eHEALTH DIGEST

Live teleconsultations in neurology are now being offered at the French Medical Institute for Children (FMIC) in Afghanistan. An increase in patient demand for neurology consultations led to the service being added to the AKDN eHealth Programme in Afghanistan. This new service will enable patients at FMIC to seek diagnosis and treatment from specialists at the Aga Khan University Hospital, Karachi (AKUH, K). Weekly clinics, conducted by Dr. Ayeesha Kamal, Associate Professor, Neurology at AKUH, K started in May.

In addition, paediatric teleneurology services also started between FMIC and AKUH, K in July, based on a similar demand at FMIC. Monthly clinics are conducted by Dr. Shahnaz Ibrahim, Professor, Paediatrics and Child Health, AKUH, K.

Over 20 adults and children have been consulted and assessed till September by specialists at AKUH, K.

The number of eHealth sites in Afghanistan also increased. In July, Bharak District Hospital was connected to Faizabad Provincial Hospital for live teleconsultations in general specialities. Services started in August and 40 patients have been consulted in seven specialities.

The French Medical Institute for Children (FMIC) in Afghanistan offers an eLearning-based Continuing Nursing Education programme to increase professional development opportunities for health care providers at FMIC, the Bamyan and Faizabad Provincial Hospitals, Mirwais Regional Hospital Kandahar, and Khorog Oblast General Hospital in Tajikistan.

A study is being conducted to determine the efficacy of this eLearning intervention on improvement of maternal and child health knowledge and on practices of health care providers in Afghanistan and Tajikistan. The study will determine the extent to which the eLearning intervention has helped improve the quality of clinical practice and knowledge of health care providers at these hospitals. It will also identify the strengths and weaknesses of this approach and the factors that lead to the success or failure of such interventions in health care settings in low- and middle-income countries.

The study commenced in April 2015 and will carry on until January 2017. Azra Naseem, Assistant Director, Blended and Digital Learning Network, Office of the Provost and Senior Instructor, Institute for Educational Development, Aga Khan University is the principal investigator on the research project.

AKDN eHRC participated in the GCC Healthcare Innovation Congress in Dubai, UAE in May. Afroz Sajwani, Research Coordinator, AKDN eHRC, presented on AKDN's eHealth Programme in Asia, focusing on the activities, outcomes, challenges and success stories of the programme.

AKDN eHRC's presentation was unique as it focused on teleconsultations and eLearning services - areas of eHealth that were not discussed by other speakers at the congress. Participants were appreciative of the setting in which AKDN works, that is, the low-resource, isolated areas of Central and South Asia that face great social and political instability. They commended AKDN agencies for working in such high-risk settings and praised the Programme for adopting simple innovations and technologies to improve lives by increasing access to quality health care services and reducing the cost of seeking health care.

AKDN eHRC promoted the AKDN eHealth Programme on an international platform and learned from the experiences of global implementers and experts in the field of eHealth. Speakers from various countries including India, KSA, Lebanon, Pakistan, Qatar, Switzerland, UAE and UK shared their knowledge on health care innovations implemented in their respective countries.

Given the high incidence of mental health issues and lack of mental health services, live telepsychiatry consultations were initiated in Gilgit Baltistan in April 2014 and in Chitral in November 2014, as part of Central Asia Health System Strengthening project. Teleconsultation services are intended to increase access to specialised care, improve care quality and reduce the cost of health care services. However, the clinical and economic impact of the telepsychiatry consultation service has not been objectively measured so far. A study is therefore being conducted to evaluate the effectiveness of the AKDN eHealth Programme's existing telepsychiatry services in Gilgit-Baltistan and Chitral districts of Pakistan.

The study will be conducted at telepsychiatry clinics at Gilgit Medical Centre and the Aga Khan Booni Medical Centre in Gilgit and Chitral, respectively. These centres operate under the Aga Khan Health Service, Pakistan which serves as a research partner institution and provides support for conducting telepsychiatry consultations and implementing the research activities. Both qualitative and quantitative analysis will be performed to measure the effectiveness of the service in terms of increased access to health care, improved care quality and reduced costs for clients.

Dr. Rozina Karmaliani, Professor, School of Nursing and Midwifery and Community Health Sciences Medical College, Aga Khan University, is the primary investigator of the study. The study commenced in April 2015 and will carry on until January 2017.