Aga Khan Development Network
eHealth Programme


Live teleconsultations were initiated in Kyrgyz Republic as patients at the Naryn Oblast Hospital began receiving teleconsultations in Paediatrics from specialists at the Republican Children’s Clinical Hospital, Bishkek.

Q4 AT A GLANCE


AFGHANISTAN


TELECONSULTATIONS

Total Teleconsultations: 1318

Live Teleconsultations: 1038

Store-and-Forward Teleconsultations: 280


Live Teleconsultations

In Q4 2015, 1,038 live teleconsultations were conducted across all sites in Afghanistan as compared to 701 teleconsultations in Q4 2014.

393 teleconsultations took place between the French Medical Institute for Children (FMIC) and Bamyan Provincial Hospital (BPH) and 409 teleconsultations were conducted between FMIC and Faizabad Provincial Hospital (FPH). FMIC conducted 11 teleconsultations with Aga Khan University Hospital, Karachi (AKUH, K) in Pakistan.

Bashore, Ishkashim and Nusai Comprehensive Health Centres conducted 77 teleconsultations with FPH and 33 teleconsultations with Khorog Oblast General Hospital (KOGH) in Tajikistan.

57 teleconsultations were conducted between Bharak District Hospital (BDH) and FPH. Live teleconsultations were initiated between Kisham District Hospital (KDH) and FPH in October and 30 teleconsultations were conducted between the two sites.

In September, FMIC initiated live telecardiology services with La Chaîne de l'Espoir, a French NGO. In Q4 2015, 28 patients benefited from the services. La Chaîne de l'Espoir is a partner of FMIC and provides donor services. FMIC is managed through a four-way partnership between La Chaîne de l'Espoir, the Government of Afghanistan, the Government of France, and the AKDN.

Store-and-Forward Teleconsultations

Store-and-forward services have expanded to additional sites over the past few quarters. In Q4 2015, 280 store-and-forward teleconsultations were conducted in teleradiology, telepathology and teleopthamology at various sites across Afghanistan. In Q4 2014, 285 cases were referred.

Teleradiology services connect BPH and FPH with FMIC and FMIC with the AKUH, K. Additionally, BDH and KDH refer cases to FPH.

In November, teleradiology was also initiated at the Bashore, Ishkashim and Nusai CHCs with consultations taken from FPH. eHealth equipment to enable teleradiology services was also installed. 250 teleradiology cases were referred and diagnosed across all sites in Q4 2015.

Telepathology cases are referred from BPH and FPH to FMIC. In Q4 2015, 20 cases were referred to FMIC for consultation.

Teleophthalmology services were initiated at FMIC in November with consultations taken from AKUH, K. Ten cases were referred for diagnosis in Q4.


eLEARNING

eLearning Sessions: 20

eLearning Participants: 214


FMIC delivers eLearning sessions to BPH and FPH, Mirwais Regional Hospital (MRH) on various topics including medical, allied health and nursing. In Q4 2015, eLearning services expanded considerably as numerous sites were added to the eLearning network in Afghanistan.

In November, FPH also began delivering eLearning sessions to Bharak District Hospital, Bashore, Ishkashim and Nusai CHCs.

In Q4 2015, 214 medical, allied health and nursing staff were trained through 20 eLearning sessions across all sites.

In addition to these eLearning sessions, the following live conferences were broadcasted in Q4 2015:

  • National Annual Symposium of Pakistan Paediatric Cardiology and Cardiac Surgery from AKU to FMIC;
  • Fifth FMIC Quality Improvement and Patient Safety Convention from FMIC to AKU in November;
  • FMIC Fifth International Conference telecast live from FMIC to AKU.

In Q4 2014, 284 participants benefitted from 20 sessions delivered by FMIC to BPH, FPH and MRH.

KYRGYZ REPUBLIC


eHEALTH SERVICES INITIATED IN KYRGYZ REUBLIC


In November, eHealth services were initiated at three government-owned health care facilities in Kyrgyz Republic. The Republican Children’s Clinical Hospital in Bishkek was connected to the Naryn Oblast Hospital and the Naryn Oblast Family Medicine Centre, respectively.

The Republican Children’s Clinical Hospital provides live teleconsultations to patients at the Naryn Oblast Hospital and broadcasts eLearning courses in Child Health and Family Medicine to health care professionals at the Naryn Oblast Family Medicine Centre.

This is the first time that purely government-owned facilities have been connected under the AKDN eHealth Programme. The Ministry of Health, Kyrgyz Republic has taken ownership of eHealth services and their sustainability. AKDN eHRC is providing technical assistance to these facilities under the Aga Khan Foundation, Kyrgyz Republic.

AKDN eHRC plans to observe the progress very closely so lessons learned can be implemented in other Central Asian countries.


TELECONSULTATIONS

Total Teleconsultations (Live): 4


Live Teleconsultations

In Q4 2015, four live teleconsultations were conducted between the Republican Children’s Clinical Hospital, Bishkek and the Naryn Oblast Hospital.

eLEARNING

eLearning Sessions: 2

eLearning Participants: 10


Two structured, online conferences were broadcast by the Kyrgyz State Medical Academy which were attended by ten female health care providers in Naryn.

PAKISTAN


TELECONSULTATIONS

Total Teleconsultations: 122

Live Teleconsultations: 65

Store-and-Forward Teleconsultations: 57


Live Teleconsultations

In Q4 2015, 65 teleconsultations were conducted in Pakistan as compared to 63 teleconsultations in Q4 2014. Thirty-five teleconsultations were conducted at Gilgit Medical Centre (GMC) from the Aga Khan University Hospital, Karachi (AKUH, K) whereas 30 teleconsultations were conducted at the Aga Khan Booni Medical Centre (AKBMC) from AKUH, K.

In Q3 2015, eHealth services were being shifted to the new Al Azhar campus because of which there was a decline in the number of teleconsultations conducted. In Q4 however, the uptake of teleconsultations steadily started increasing once the shift was complete.

In October, AKUH, K started offering live teleconsultations in Dermatology to patients at GMC in addition to live teleconsultation in Psychiatry. Patients at AKBMC benefit from live teleconsultations in Psychiatry offered from AKUH, K.

eHealth connectivity was established between Garam Chashma Tehsil Hospital and AKBMC in October 2015. Implementation activities were carried out at the hospital in preparation for live teleconsultations in various specialities and the eHealth room was equipped with eHealth equipment.


Store-and-Forward Teleconsultations

In Q4, 57 store-and-forward teleconsultations were conducted in various specialties across all connections in Gilgit-Baltistan. This is a remarkable increase in the uptake of services as compared to Q4 2014, during which no store-and-forward teleconsultations took place. In 2015, various training, reinforcement, monitoring and implementation activities were carried out in Gilgit-Baltistan which resulted in an increase in the uptake of services.

At the Gulmit Health Centre, eHealth services were discontinued in December 2015 due to no eHealth activity at the site since October 2014. One of the reasons for this was that a series of five tunnels parallel to Attabad Lake were inaugurated by Prime Minister Nawaz Sharif in September 2015. These tunnels reduced the travel time and hardship between Gulmit and Aliabad, which resulted in a diminished need for teleconsultation services between the two health centres.


eLEARNING

eLearning Sessions: 9

eLearning Participants: 44


eLearning services initiated in April 2015. AKUH, K began offering Continuing Medical Education (CME) courses to AKBMC, GMC and Singal Medical Centre in an effort to strengthen the capacity of health care professionals. In addition to CME courses, AKUH, K also broadcasts Grand Rounds to AKBMC, GMC and Singal Medical Centre. Grand Rounds are structured online conferences allowing health care professionals to enhance their medical knowledge and skills.

In November, AKUH, K also began giving credit hours to participants at the three sites for attending the CME courses, allowing health care professionals to earn credit remotely.

In Q4 2015, AKUH, K delivered nine sessions benefitting 44 participants. Four of these sessions were CME sessions and five were Grand Rounds.

TAJIKISTAN


TELECONSULTATIONS

Total Teleconsultations: 241

Live Teleconsultations: 109

Store-and-Forward Teleconsultations: 132


Live Teleconsultations

In Q4 2015, 109 live teleconsultations were conducted across all sites in Tajikistan as compared to 70 teleconsultations in Q4 2014.

Eighty-five teleconsultations took place between Khorog Oblast General Hospital (KOGH) and the three district hospitals, with Darwaz District Hospital (DDH) referring 25 cases, Ishkashim District Hospital (IDH) referring 26 cases and Roshan District Hospital (RDH) referring 34 cases, respectively. This is considerably higher than the 55 consultations conducted between KOGH and these three district hospitals in Q4 2014.

Twenty-four teleconsultations took place between National Medical Centre (NMC), Karabolo and KOGH in Q4 2015 as compared to 15 teleconsultations in Q4 2014. No teleconsultations were conducted between KOGH and FMIC in either quarters.

In December, a focal eHealth coordinator was assigned at the three district hospitals to facilitate eHealth operations.

Store-and-Forward Teleconsultations

In Q4 2015, 132 patients benefitted from teleradiology services at KOGH as opposed to 126 in Q4 2014. 130 teleradiology cases were referred from KOGH to NMC, Dushanbe and two cases were referred from KOGH to the Aga Khan Health Board (AKHB), USA.

In Q4 2014, the radiologist at NMC was away on training in Moscow. Teleradiology cases were therefore being sent to AKHB, USA for second opinion and diagnosis. In January 2015, the radiologist returned from the training and KOGH started referring cases with NMC again instead of AKHB, USA. As only complicated cases are now shared with AKHB, USA for second opinion, the number of cases sent to AKHB, USA has decreased considerably from last year whereas the number of cases sent to NMC has increased drastically.

eLEARNING

eLearning Sessions: 17

eLearning Participants: 208


eLearning sessions are offered by KOGH to health care providers at the three district hospitals. KOGH receives eLearning sessions from FMIC as well.

In Q4 2015, 17 eLearning sessions were conducted, which were attended by 208 participants. Of these, KOGH offered six courses to RDH, benefitting 69 nurses; seven courses to IDH, benefiting 76 nurses and doctors and three courses to DDH, benefiting 36 nurses and doctors. One eLearning course was offered from FMIC to KOGH benefitting 27 nurses.

PLANS AHEAD


AFGHANISTAN


  • Initiate live teleopthalmology between FMIC and AKUH, K.
  • Develop and test a business model to sustain teleconsultation services once donor funding ends.

KYRGYZ REPUBLIC


  • Monitor on-going services so lessons learned can be implemented in other Central Asian countries.
  • Add further specialties in teleconsultation services.
  • Collaborate with other eHealth programmes in the Kyrgyz Republic.

PAKISTAN


  • Initiate live teleconsultations from Garam Chasma Tehsil Hospital to AKBMC (hub) in various specialties.
  • Initiate live teleconsultations from Soust Health Centre to Aliabad Extended Family Health Centre (hub); Chatorkhand Health Centre to Singal Medical Centre (hub) and Singal Medical Centre to GMC (hub).
  • Reevaluate eHealth services at Civil Hospital, Gupis and Yasin Health Centre to determine the need to continue services.

TAJIKISTAN


  • Connect KOGH with Dushanbe Medical Diagnostic Centre for live teleconsultations.
  • Connect Postgraduate Medical Institute, Dushanbe with KOGH for eLearning sessions.
  • Establish robust and reliable connectivity to initiate telepathology services between KOGH and FMIC for second opinions and diagnosis.
  • Implement new eHealth equipment and offer training in three district hospitals and KOGH.
  • Develop and test business model for teleconsultations to ensure sustainability of the programme.

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.

G-3a,   Block 17,
Gulshan-e-Iqbal,
Karachi,   Pakistan

(+92 21) 9924-4230

ehrc@akdn.org