Aga Khan Development Network
eHealth Programme


AKDN eHRC conducts a 2-day training session, 'Telemedicine and mHealth Innovations: Exploring Possibilities in the Health Care Sector' for health care professionals in Gilgit-Baltistan, benefitting 14 health care professionals. The focus of the training was core eHealth concepts and services and eHealth related innovations.

Executive Summary


Teleconsultations

Teleconsultations increased notably across all countries, from 1335 in Q3 2015 to 2097 in Q3 2016. This increase is a result of the AKDN eHealth Programme expanding to include new sites, services and connections over the course of the year. In Afghanistan, teleconsultation services expanded to five sites while a new speciality was introduced. The overall increase also reflects teleconsultations from three sites in Kyrgyz Republic, which were not active in Q3 2015. In Pakistan, a new site was added to the network while teleconsultation services were expanded to two existing sites. In Tajikistan, in addition to a new site being added to the network, there has been a general increase in the uptake of live teleconsultation services.


eLearning

The number of eLearning participants has almost doubled from 294 in Q3 2015 to 586 in Q3 2016. eLearning services initiated at two new sites and expanded to three existing sites in Afghanistan and to one site in Tajikistan. Furthermore, under the Central Asia Health Systems Strengthening eLearning research project, courses are being delivered from the Aga Khan University to sites in Afghanistan and Tajikistan, resulting in an increase in participants attending the courses. The overall increase also reflects the number of beneficiaries reported from the three sites in Kyrgyz Republic, which were not active in Q3 2015.

Q2 AT A GLANCE


AFGHANISTAN



TELECONSULTATIONS

Total Teleconsultations: 1600

Live Teleconsultations: 568

Store-and-Forward Teleconsultations: 1032


Live Teleconsultations

In Q3 2016, 568 live teleconsultations were conducted across all sites in Afghanistan compared to 732 teleconsultations in Q3 2015.

The French Medical Institute for Children (FMIC) conducted 161 teleconsultations with Bamyan Provincial Hospital (BPH) and 192 teleconsultations with Faizabad Provincial Hospital (FPH). FMIC also conducted 24 teleconsultations with the Aga Khan University Hospital, Karachi in Pakistan and 48 teleconsultations with La Chaîne de l'Espoir in France.

Bashore, Ishkashim and Nusai Comprehensive Health Centres (CHCs) conducted 54 teleconsultations with FPH and 36 teleconsultations with Khorog Oblast General Hospital in Tajikistan.

Twenty-one teleconsultations were conducted between Bharak District Hospital (BDH) and FPH. Thirty-two 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 Q3 2015.


Store-and-Forward Teleconsultations

In Q3 2016, 1032 store-and-forward cases were referred across all sites in Afghanistan compared to 252 cases in Q3 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 Q3 2016, 1006 teleradiology cases were resolved compared to 221 cases in Q3 2015. The radiologist at FMIC has been on leave since June 2016, as a result, cases are being sent to a consultant. As a result, there has been a sudden upsurge in teleradiology cases.

Telepathology services connect BPH and FPH with FMIC and Bharak and Kisham District Hospitals with FPH. In Q3 2016, 18 telepathology cases were referred for second opinion. FMIC resolved 13 cases while FPH resolved five cases.

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

The graph below displays the comparison from Q3 2015.

*Note: eHealth services did not exist at the site in Q3 2015.


eLEARNING

eLearning Sessions: 19

eLearning Participants: 328


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

In Q3 2016, 328 participants were trained through eLearning sessions delivered by FMIC and FPH in Afghanistan and Aga Khan University in Pakistan. FMIC offered nine sessions to 122 medical and nursing staff at BPH, FPH and MRH. FPH delivered ten sessions, benefitting 57 participants at the three CHCs, BDH and KDH.

Under the ongoing Central Asia Health Systems Strengthening eLearning research project, the Aga Khan University School of Nursing and Midwifery delivered eLearning sessions to 149 health care professionals at BPH, FPH and MRH.

*Note: eHealth services did not exist at the site in Q3 2015.

KYRGYZ REPUBLIC


TELECONSULTATIONS

Total Teleconsultations (Live): 39


Live Teleconsultations

Live teleconsultations are conducted between the Republican Children’s Clinical Hospital in Bishkek and the Naryn Oblast Hospital. Apart from routine services, the Geneva University Hospitals, Switzerland, continues to offer teleconsultation services for patients at the Naryn Oblast Hospital with the support of the Medical Education Reforms Project.

In Q3, 39 teleconsultations were conducted. Among these, 32 teleconsultations were conducted by the Republican Children’s Clinical Hospital and seven were conducted by Geneva University Hospitals. Cases consulted by the Geneva University Hospitals were in adult cardiology, rheumatology and neurology.

*Note: Teleconsultation services were initiated in Q4 2015.

The Aga Khan Medical and Diagnostic Centre in Naryn, inaugurated in May 2016, appointed a paediatrician from the Republican Children’s Clinical Hospital to visit Naryn and provide face-to-face consultations on several occasions. Resultantly, fewer patients opted for live teleconsultation services. Moreover, electricity power cuts were experienced during teleconsultation sessions, leading to the rescheduling of sessions to later dates. Another reason for reduced patient inflow was that consultants were unavailable to conduct teleconsultations as they were away during the summer vacation.

Apart from the regular teleconsultation sessions, two teleconferences were held between the Ministry of Health, Kyrgyz Republic and multiple district health offices, including Naryn. The eHealth connection was used to facilitate the process. To facilitate eHealth services at the Naryn Oblast Hospital, a 3 in 1 printer, xerox and scanner machine was installed in the eHealth room.

eLEARNING

eLearning Sessions: 4

eLearning Participants: 40


In Q3, four eLearning sessions were conducted by the Kyrgyz State Medical Institute of Continuous Education (KSMICE) benefiting 40 health professionals at the Naryn Oblast Hospital and the Naryn Oblast Family Medicine Centre. Since KSMICE staff was on vacation, eLearning sessions were held only in September.

*Note: eLearning services were initiated in Q4 2015.


No eLearning sessions were conducted by the Republican Children’s Clinical Hospital in Q3 since there was no request submitted from the spoke site. The reason for this was that many face-to-face professional development trainings were conducted in Naryn, particularly on maternal and neonatal child health topics, under the Central Asia Health Systems Strengthening project.

PAKISTAN


TELECONSULTATIONS

Total Teleconsultations: 105

Live Teleconsultations: 105

Store-and-Forward Teleconsultations: 0


Live Teleconsultations

Live teleconsultations were initiated at Garam Chashma Tehsil Headquarter Hospital in Q3 2016. The health care facility now offers patients access to psychiatrists at the Aga Khan Medical Centre, Gilgit (AKMC, G). Internet connectivity had already been established at the site in late 2015, with teleconsultation services starting in Q3.

During Q3 2016, 105 live teleconsultations were conducted in Pakistan compared to 25 teleconsultations in Q3 2015. Fifty-one teleconsultations were conducted between the Aga Khan Booni Medical Centre (AKBMC) and the Aga Khan University Hospital, Karachi (AKUH, K) and 41 teleconsultations were conducted between AKMC, G and AKUH, K. Twelve teleconsultations were conducted between AKMC, G and Chatorkhand Health Centre while three teleconsultations were conducted between AKMC, G and Garam Chasma Tehsil Head Quarter.

The graph below depicts the comparison from Q3 2015.

*Note: Live teleconsultation services did not exist between the sites in Q3 2015.


Store-and-Forward Teleconsultations

In Q3 2016, no store-and-forward teleconsultations were conducted in Gilgit-Baltistan. In Q3 2015, 34 store-and-forward teleconsultations were conducted.

AKDN eHRC Conducts Training and Monitoring Activities in Gilgit-Baltistan and Chitral

The AKDN eHRC team visited Gilgit-Baltistan and Chitral in September 2016 to conduct training and monitoring. The team visited seven sites - Aliabad Extended Family Health Centre, Aga Khan Booni Medical Centre, Chatorkhand Health Centre, Garam Chashma Tehsil Headquarter Hospital, Aga Khan Medical Centre Gilgit, Singal Medical Centre and Soust Health Centre. Various activities were carried out during the visit including:

  • Monitoring
    • Monitoring of existing eHealth services and identification of priority health issues and gaps in health care services that can be addressed by connecting Aga Khan Health Service, Pakistan facilities;
    • Meetings with the stakeholders and the community to gain insight through community feedback and on the progress of the current eHealth programme;
    • Identification of equipment, network, technology support and trainings required to implement and manage a well-functioning eHealth system in the identified health centres.
  • Training
    • Identification and training of potentially new eHealth resources at all seven sites of Gilgit-Baltistan and Chitral. Training was conducted on the teleconsultation process and on VirtualDoc to facilitate teleconsultation services as well as the research tool of the on-going Central Asia Health Systems Strengthening Telepsychiatry research project.
    • A 2-day training session on ‘Telemedicine and mHealth Innovations: Exploring Possibilities in the Health Care Sector’. The focus of the training was on explaining core eHealth concepts and services and exploring eHealth related innovations. Objectives of the training were to build the eHealth capacities of professionals in the health sector; help them understand the applications of telemedicine and mHealth solutions; and address the challenges around eHealth service delivery. The training was conducted on September 5-6, 2016 at the Professional Development Centre North, Gilgit-Baltistan and was attended by 14 health care professionals.

eLEARNING

eLearning Sessions: 13

eLearning Participants: 9


In Q3 2016, the Aga Khan University (AKU) delivered 13 eLearning sessions. Of these, seven eLearning sessions, including two Continuing Medical Education (CME) sessions, were delivered to 9 health care professionals in Pakistan. Six of these sessions were part of the ongoing CAHSS eLearning research project and were delivered by the AKU School of Nursing and Midwifery to health care professionals at Bamyan Provincial Hospital, Faizabad Provincial Hospital and Mirwais Regional Hospital in Afghanistan and at Khorog Oblast General Hospital in Tajikistan (the number of beneficiaries for these eLearning sessions are available in the respective country sections).

In Q3 2015, 11 eLearning sessions were attended by 11 health care professionals. Reasons for decreased attendance include occasional connectivity problems and lack of availability of health care providers to attend courses at spoke sites in Pakistan.

The graph below depicts the comparison from Q3 2015.

TAJIKISTAN


TELECONSULTATIONS

Total Teleconsultations: 353

Live Teleconsultations: 163

Store-and-Forward Teleconsultations: 190


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

The graph below depicts the comparison from Q3 2015.

*Note: The KOGH-DMDC connection did not exist in Q3 2015.


Store-and-Forward Teleconsultations

In Q3 2016, KOGH referred 190 cases to NMC and the Aga Khan Health Board (AKHB), USA for second opinion. Of these, 168 were referred to NMC and 22 were referred to the AKHB, USA.

The graph below depicts the comparison from Q3 2015.

eLEARNING

eLearning Sessions: 21

eLearning Participants: 201


In Q3 2016, 21 eLearning courses were offered, benefitting 201 nurses and physicians. Of these, eight eLearning sessions were offered to physicians while 13 sessions were offered to nursing staff. Two eLearning courses were offered from DMDC to KOGH, benefitting 14 physicians. KOGH offered six courses to 63 participants at RDH; three courses to 36 participants at IDH and six courses to 45 participants at DDH.

Under the Central Asia Health Systems Strengthening eLearning project, the Aga Khan University School of Nursing and Midwifery in Pakistan delivered eLearning sessions to 43 participants at KOGH.

The graph below depicts the comparison from Q3 2015.

*Note: eLearning services did not exist between the sites in Q3 2015.

PLANS AHEAD


AFGHANISTAN


  • Equip the cardiology and dental clinics at FMIC with eHealth modalities.

KYRGYZ REPUBLIC


  • Purchase eHealth equipment internationally and install with the support of AKDN eHRC.
  • AKDN eHRC to conduct monitoring visit, as well as VirtualDoc training for eHealth coordinators in Q4 2016.
  • AKDN eHRC to present the AKDN eHealth Programme at the ITU Regional Development Forum for CIS and Georgia, “ICT for Sustainable Development” in Q4 2016.

PAKISTAN


  • Develop and disseminate marketing materials and videos in Gilgit-Baltistan to increase awareness of eHealth services.
  • Conduct internet survey for upcoming Access to Quality Care through Extending and Strengthening Health Systems in Africa and Pakistan project.
  • Hire a physician to coordinate eHealth activities in the region for AKHS, P.
  • Upgrade connectivity at health centres in Booni and Garam Chashma.
  • Establish back-up connectivity at the Aga Khan Medical Centre, Gilgit.

TAJIKISTAN


  • Implement business model for teleconsultations to ensure sustainability of the programme in Q4 2016.
  • Conduct meetings with community health workers regarding eHealth awareness and marketing.

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