The Novartis Foundation, the philanthropic arm of Swiss pharmaceutical giant Novartis, has enjoyed such success with its pilot of a telemedicine program in Ghana that the country’s healthcare service is to implement it nationwide.
The telemedicine service started as a pilot model in the Amansie West District of the Ashanti Region in 2011, covering 30 communities of around 35,000 people.
It uses mobile technology to connect community health workers in the field with specialist healthcare professionals via 24-hour teleconsultation centres, with doctors, nurses and midwives in these centres able to coach community health workers and advise on treatment of patients.
The goal is to strengthen healthcare capacity and empower community health workers while improving quality of care and avoiding unnecessary referrals. The pilot, it seems, worked, with more than half of all “teleconsultations” resolved directly by phone, including 31 percent that avoided referrals.
As a result, the Ghana Health Service is to implement the program across the nation as part of its national e-health strategy. The Novartis Foundation will provide a roadmap for scale-up, while the Ghana Health Service and the Ministry of Health have now set up six teleconsultation centres across the country. They hope to make full national coverage possible by 2019.
Dr Ann Aerts, head of the Novartis Foundation, told AFKInsider that the technology behind the telemedicine project was intentionally straightforward.
“The real innovation is in how a simple digital health solution, built around communities’ realities, can have a transformational impact on healthcare delivery,” she said.
“Community health workers in the field use mobile phones to call into regional teleconsultation centres, where they are connected with doctors, nurses and midwives for advice on treating their patients, often in emergency cases. This improves care in a number of ways: this coaching helps community health workers develop their capacity to treat patients, but most importantly, it reduces unnecessary referrals of patients to specialist care. This is particularly important in rural areas, where patients may otherwise need to travel long distances, sometimes at their own expense, for such care.”
Aerts said telemedicine was an important step towards the Ghana Health Service’s larger ambition to achieve Universal Health Coverage by 2020.
“It has the potential to improve care for many healthcare challenges in addition to emergency care, like chronic disease management and consultations for mental health patients,” she said.
Though the technology is obviously applicable to other countries, the scale-up recently announced is specific to Ghana, and the Novartis Foundation is not currently involved in telemedicine programs in other African countries.
“The Ghana Health Service will share its learnings as it takes over full programmatic and financial responsibility for telemedicine as it is integrated into national health services. The foundation will also apply its experience in telemedicine to its other initiatives all over the world,” Aerts said.
“The foundation also will continue to work on other digital health programs in Ghana, such as the community-based Hypertension Improvement Project in the Lower Manya-Krobo District. This program seeks to improve the control and management of hypertension through a community-based model.”
She is optimistic, however, as to the role telemedicine could yet play in other countries.
“The telemedicine model has the potential to be translated into other countries’ national digital health strategies as well as into other areas of care, like chronic disease management and consultations for mental health patients,” said Aerts.
Government involvement is key, however. In Ghana, the Novartis Foundation worked closely with the Ghana Health Service throughout, and will continue to do so during the handover.
“The Ghana Health Service, the Ministry of Health, the National Health Insurance Authority and the Ministry of Communications provided the national leadership to scale telemedicine services,” Aerts said.
“This government leadership is crucial to ensure the sustainability of programs like telemedicine, so we take great pride in seeing telemedicine integrated into national services; the fact that the national Ghanaian government chose to take the telemedicine program to scale is a huge success for the initiative.”
It goes further than that, however, with Aerts saying multi-sector collaboration was at the heart of the Novartis Foundation’s work, and allowed partners to contribute unique resources toward designing and delivering services that can scale.
“In Ghana, the Novartis Foundation and partners contributed experience in innovating healthcare delivery, with the ability to take on financial risk, and to bring stakeholders together. This provided an important catalyst for what was already a priority for the Ghanaian government – telemedicine became a flagship for digital health in Ghana and the basis for the Ministry of Health’s national e-health strategy,” she said.
Tom Jackson is co-founder of Disrupt Africa, a news and research company focused on the African tech startup ecosystem.
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