Author Topic: Why is the medical fields slow to embrace technology like kenya financial sector  (Read 16193 times)

Offline RV Pundit

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This lady Ms Nyokabi has done something quite simple and revolutionary. I think if medical field (that is dominated by old school MOH and religious bodies) like the education sector can embrace the fully use of ICT and MPESA type tech....we could easily solve many of our health issues.

http://www.nation.co.ke/lifestyle/money/Clinic-where-doctors-access-X-ray-reports-round-the-clock/-/435440/2723234/-/fofv00z/-/index.html

Offline Omollo

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Some years ago, I travelled home from Graduate School and found a neighbor dying of ulcers. I rushed him to hospital and ran in to archaic doctors telling me Ulcer is an incurable distemper. I contacted my friends abroad who sent a prescription. I had some drugs airlifted. The man died however on the day the customs released the meds after a lot of "invisible" costs.

Needless to say a lot of good came out of it. I linked the local docs to others and several years later, some of those bozos are "experts" on the treatment of ulcers.

This lady Ms Nyokabi has done something quite simple and revolutionary. I think if medical field (that is dominated by old school MOH and religious bodies) like the education sector can embrace the fully use of ICT and MPESA type tech....we could easily solve many of our health issues.

http://www.nation.co.ke/lifestyle/money/Clinic-where-doctors-access-X-ray-reports-round-the-clock/-/435440/2723234/-/fofv00z/-/index.html

... [the ICC case] will be tried in Europe, where due procedure and expertise prevail.; ... Second-guessing Ocampo and fantasizing ..has obviously become a national pastime.- NattyDread

Offline RV Pundit

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They need to fully embrace technology..now that internet is a google a way and they've all the tools for make e-medicine a reality. Just like Mpesa is transforming the lives of people in terms of financial access, I think medical and education field will be transformed in the next few yrs in ways we cannot even imagine.
Some years ago, I travelled home from Graduate School and found a neighbor dying of ulcers. I rushed him to hospital and ran in to archaic doctors telling me Ulcer is an incurable distemper. I contacted my friends abroad who sent a prescription. I had some drugs airlifted. The man died however on the day the customs released the meds after a lot of "invisible" costs.

Needless to say a lot of good came out of it. I linked the local docs to others and several years later, some of those bozos are "experts" on the treatment of ulcers.

Offline Omollo

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As you already know I am familiar with Switzerland. I once took a short tour of their pharmaceutical industry. I thought I would find huge structures straddling the borders of various cantons. Nope! Nothing grand. Then I found out they invest more in technology and eliminate unnecessary human labour.

You may have missed this... but Ivory Coast opened it first Chocolate Plant nearly 60 years after independence!

There is something seriously wrong with us. Nobody stopped Kenya from starting the Mobile Phone revolution in Africa. The fear that the opposition would use it dictated the way. FM radios are now being licensed at a time when the rest of the world is getting rid of FM - just think about it!

You have a guy like Dr. Ndemo pretending to be far sighted. Yet he works closely with Safaricom to keep mobile user costs high! I wondered aloud who he works for.

I think Kenyan doctors are used to how things are and do not want change.

They need to fully embrace technology..now that internet is a google a way and they've all the tools for make e-medicine a reality. Just like Mpesa is transforming the lives of people in terms of financial access, I think medical and education field will be transformed in the next few yrs in ways we cannot even imagine.
... [the ICC case] will be tried in Europe, where due procedure and expertise prevail.; ... Second-guessing Ocampo and fantasizing ..has obviously become a national pastime.- NattyDread

Offline Georgesoros

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Its not embracing, rather someone whos willing to invest in change. Most docs may be used to the old system and they may also not be willing to change. It needs new thinking. A good example is KNH. It has an antiquated management system that will never change, so until its goes bankrupt it will stay the same. Youve got to change everyones attitude before things can change.

Offline MOON Ki

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There is something seriously wrong with us. Nobody stopped Kenya from starting the Mobile Phone revolution in Africa. The fear that the opposition would use it dictated the way. FM radios are now being licensed at a time when the rest of the world is getting rid of FM - just think about it!

And what a change!   For "sentimental reasons", I still have my father's old Short-Wave radio: a huge wooden Grunding, with the names of stations written on the face.    It still works and always makes for a great conversation piece: the "older types" recall the "good old days", and the younger ones marvel at the idea of SW.  Reminds me of the days when anyone who wanted to know what was rely happening in Kenya would tune into BBC World Service ...

But in these Amazing Days, in which people make their own "radio stations" on the internet---almost a decade old in places like Korea---one still finds places like Burundi, where a coup starts with an attack on the radio station.  A different kind of "good old days", I suppose ...

Your comment on fear is an amusing one.   Back in the day, my school had this expat British teacher who was into Morse Code---anyone remember that!---over radio.  He was keen to teach some of us about that, and he duly ordered all the required equipment from the UK---long, fancy antennae and the like.   It then took a year to get going because GoK (the military) was concerned about the guy might transmit ...
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Offline MOON Ki

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Its not embracing, rather someone whos willing to invest in change. Most docs may be used to the old system and they may also not be willing to change. It needs new thinking. A good example is KNH. It has an antiquated management system that will never change, so until its goes bankrupt it will stay the same. Youve got to change everyones attitude before things can change.

Kenyan hospitals need to first focus on some very basic things---such as cleanliness.   Most public hospitals are filthy places that pose a great danger to the health of Kenyans: you might go in with one thing and come out with ten new ones.

After that would the sort of corruption that means that most "free" or "cheap" drugs that are supposedly in the hospitals actually have to be paid for in little nooks-and-crannies "pharmacies" near the hospitals.
MOON Ki  is  Muli Otieno Otiende Njoroge arap Kiprotich
Your True Friend, Brother,  and  Compatriot.

Offline Omollo

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MoonKi

It is the same solution. The reason most of these hospitals are filthy is simple: They still base all cleaning on human beings who still use the same old style and tools to clean.

Most modern hospitals from design to construction and equipping made to be easily cleaned using modern technology. Just about ten people can keep clean the entire Kenyatta National Hospital. As a student fresh from Kenya, I took up cleaning to make some extra cash. I had to take up a course in cleaning which basically trained me in operating the equipment to be used in cleaning. Once I mastered it, I could carry out tasks that would require 100 people in Kenya.

I have to add some caution: It is not that Kenyans are ignorant of this. No sir! The other reason technology is not embraced is that it interferes with "income generating activities" going on by the side. You may recall that Moi had to get rid of toll stations after those working there became instant millionaires.

If you eliminate mama kifagio in Nairobi and replace her with an advanced Street Cleansing Machine, you will run in to problems. The MCAs whose constituents are "Ghost" workers may even impeach you.

It doesn't even have to be advanced:

This street cleaner was spotted by tourists in Qinghuangdao city, Hebei province

Kenyan hospitals need to first focus on some very basic things---such as cleanliness.   Most public hospitals are filthy places that pose a great danger to the health of Kenyans: you might go in with one thing and come out with ten new ones.

After that would the sort of corruption that means that most "free" or "cheap" drugs that are supposedly in the hospitals actually have to be paid for in little nooks-and-crannies "pharmacies" near the hospitals.
... [the ICC case] will be tried in Europe, where due procedure and expertise prevail.; ... Second-guessing Ocampo and fantasizing ..has obviously become a national pastime.- NattyDread

Offline jakoyo

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We need to take care of the basic things  - like eliminating Cholera , which is threatening to become an epidemic. 30 visitors from Germany  who were meant to visit us in Nakuru and Kisumu have cancelled their trip. They could not get travel insurance due to the security issue and cholera out breaks going on in Kenya.

Offline RV Pundit

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This is the same argument we had when computers and mobile phones were being introduced. That we should focus on basic things. Like food and ending starvation. But now look at what Mpesa is doing and what mobile phone has done.Technology will eliminate cholera...and the need to go to hospital or clean one.

That lady with a few radiologist...can give us world class radiology service...at a fraction of the cost.

Now If we had more of that....we wouldn't need to overcrowd in KNH...


We need to take care of the basic things  - like eliminating Cholera , which is threatening to become an epidemic. 30 visitors from Germany  who were meant to visit us in Nakuru and Kisumu have cancelled their trip. They could not get travel insurance due to the security issue and cholera out breaks going on in Kenya.

Offline Kim Jong-Un's Pajama Pants

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I believe another area of potential growth is medical coding.  Medical insurances live and die by it in the US.
"I freed a thousand slaves.  I could have freed a thousand more if only they knew they were slaves."

Harriet Tubman

Offline RV Pundit

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Right. Telemedicine out to be work here. Like Mpesa there is no competitor or comparator..considering the lack of real hospitals out there. Even if telemedicine or e-medicine is not as good as see jakoyo in person...it better than what we most have here.

All you need are agents [business for someone] with basic equipment that can do blood test, do some scans, mris and perhaps manned by a nurse and clinian...then linked to somewhere in Nairobi....where real doctors...sit round the clock.

Why travel all the way to KNH only to be seen by doctor for less than 20mins...in two rounds every day?

All it takes is for someone of Safaricom like clout to try it out...with well known hospital brand.

I believe another area of potential growth is medical coding.  Medical insurances live and die by it in the US.

Offline Kim Jong-Un's Pajama Pants

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Right. Telemedicine out to be work here. Like Mpesa there is no competitor or comparator..considering the lack of real hospitals out there. Even if telemedicine or e-medicine is not as good as see jakoyo in person...it better than what we most have here.

All you need are agents [business for someone] with basic equipment that can do blood test, do some scans, mris and perhaps manned by a nurse and clinian...then linked to somewhere in Nairobi....where real doctors...sit round the clock.

Why travel all the way to KNH only to be seen by doctor for less than 20mins...in two rounds every day?

All it takes is for someone of Safaricom like clout to try it out...with well known hospital brand.

I believe another area of potential growth is medical coding.  Medical insurances live and die by it in the US.
Ok.  That is different from what I am thinking.  But a good idea nevertheless.

I was thinking along the lines of processing ICD codes.  A regular doctor's visit, a diagnosis and creating a digital record of the same using ICD codes in the states, I believe Read codes in the UK.

The doctor's office normally does not handle that process, but they outsource it to specialists.  The specialists convert the doctor's notes into a code that can be used to bill the insurance company.

I was thinking coding specialists could be based out of Kenya. 
"I freed a thousand slaves.  I could have freed a thousand more if only they knew they were slaves."

Harriet Tubman

Offline RV Pundit

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Yes I understood. There is certainly scope for that here. If it will help for instance reduce fraud in billing..that will be helpful.
I was thinking along the lines of processing ICD codes.  A regular doctor's visit, a diagnosis and creating a digital record of the same using ICD codes in the states, I believe Read codes in the UK.

The doctor's office normally does not handle that process, but they outsource it to specialists.  The specialists convert the doctor's notes into a code that can be used to bill the insurance company.

I was thinking coding specialists could be based out of Kenya. 

Offline MOON Ki

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Technology can certainly help, but first it requires that the government spend more money on health.   As far as I can tell, spending health, taken as a % of budget or GDP, has been going down for quite some time.   This article, from not-too-long ago, summarizes the grim picture:

http://www.standardmedia.co.ke/article/2000086000/kenya-s-2013-14-health-budget-cuts-threaten-to-cripple-sector?articleID=2000086000&story_title=kenya-s-2013-14-health-budget-cuts-threaten-to-cripple-sector&pageNo=1

Even more alarming is that quite a bit of that money apparently does not go where it is supposed to go. 

This (from the same article) is alarming, if true:

Quote

Omollo:

I would not have problems with Mama Kifagios if they actually did what they were paid to do; as it is, there are too many idlers-on-the-job.  In the particular case of hospitals, I have seen much that could easily be done with just a small number of people armed with mops, detergents, etc.; at the same time I have observed the "workers" out basking in the sun or busily engaged in chit-chat.   Go take a look at "Russia", for example.

Speaking of "Russia", I have just had a rude reminder of the state of such hospitals.    I am in the process of getting a relative transferred from there to a private facility.   He was admitted last night, no doctors with time to see him until the morning, and  given the choice of sharing a bed with another person (apparently standard practice there) or sitting on the floor until the morning as he waited for a doctor.

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Offline Kim Jong-Un's Pajama Pants

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Technology can certainly help, but first it requires that the government spend more money on health.   As far as I can tell, spending health, taken as a % of budget or GDP, has been going down for quite some time.   This article, from not-too-long ago, summarizes the grim picture:

http://www.standardmedia.co.ke/article/2000086000/kenya-s-2013-14-health-budget-cuts-threaten-to-cripple-sector?articleID=2000086000&story_title=kenya-s-2013-14-health-budget-cuts-threaten-to-cripple-sector&pageNo=1

Even more alarming is that quite a bit of that money apparently does not go where it is supposed to go. 

This (from the same article) is alarming, if true:

Quote

Omollo:

I would not have problems with Mama Kifagios if they actually did what they were paid to do; as it is, there are too many idlers-on-the-job.  In the particular case of hospitals, I have seen much that could easily be done with just a small number of people armed with mops, detergents, etc.; at the same time I have observed the "workers" out basking in the sun or busily engaged in chit-chat.   Go take a look at "Russia", for example.

Speaking of "Russia", I have just had a rude reminder of the state of such hospitals.    I am in the process of getting a relative transferred from there to a private facility.   He was admitted last night, no doctors with time to see him until the morning, and  given the choice of sharing a bed with another person or sitting on the floor until the morning as he waited for a doctor.


Those are disastrous numbers for corruption.  That is almost half the budget.  It is just possible that the mama vifagios and general staff are poorly motivated. 

It can happen in an environment where year in year out a Mama Ngilu to pick a perfectly random example moves from one rewarding public post to another, the trail of destruction and controversy that follows her notwithstanding.
"I freed a thousand slaves.  I could have freed a thousand more if only they knew they were slaves."

Harriet Tubman

Offline mya88

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Ok.  That is different from what I am thinking.  But a good idea nevertheless.

I was thinking along the lines of processing ICD codes.  A regular doctor's visit, a diagnosis and creating a digital record of the same using ICD codes in the states, I believe Read codes in the UK.

The doctor's office normally does not handle that process, but they outsource it to specialists.  The specialists convert the doctor's notes into a code that can be used to bill the insurance company.

I was thinking coding specialists could be based out of Kenya. 

ICD 9 or upcoming 10's most important function is billing for services provided by clinicians. That is its most basic function, so that physicians are not making up things and billing fraudulently for service not provided. Actually most clinicians are now coding as they see patients, and if they are too busy, they write them down and a medical biller enters it on the template for Medicare/Insurance payments systems..I fail to see how such a service can benefit a country that lacks the most basic of services such as Kenya. It doesn't cost much to provided basic services, and clinical officers can provided such services all over Kenya if lack of physicians is the issue.

Growing up there were dispensaries in almost every estate that provided basic medical care including childhood immunizations so that kids are not dying for no reason. All these can be accomplished by basic assessments and a few tests that are provided on site. Kenya can afford to have such clinics in almost every corner of the country if they were serious about health care in the first place.Computerized healthcare will be important in communicating findings with other providers, ie specialists in in other locations.

 The only thing that is outsourced are radiology services, where they send pictures (x-rays, CT scan, MRI's) to a different location, the  radiologist reads them and sends his result to the provider. There aren't that many radiologists around so this is a much more efficient way to still provide the services. Kenya could benefit from this particular technological advancement.
"We must be the change we wish to see" - Mahatma Ghandi

Offline Kim Jong-Un's Pajama Pants

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Ok.  That is different from what I am thinking.  But a good idea nevertheless.

I was thinking along the lines of processing ICD codes.  A regular doctor's visit, a diagnosis and creating a digital record of the same using ICD codes in the states, I believe Read codes in the UK.

The doctor's office normally does not handle that process, but they outsource it to specialists.  The specialists convert the doctor's notes into a code that can be used to bill the insurance company.

I was thinking coding specialists could be based out of Kenya. 

ICD 9 or upcoming 10's most important function is billing for services provided by clinicians. That is its most basic function, so that physicians are not making up things and billing fraudulently for service not provided. Actually most clinicians are now coding as they see patients, and if they are too busy, they write them down and a medical biller enters it on the template for Medicare/Insurance payments systems..I fail to see how such a service can benefit a country that lacks the most basic of services such as Kenya. It doesn't cost much to provided basic services, and clinical officers can provided such services all over Kenya if lack of physicians is the issue.

Growing up there were dispensaries in almost every estate that provided basic medical care including childhood immunizations so that kids are not dying for no reason. All these can be accomplished by basic assessments and a few tests that are provided on site. Kenya can afford to have such clinics in almost every corner of the country if they were serious about health care in the first place.Computerized healthcare will be important in communicating findings with other providers, ie specialists in in other locations.

 The only thing that is outsourced are radiology services, where they send pictures (x-rays, CT scan, MRI's) to a different location, the  radiologist reads them and sends his result to the provider. There aren't that many radiologists around so this is a much more efficient way to still provide the services. Kenya could benefit from this particular technological advancement.
mya88,

My idea was for the coding part to be done by Kenyans, rather than to be incorporated into the Kenyan system.  Hence the outsourcing bit.  A service by Kenyans for others if you will
"I freed a thousand slaves.  I could have freed a thousand more if only they knew they were slaves."

Harriet Tubman

Offline mya88

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Ok.  That is different from what I am thinking.  But a good idea nevertheless.

I was thinking along the lines of processing ICD codes.  A regular doctor's visit, a diagnosis and creating a digital record of the same using ICD codes in the states, I believe Read codes in the UK.

The doctor's office normally does not handle that process, but they outsource it to specialists.  The specialists convert the doctor's notes into a code that can be used to bill the insurance company.

I was thinking coding specialists could be based out of Kenya. 

ICD 9 or upcoming 10's most important function is billing for services provided by clinicians. That is its most basic function, so that physicians are not making up things and billing fraudulently for service not provided. Actually most clinicians are now coding as they see patients, and if they are too busy, they write them down and a medical biller enters it on the template for Medicare/Insurance payments systems..I fail to see how such a service can benefit a country that lacks the most basic of services such as Kenya. It doesn't cost much to provided basic services, and clinical officers can provided such services all over Kenya if lack of physicians is the issue.

Growing up there were dispensaries in almost every estate that provided basic medical care including childhood immunizations so that kids are not dying for no reason. All these can be accomplished by basic assessments and a few tests that are provided on site. Kenya can afford to have such clinics in almost every corner of the country if they were serious about health care in the first place.Computerized healthcare will be important in communicating findings with other providers, ie specialists in in other locations.

 The only thing that is outsourced are radiology services, where they send pictures (x-rays, CT scan, MRI's) to a different location, the  radiologist reads them and sends his result to the provider. There aren't that many radiologists around so this is a much more efficient way to still provide the services. Kenya could benefit from this particular technological advancement.
mya88,

My idea was for the coding part to be done by Kenyans, rather than to be incorporated into the Kenyan system.  Hence the outsourcing bit.  A service by Kenyans for others if you will
Ok, Maybe I got lost in translation somewhere....... service for Kenyans by Kenyans is always good. But would that make our health system any better than it currently is?
"We must be the change we wish to see" - Mahatma Ghandi

Offline Kim Jong-Un's Pajama Pants

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Ok.  That is different from what I am thinking.  But a good idea nevertheless.

I was thinking along the lines of processing ICD codes.  A regular doctor's visit, a diagnosis and creating a digital record of the same using ICD codes in the states, I believe Read codes in the UK.

The doctor's office normally does not handle that process, but they outsource it to specialists.  The specialists convert the doctor's notes into a code that can be used to bill the insurance company.

I was thinking coding specialists could be based out of Kenya. 

ICD 9 or upcoming 10's most important function is billing for services provided by clinicians. That is its most basic function, so that physicians are not making up things and billing fraudulently for service not provided. Actually most clinicians are now coding as they see patients, and if they are too busy, they write them down and a medical biller enters it on the template for Medicare/Insurance payments systems..I fail to see how such a service can benefit a country that lacks the most basic of services such as Kenya. It doesn't cost much to provided basic services, and clinical officers can provided such services all over Kenya if lack of physicians is the issue.

Growing up there were dispensaries in almost every estate that provided basic medical care including childhood immunizations so that kids are not dying for no reason. All these can be accomplished by basic assessments and a few tests that are provided on site. Kenya can afford to have such clinics in almost every corner of the country if they were serious about health care in the first place.Computerized healthcare will be important in communicating findings with other providers, ie specialists in in other locations.

 The only thing that is outsourced are radiology services, where they send pictures (x-rays, CT scan, MRI's) to a different location, the  radiologist reads them and sends his result to the provider. There aren't that many radiologists around so this is a much more efficient way to still provide the services. Kenya could benefit from this particular technological advancement.
mya88,

My idea was for the coding part to be done by Kenyans, rather than to be incorporated into the Kenyan system.  Hence the outsourcing bit.  A service by Kenyans for others if you will
Ok, Maybe I got lost in translation somewhere....... service for Kenyans by Kenyans is always good. But would that make our health system any better than it currently is?
No.  They would not be working for the Kenyan system at all.  Mwananchi healthcare would continue to remain dire(or improve) in this particular scenario. 

Think in terms of the guy who answers your phone from India asking you if watched the Cubs vs Whitesox game when you call to complain that cable is not working in the first place.

The Kenyans would be working as outsourced resources; as coders.  This particular angle is not about Kenyan healthcare itself at all.  I am not sure it makes sense anymore if the clinicians are doing the coding themselves though.
"I freed a thousand slaves.  I could have freed a thousand more if only they knew they were slaves."

Harriet Tubman