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E-Health’s Promise For The Developing World

2010; Project HOPE; Volume: 29; Issue: 2 Linguagem: Inglês

10.1377/hlthaff.2010.0006

2694-233X

Susan Dentzer,

Medication Adherence and Compliance

From the Editor-In-Chief Health AffairsVol. 29, No. 2: E-Health in the Developing World E-Health’s Promise For The Developing WorldSusan DentzerPUBLISHED:February 2010Free Accesshttps://doi.org/10.1377/hlthaff.2010.0006AboutSectionsView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsDownload Exhibits TOPICSHIV/AIDSTechnologyMedicaidPharmaceuticalsAccess to careHealth reformLegislationImagine a health worker in a remote clinic in mountainous Rwanda, who must ensure that HIV/AIDS patients take their daily medication. Whipping out her cell phone, she sends a text message to a national health registry in Rwanda’s capital, Kigali, noting that Patient X, who just came in for a clinical consultation, has been taking his meds and that a new round of antiretrovirals has been dispensed on his behalf.Minutes later, other workers at the national health ministry take this information and add it into their records of the nation’s roster of known HIV/AIDS patients. The health ministry uses the database to look for ways to improve medication adherence—while at the same time noting that adherence rates in Rwanda already exceed those of patients in parts of the United States. This anecdote isn’t imaginary or futuristic; a version of it happens every day. Rwanda, in the heart of East Africa, is at the leading edge of developing nations tapping modern information and communications technology to transform health and health care. The potential of these technologies, often dubbed e-health, to similarly transform health care in other poor and low-income countries is a central focus of this February 2010 issue of Health Affairs . The issue’s cluster of e-health papers grew out of a Rockefeller Foundation conference on e-health that took place at the foundation’s famed Bellagio center in Italy in the summer of 2008. We are deeply grateful to the foundation for the financial support that enabled us to publish expanded and revised versions of those papers now.In part, the papers constitute a broad review of the multiple e-health applications already in use in Asia, sub-Saharan Africa, and Latin America. They also discuss issues to be addressed so that e-health’s potential can be achieved. These include establishing global “interoperability” standards for information exchange, and building a health informatics workforce with competencies tailored to various nations or regions. Also critical will be evaluating future e-health programs to make certain that what seems to be their potential is more than technological fantasy.“About the Author” and “People and Places” columns briefly profile leaders and institutions helping shape the e-health field. One of the most notable is Rwanda’s national e-health coordinator, Richard Gakuba, who confesses that he got the job because he was the only person in the country with the appropriate training. Lester Feder was dispatched to Mexico for this issue’s “Report From The Field,” in which he describes how the Carso Health Institute is testing e-health approaches to combat a variety of conditions, including AIDS and diabetes. These efforts are just one example of how the institute, endowed by Mexican telecom magnate Carlos Slim, has become Latin America’s equivalent of the Bill & Melinda Gates Foundation in addressing health and health care in the region.If the transforming of technology is one theme of this issue, another is transformation and change. Despite the disparities among nations, we clearly face common challenges in expanding access to health and health care among disenfranchised peoples everywhere.As this issue goes to print, for example, congressional negotiators are attempting to bridge differences between House and Senate bills to arrive at a final version of health reform legislation. John Iglehart’s EntryPoint focuses on one aspect: Medicaid, the program that may eventually provide coverage for up to a quarter of America’s nonelderly population. Assuming that the legislation passes, the federal and state fiscal challenges of this initiative will be enormous. And at the same time, as health policy consultant Lynn Etheredge notes, the potential may also exist to turn Medicaid into a model program that advances health and delivers health care efficiently for the various populations it serves.A bookend is my interview with Mark Smith, president of the California HealthCare Foundation, a key supporter of this journal. Among the foundation’s areas of focus is Medi-Cal, the state’s Medicaid program—and Smith’s hope that the foundation “can help bring providers and policymakers together to examine an alternative to our current path, which is annual wrenching cuts in eligibility and benefits.” That, of course, is the future—unless the national health care reform that we may soon be ushering in truly lives up to that description. Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article MetricsCitations: Crossref 6 History Published online 1 February 2010 Information Project HOPE—The People-to-People Health Foundation, Inc. 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