41 cases, respectively.

Twenty-nine teleconsultations took place between National Medical Centre (NMC) and KOGH and 16 teleconsultations were conducted between Dushanbe Medical and Diagnostic Centre (DMDC) and KOGH. No teleconsultations took place between the French Medical Institute for Children in Afghanistan and KOGH.

The graph below depicts the comparison from Q2 2015.

*Note: The KOGH-DMDC connection did not exist in Q2 2015.

Store-and-Forward Teleconsultations

In Q2 2016, KOGH referred 209 cases to NMC and the Aga Khan Health Board (AKHB), USA for second opinion. Of these, 198 were referred to NMC and 11 were referred to the AKHB, USA.

The graph below depicts the comparison from Q2 2015.

eLEARNING

eLearning Sessions: 13

eLearning Participants: 136


In Q2 2016, 13 eLearning courses were offered to 78 nurses and 58 physicians. One eLearning course was offered from DMDC to eight participants at KOGH. KOGH offered five courses to 62 participants at RDH; three courses to 32 participants at IDH and four courses to 34 participants at DDH.

As part of the Central Asia Health Systems Strengthening eLearning project, which aims to evaluate the efficacy of the eLearning Programme in Afghanistan, eLearning courses were initiated in Q2 by the Aga Khan University School of Nursing and Midwifery in Pakistan. Courses are offered to KOGH and other hospitals in Afghanistan. Through the project, 10 participants were trained at KOGH in Q2.

The graph below depicts the comparison from Q2 2015.

*Note: eLearning services did not exist between the sites in Q2 2015.

PLANS AHEAD


AFGHANISTAN


  • Bamyan Provincial Hospital will shift to a new facility in the upcoming months; resultantly, the eHealth room will shift to the new facility as well.
  • Based on the security situation in Afghanistan, it was decided that AKHS, A will supervise eHealth sites once every quarter.

KYRGYZ REPUBLIC


  • Procurement of remaining eHealth equipment in Q3.
  • AKDN eHRC team to conduct monitoring, Virtual Doc training and installment of equipment.
  • Adult surgery speciality to be added later in the year.

PAKISTAN


  • Initiate live teleconsultations in Psychiatry from AKMC, G to Aliabad Extended Family Health Centre; Chatorkhand Health Centre, Garam Chashma Tehsil Hospital; and Soust Health Centre.
  • Change internet service provider for Aliabad, Soust and Chatorkhand health centres for improved after-sales service support.
  • Enhance internet connectivity from 128 kbps to 256 kbps on the day of clinics at Garam Chashma Tehsil Hospital and Aga Khan Booni Medical Centre.

TAJIKISTAN


  • AKDN eHRC to make a monitoring visit to Khorog Oblast General Hospital and the district hospitals in Darwaz, Ishkashim and Roshan.
  • On the basis of the monitoring report, equipment will be procured in July and implemented in August 2016.
  • Explore possibility of changing Wi-Fi connectivity in Roshan, Darwaz and Ishkashim district hospitals to fiber optic.
  • Validate and implement business model for teleconsultations.

AKDN eHealth Resource Centre


The Aga Khan Development Network eHealth Resource Centre (AKDN eHRC) was established in 2011 to provide strategic eHealth support to the AKDN health agencies and their partner health institutions that are managing eHealth operations. AKDN eHRC employs Information and Communication Technologies to support the assessment, development and implementation of eHealth initiatives and activities of its clients in Asia and Africa.

The mission of AKDN eHRC is to make health care accessible to communities with reduced access, increase the quality of health care provision, build the capacities of health care professionals and ultimately strengthen health systems.

Stadium Road
P.O.Box 3500
Karachi, Pakistan

ehrc@akdn.org

(+92 21) 9924-4230