The lack of comprehensive data on pharmaceutical consumption in Africa makes it difficult for governments and pharmaceutical companies to gain market intelligence on medicine use. By automating prescription services, mPharma provides patients with faster and surer access to needed medications, alerting doctors with real-time drug reaction monitoring, and the delivery of real-time anonymous drug consumption and diagnostic market analysis to doctors, pharmacies, and pharmaceutical providers

“The IMS Institute estimates that pharmaceutical spending in Africa will reach US$45 billion by 2020. However, the lack of comprehensive data on pharmaceutical consumption makes it difficult for governments and pharmaceutical companies to gain market intelligence on medicine use.”

This is “The Problem” that mPharma set out to solve.

Their intended solution is best expressed in their “Vision,” which is “To provide patients and caregivers access to high quality medicines and information, while enabling health ministries and pharmaceutical companies to obtain real-time pharmaceutical and health information.”

To achieve this, mPharma set out three primary goals:

• Delivering Paperless Prescription services to automate and thereby dramatically improve the process of prescribing, locating, and obtaining needed drugs.

• Providing real-time health monitoring of adverse drug reactions leveraging simple message service (SMS) which is already widely used in Africa.

• Giving governments, hospitals, doctors, and pharmacies subscription-based access to real-time anonymous drug consumption and diagnostic market analysis services.

Microsoft Accelerates Fulfillment of the Vision
Achieving these goals would require not only financial support, it would require technological and business process support as well. To obtain these, mPharma applied to the Microsoft Ventures Accelerator Program. For promising early-stage startups or first-time entrepreneurs, Microsoft Accelerators are immersive programs aimed at “squeezing the countdown to launch” and “creating great businesses at breakneck pace.”

Participants receive four months of strong mentoring, technical guidance and connections to other startups. They are also onboarded onto Microsoft Azure and receive US$5,000 worth of Azure services per month for the first year of operation.  Once the startup ball is rolling, participating start-ups are introduced to global seed funds that offer the opportunity to receive strategic investments to propel their business to the next level. Currently, about 80% of the over 200 start-ups graduating the program have been awarded funding averaging US$1.5M in the first round.

“One of our board members was actually a mentor in the Accelerator program,” explains mPharma co-founder and CEO Gregory Rockson. “At that time we had already begun to develop our solutions and realized that the research and other resources available in a program like the Accelerator would be very valuable, so we applied immediately.” mPharma was one of only eleven applicants accepted.

Improving Healthcare through Pharmaceutical Lifecycle Tracking
mPharma’s solution begins in the doctor’s office when they prescribe medications. Formerly these prescriptions were written on paper. The patient would then attempt to fill the prescription, often finding it unavailable in the pharmacies they visited. Once they did find it and obtain it the flow of information ended.

Now, doctors enter prescriptions into the Azure-cloud-accessible mPharma database, which informs the patient of the nearest pharmacy that has their medication in stock. mPharma provides a plug-in for the pharmacies to link their inventory information systems to. Upon being prescribed the patient receives a code via SMS, which can be received on any mobile phone, they are not required to possess a smartphone!

The patient subsequently reports their use of the medication and any adverse reactions via SMS as well. The individual data can be used by the doctor for follow-up, and the aggregated data is then used anonymously to provide real-time utilization data that governments, hospitals, and pharmacies use to learn more about doctors’ prescription practices, patient usage, and other patterns important to better management of healthcare delivery.

“Let’s say a company like Novartis wants to introduce a new malaria drug into a country like Zambia,” explains Rockson. “They can use our data to help them pinpoint where in-country the drug is most needed and then track how well that drug performed!”

Azure an Ideal Platform for Open Source Development
There are many applications required to connect mPharma to the doctors who write the prescriptions, the pharmacies that fill them, the patients reporting any drug interactions or other adverse effects, and the government and pharmaceutical providers who use the reporting. To accomplish this, the mPharma development team leveraged a wide variety of open source platforms, databases, and other software engines including MongoDB, PostgreSQL, Django, Redis, RabbitMQ, Angular.js and Node.js. These also included Linux distributions such as Ubuntu for their node server and CentOS for their database server.

“We have yet to run into any issues with Azure,” remarks mPharma Chief Technical Officer James Finucane, “and it tends to perform as well or better than other solutions we have tried!”

Healthcare providers are good at managing patients’ medical conditions while they are in the hospital or office, but for patients with chronic health conditions, that is only one piece of the puzzle. What happens while the patient is at home? Is their condition improving or worsening? What factors affect the likelihood of them needing to be readmitted? The question is: how can healthcare organizations change the way they deliver care to improve patient outcomes over the long term – especially when they have limited resources at their disposal?

For PinnacleHealth, the key is to look beyond how a patient is managed in the hospital and examine the bigger picture. Today, the organization uses IBM analytics solutions to assemble, explore and discover data from patient records, and combine it with information gathered during a hospital stay. It then uses this holistic view of the patient’s life to predict the risk of readmission.

By alerting physicians and caregivers to high-risk patients, PinnacleHealth can focus intervention on the patients who really need help, and intervene in a timely manner. Working with Waypoint Consulting, PinnacleHealth is taking the first steps towards a revolutionary new approach to healthcare delivery.

Striving to do better
PinnacleHealth’s mission is to improve the health and quality of life for the people of central Pennsylvania, and it has consistently ranked highly in quality and patient experience across a wide range of medical conditions and procedures. To retain its reputation for excellence, the organization cannot afford to stop innovating. When it saw a chance to improve the long-term outlook for patients with chronic health conditions, it seized the opportunity.

Dr. George Beauregard, senior vice president and chief clinical officer at PinnacleHealth System, elaborates: “Hospital readmissions for patients with chronic health conditions are a hot-button issue in the United States right now, with the government recently imposing financial penalties for organizations with higher than acceptable rates. Although our readmission rate was already lower than the national average, we saw an opportunity to do even better – to improve population health and reduce costs.”There are a number of intervention activities that have proven to be effective in helping those with chronic conditions maintain a good health status for longer with limited resources; the challenge is working out where they will be most effective.

“When a patient is admitted to a hospital, it is very easy to concentrate on solving the immediate problem and then send them home,” comments Dr. Beauregard. “The unfortunate reality is that there are so many factors in that environment that can lead to that person’s health declining again. Adherence with follow-up care, their level of engagement, attitude and confidence in managing their condition, whether they understand their diagnosis, and prognosis and medications are just some of the things that can make a significant impact. Our challenge was: how could we make it easy for physicians and caregivers – whose time and resources are limited – to look at the bigger picture?”

Embracing predictive analytics
For PinnacleHealth, the answer to this question was clear: if it could predict which patients were most at risk of readmission, it could use this insight to focus attention on the people who need it most and plan intervention activities that would really make a difference. The organization engaged IBM Premier Business Partner and analytics specialist Waypoint Consulting to make these goals a reality.

“It was a natural decision for us to extend our existing IBM Cognos Business Intelligence solution with a predictive component based on IBM SPSS Modeler,” says Dr. Beauregard. “Waypoint Consulting brought the data science knowledge and healthcare expertise needed to make the project a success.”

PinnacleHealth initiated a pilot study, taking three years’ worth of data on 225 patients with chronic obstructive pulmonary disease (COPD) and creating a model to predict their admissions using a range of clinical factors.

“The pilot study was a success: our SPSS model predicts readmissions for COPD patients with 85 percent accuracy – a rate that will improve as we refine the model,” explains Dr. Beauregard. “We used this pilot to build a business case showing the potential financial savings and improvements in patient outcomes if we target the patients who are most likely to be readmitted. With the cost per readmission for a patient with COPD around USD6,200 and the possibility of extending similar analytical techniques to a variety of other chronic conditions, our CEO immediately saw the potential. We assembled a multidisciplinary team and started the work.”

Solution in action
The solution automatically delivers a report to physicians at the point of care when a patient with COPD is admitted to one of PinnacleHealth’s hospitals. This report predicts the likelihood of readmission within a range of time periods and the probable time until an exacerbation of the patient’s condition is likely to occur, alongside details such as comorbidities and other medications. The report is built on data from the organization’s core clinical and financial systems, as well as vital signs and lab results recorded during the patient’s hospital stay.

Dr. Beauregard says: “The insights we glean from the IBM solution help encourage our physicians and care coordinators to step back and look at the entire health continuum for those patients who are most at risk of readmission. As a result, we can initiate a set of interventions where they are most needed.
“For example, we can check whether a patient can easily access their medication and understands how to take it; we can ensure that they are adequately engaged in self-care; we can arrange a home visit by our community paramedicine team, or a follow-up appointment with a pulmonologist; we can even offer counseling to help patients quit smoking while they are still in the hospital.”

Just the beginning
By revealing aspects of the patient that were invisible before, the solution helps PinnacleHealth make decisions that offer patients the maximum benefit over the long term, reducing the rate of readmissions. Dr. Beauregard adds: “As soon as the intervention activities are hardwired into our care delivery process, we expect to realize the benefits for patient health and cost efficiency provided by the IBM solution.”

Dr. Beauregard concludes: “Reducing the number of readmissions for patients with COPD is just the beginning. We already plan to build predictive models to help retard the progression of chronic kidney disease, cardiovascular disease and others. We’re early in this process and many lessons have already emerged. With IBM solutions and Waypoint Consulting, we are revolutionizing our approach to healthcare delivery across the board.”

About PinnacleHealth
PinnacleHealth is the leading hospital and healthcare system in central Pennsylvania. A non-profit organization, PinnacleHealth delivers more than 5,000 babies and performs more than 23,000 surgical procedures, 588 open heart surgeries and 70 kidney transplants each year.

To learn more about PinnacleHealth, please visit http://www.pinnaclehealth.org/

About Waypoint Consulting
Waypoint Consulting is one of the leading providers of business intelligence and financial performance management solutions in the mid-Atlantic region of the United States. Based outside of Philadelphia, the company specializes in taking companies to the next level in their data strategies.

To learn more about products, services and solutions from Waypoint Consulting, please visit http://www.waypointco.com/

About IBM Big Data & Analytics
When you are able to harness big data from a wide range of sources, and analyze it in many different ways, you uncover insights that can have a profound effect on your business. See how IBM has helped organizations in every industry realize the value of big data and analytics.

The role Big Data could play in the emerging healthcare systems of the Middle East and North Africa.

If a diabetic patient came into hospital complaining of numbness and pain in their toes, a doctor might assume diabetes is the cause. They could prescribe painkillers and send the patient on their way. But what if something more sinister was around the corner, like a stroke or an aneurysm?

By using software that channels Big Data into readable, usable statistics, the doctor could instead monitor the patient’s blood flow and oxygen saturation and predict the likelihood of a stroke or aneurysm occurring. He could take a better-informed course of action and even share his information with other healthcare professionals to help improve the management of similar patients elsewhere.1

This is the role Big Data could play in the emerging healthcare systems of the Middle East and North Africa.

‘Big Data’ has become a buzzword in the last couple of years, and for good reason: we now have enough computing power and resources to gather data about every detail of a system’s inner workings, from air traffic control to trends in crime. The amount of data being produced is so vast that traditional means of analyzing it (i.e. humans analyzing spreadsheets) are no longer viable. Hence the term, ‘Big Data’. Hundreds of computer servers are now needed to number-crunch the data and extract information or extrapolate trends.

“Today, big data analytics are transforming many industries. Effectively analyzing massive amounts of data can deliver insights that help to achieve faster and better decision-making.” said By Laurent Rotival, CEO of GE Healthcare IT for Eastern and Africa Growth Markets.

 “ For the healthcare sector this can mean more accurate diagnoses, greater operational efficiency and identifying evidence-based treatment plans that deliver better results with reduced risk. Big data analytics integrate prior knowledge, historical data and experimental learning to create intelligent, actionable solutions in real-time.”

To get a feel for just how much better we are at processing data than we were even a decade ago, consider this: the entire human genome originally took ten years to process. Now, it can be done in less than a day.2 Such phenomenal increases in computing power (in keeping with Moore’s Law) have given unprecedented trend-spotting power to those who know how to use it.

One way Big Data is being used innovatively is with the Industrial Internet. Sometimes called the Internet of Things, this is a network linking machines to each other, autonomously sharing data to yield better insights into productivity and efficiency.3 For instance, a software platform called Predix is being used to link the reams of data produced by ‘big iron’ machines (like wind turbines or jet engines) directly to engineers. So rather than manually monitoring a machine to see if it needs maintenance, the machine itself can alert engineers at just the right moment.

In the healthcare world, similar efforts to make the most of data are leading to improved efficiency, shorter waiting times, better resource allocation, and ultimately a better outcome for patients.4

In the Middle East and North Africa region, the rise of non-communicable diseases (NCDs) is predicted to cost over USD 68 billion by the year 2022. By 2030, almost 80 percent of deaths in the Middle East will result from non-communicable diseases (NCDs) or ‘lifestyle’ diseases, such as cardiovascular disease (CVD) or cancer.5 The high prevalence of unhealthy diets, smoking and lack of physical exercise, a direct result of urbanization and rising per capita income, are big contributing factors.6

To make matters worse, the region is lagging behind when it comes to gathering and sharing clinical data. They still rely on traditional data like medical records and histories, as well as real-time data on a patient’s condition, such as blood pressure or heart rate, with little (if any) sharing of said data.

A new generation of applications, much like Predix but for healthcare settings, is changing that. And various government bodies are also moving ahead and collaborating with Healthcare IT giants to achieve the objectives like in Saudi Arabia for instance, the Ministry of Health and GE Healthcare are working to deploy an e-health interoperability standards program between different parts of the Kingdom’s healthcare system to improve access, patient safety and the quality of healthcare.

In Egypt and Turkey, GE Healthcare has worked with public and private healthcare providers on pilot projects to develop image exchange capabilities, enabling hospitals to share, store send diagnostic images for remote assessment by radiologists.

“Ultimately the productivity transformation through big data is about meeting the requirements of patients with the services provided by healthcare practitioners,” said By Rotival.

“Patients seek more face time with providers, care that revolves around them, more active role in decisions about their care and more consistent and higher quality outcomes. Big data can help to facilitate all of that.”

In a region containing some of the most densely, and sparsely, populated areas of the planet7, linking patients, doctors and hospital equipment using Big Data and the Industrial Internet could bring quality healthcare much closer to home for all in the Middle East and North Africa.

References

1 – http://www.theguardian.com/healthcare-network/2014/nov/04/big-data-enabling-future-healthcare

2 – http://www.oecd.org/sti/ieconomy/Session_3_Delort.pdf#page=6

3 – http://www.forbes.com/sites/castlight/2014/11/10/how-big-data-will-help-save-healthcare/

4 – http://www.who.int/mediacentre/factsheets/fs355/en/

5 – http://www.indexmundi.com/map/?v=21000&r=me&l=en

Lose a limb or lose a life – this was the worst-case dilemma confronting Georg M., a 47-year-old man from Stuttgart, Germany. His pelvis had become riddled with a rare, malignant tumor – an osteosarcoma – which threatened to kill him. Conventional surgical procedure would require removal of nearly half his pelvis, which would likely ward off imminent death, but at the same time possibly render it incapable of proper function.

Finding The Best Approach
Faced with the choice of avoiding the grave to end up potentially in a wheelchair, most patients would have to accept this quasi-Faustian bargain. But Georg M.’s doctor instead referred him to the University Clinic of Ulm, a sprawling medical center to the south of Germany, with 1,100 beds, over 5,000 staff, and a world-class department of orthopedic traumatology, hand, plastic, and reconstructive surgery. There, thought the referring physician, lay the patient’s best chance of beating both perils: death or a destroyed pelvis.  

The Operating Room of the Future

Maximized Minimalism

Have Your Cake and Eat it, too

Next-Level Surgery