Telemedicine or healing at a distance uses technology to overcome geographical borders and increase health care for all. VINO GOVENDER CM(SA), Executive for Product Innovation and Marketing at Dark Fibre Africa, explains how it works.
Telemedicine, a term which literally means “healing at a distance”, speaks to the use of technology to overcome geographical barriers, and increase access to health care services. This is particularly beneficial for extending medical services to communities that lack access to specialised health care services to their geographic location. These communities frequently experience situations where the intervention time from disease detection to beginning of care, affects the final result of the care itself.
As one of Africa’s largest economies, it is becoming increasingly important for South Africa to efficiently execute strategies that serve and enhance the lives of all its citizens. Patients in non-urban areas sometimes have to travel hundreds of kilometres to access medical facilities – often, resulting in progression of the illness or the demise of the patient. This is where technologies based on resilient and high speed data connectivity can assist significantly in reducing and even eliminating the “distance barrier” to specialised health and medical care services. For example, the deployment of video solutions can easily connect patients at family health clinics to specialists in larger medical centres. Meaning that children could potentially consult a doctor whose practise is hours away, without travelling the distance.
Technological solutions can also connect clinics in remote areas to experts and information at medical schools, university sites and larger hospitals. Dark Fibre Africa (DFA), through its open access fibre infrastructure deployment, continues to play a critical role in enabling connectivity service providers to deliver a range of high speed fixed and wireless connectivity services, upon which, specialised healthcare and medical services can be delivered to communities that cannot access such services due to geographic location that places them beyond physical reach. Today, telemedicine enables an increasingly wide range of services over much longer distances, including:
– Real-time patient consultations;
– Remote monitoring of patients’ vital signs and conditions;
– The storing and forwarding of critical health information for analysis and diagnosis
– The provision of specialised services over long distances
– The wide availability of health information to patients and care givers.
There are a few mobile applications in the market today that connect general healthcare workers directly with specialists in South Africa. Through these apps, health professionals can make referrals, get advice, find information, and undertake diagnostic tests, all through their mobile phone. This results in more accurate diagnoses and appropriate referrals, reducing inefficiencies in current systems. Additionally, specialists are able to review a patient’s information, including test results and photographs, before the patient arrives at the referred hospital. This means doctors can prioritise urgent cases and prepare for their arrival ahead of time.
Innovations such as IoT sensors, smart pill bottles, and asset management devices are now being used to monitor the ‘cold chain’ delivery of vaccines, remind chronic patients when to take medication and monitoring the health status as well as security of critical medical equipment that are deployed at remote sites.
These and other advancements, however, are ultimately dependent on telemedicine service providers and consumers having access to robust internet connectivity. A ubiquitous high-speed connectivity ecosystem enables health departments and health care service providers to effectively and efficiently extend specialised health and medical care services to a broader reach of South Africans. In addition to this, service delivery can be improved, the costs to extend services can be reduced and a vastly decreased diagnosis and treatment to result time can be achieved. The full potential of telemedicine cannot be realized without the continued deployment and adoption of advanced and high speed connectivity technologies, such as fibre, to increase the availability and access of services to non-urban areas.
At DFA, we have seen the critical and pivotal role fibre plays in accelerating service delivery. In 2014 we connected 1181 establishments and 3966 end points. In 2015 alone those figures almost doubled and tripled respectively, with 2046 buildings and 11 706 end points being connected. Our network footprint reaches a significant number of specialised health and medical care providers, enabling them to reach a broader number of patients through digital platforms and technologies – we provide an enabling technology and connectivity foundation for the accelerated deployment of Telemedicine in South Africa. Through our wholly owned subsidiary, SqwidNet, we are also deploying the Sigfox IoT network nationally, which can be used to deliver innovative solutions and services to the health and medical care sector.
Wikipedia wants more Africa
At the recent Wikimania conference in Cape Town, a key focus was on increasing more regional contribution to the world’s largest free, collaboratively-built online encyclopaedia.
The 14th annual Wikimania 2018 conference, the annual gathering of volunteers from around the world to celebrate Wikipedia and the Wikimedia projects, is expected to bring together over 500 volunteers from around the world to discuss and share ideas around the future of Wikipedia and free knowledge globally.
Wikimedia sites are read approximately 15 billion times a month globally, however only a small portion of volunteer Wikipedia editors come from Asia, Africa, and Latin America combined.
Anyone can edit Wikipedia in any of its almost 300 different language versions including Swahili, Hausa, Amharic, Arabic and Afrikaans versions.
“To achieve knowledge equity we need to have more voices represented in our community. This is why we are creating an inclusive environment for people from all over the world to contribute knowledge in a way that considers custom, language, access to bandwidth, and more,” said Ellie Young, Conference Organizer for Wikimania.
Ghanaian Wikipedia contributor and free knowledge activist Felix Nartey says that some of the primary barriers to contribution from people living in Africa is lack of time and lack of access to an enabling environment (computers and access/affordability of internet).
“We have been engaging with our communities and holding a number of successful editathon sessions. What is apparent is that African people have a real appetite to see themselves represented on this platform. They want to see their content and their languages on Wikipedia and are crashing through some of the structural barriers to do so,” said Mr. Nartey.
For example, through a collaboration with the Social Theory Course at Ashesi University in Ghana, students have been given class assignments which have led to contributions of their research and term papers on Wikipedia through the Wikipedia Education Program model.
Across other parts of Africa, organised thematic workshops targeted at bridging the gender gap and other systematic biases that exist on Wikipedia have also been held.
“If you are passionate about a specific topic or piece of local history, or if you would like to see more articles in your own language, register and start making your contributions. The only way we are going to shift the content bias is by adding content that represents a more diverse user base,” said Douglas Scott, President of the Wikimedia Chapter of South Africa.
With over 5 million articles already on English language Wikipedia, Mr. Scott says that more African contributors can get involved by creating an account on Wikipedia and testing out different ways to edit — whether it’s fixing a grammatical error or adding a citation to an existing article, creating a new article, or asking other volunteer editors for support in reviewing a draft article you created.
Articles on Wikipedia need to have verifiable references and sources. This means that facts must be drawn from recognisable publications and institutions. A great way for more African contributors to get involved is to join a WikiProject around specific areas of interest. WikiProjects consist of groups of contributors who work together to create and improve articles about a specific topic on Wikipedia.
Africa’s fintech is migrating
Africa’s fragmented markets and lack of legacy foreign exchange trading infrastructure means that the continent has become a melting pot of fintech activity and innovation, writes TIM HUTCHINSON, Head of Digital for Financial Markets, Standard Bank.
The evolution to electronic foreign currency trading in Africa, while slow to start, is today gaining tremendous traction.
In South Africa, only five years ago, almost 90% of foreign currency trades happened over the telephone. Today, despite challenges around illiquidity and complicated political and capital control environments, approximately 75% of trades are conducted digitally, with a mere 25% conducted on the phone.
With 57.6% of the world’s 174-million active registered mobile money accounts in Sub-Saharan Africa, the continent is becoming a world leader in fintech generally, and in mobile money in particular. As African citizens and business people transact globally, Africa’s highly developed fintech culture is not only deepening on the continent, but is also migrating out of Africa.
The foreign exchange flows that Africa’s expanding fintech culture supports are very important to the continent’s financial services providers, most of whom are developing fintech capabilities or partnering with the most popular or effective home-grown African fintech’s to ensure that they capture this flow.
Standard Bank has been an integral part of driving this rapid evolution to digital in Africa’s foreign exchange trading landscape.
In order to function as an effective market maker, we need to source liquidity in market. We also need to, instantly, formulate risk-based pricing in an ever-changing world. Thereafter we need to distribute price.
In Africa this requires developing solutions that allows retail, corporate and institutional customers to access foreign exchange markets across multiple jurisdictions. At the same time in most markets, “we also need to show central banks what we are doing,” adds Mr Hutchinson. All transactions need to be transparent and electronically traceable so that local authorities are prepared to approve digital trades.
Today, however, banks are not only expected to provide the systems and networks to facilitate basic transactions but are also required to provide insight and guidance beyond pure execution by offering additional value-based services across research, hedging and, most importantly, settlement capability. Currency research for example, is increasingly a big client requirement. Having on the ground experience and local expertise as well as the ability to deliver this digitally, “differentiates Standard Bank’s distribution capabilities in this regard”.
In addition, banks are also increasingly required to inform and guide clients through the broader economic, legal and political landscapes in which transactions occur. For example, one of the considerations in developing Standard Bank’s digital capability was how to combine market intelligence and research with real-time pricing, trade execution and post-trade services. Today it is not enough just to execute trades. It is equally important that we advise and inform the broader universe in which trades happen.
From a technology point of view Regulatory Technology (Regtec), for example, is assisting Africa to manage new regulatory developments in heavily currency-controlled environments. Similarly, the rise in robotic process automation (RPA) and artificial intelligence (AI), “has allowed Standard Bank to develop solutions that leapfrog traditional business problems”.
Digital trading in Africa is also evolving in its own often very different way. We have found that it is not just a question of importing developed world systems. Our approach with clients is to work with them to help understand their internal needs in terms of governance and operational efficiency. We then partner with clients to develop and implement digital solutions that talk to the heart of their business need.
Standard Bank’s own Business Online (BOL) platform provides an example of how the bank has built digital transaction capabilities that exactly meet client need. BOL, for example, allows clients to view balances across the continent while making third party currency payments and also supporting general cash management. This kind of broad, business-wide digital cash view and capability puts control back in the hands of the clients while also allowing clients, rather than the bank, to manage their own cash flow.
From an Institutional perspective it’s very important to be able to offer customisable solutions to clients managing money on behalf of their investors. Standard Bank’s investment in Application Programming Interface (API) technology, for example, is tracking exactly its client’s growing ability to build these capabilities into their own systems.
On the retail side Standard Bank’s SHYFT app – a digital wallet allowing global transactions in USD, EUROS, GBP and Australian dollars has extended this control element to the man in the street. SHYFT has been recognised both globally and locally for its innovation.
Standard Bank presents a very compelling, unique and globally competitive digital trading proposition to local and developed world clients seeking to access Africa. Our footprint across 20 territories – most at different levels of digital development – provides a compelling pan-African proposition for global and local clients alike.
While Africa’s record in digital adaptation and innovation is impressive, the technology part is often the easier part to implement. The human and cultural systems, and client behaviour changes, required to give this digital evolution life – like getting customer analogue systems to start pricing electronically to make trades visible 24/7 – is often a lot harder to achieve than the technology upgrade. In short, bank employees, customers and regulators all need to undergo fundamental cultural shifts in how they do things and understand the world.
It is often these broader cultural and market shifts that Standard Bank as a pan-African bank is called on to advise as clients seek to understand and engage Africa effectively.
Given the rapid pace of digital evolution within Africa’s varied market, customer, legislative and cultural landscapes, we need to balance customer value and efficiency – and regulatory pressures to be more transparent – with what is, in the long run, best for the market.
As a pan-African bank inextricably committed to the growth and success of the continent, Standard Bank’s digital journey requires a judicious blend of developed world technology with African insight and innovation. This blend should be capable of balancing customer need and legislative oversight in the development of efficient and inclusive markets that sustain long term growth.