100 Million Healthy Lives: The digital innovation behind eliminating HCV and NCDs

“100 Million Healthy Lives” Campaign

Egypt was considered the country with the highest prevalence of hepatitis C virus (HCV) worldwide, while 84% of all deaths are caused by non-communicable diseases.

Egypt’s level of innovation is in line with expectations for lower-middle income countries, according to the Global Innovation Index 2019, published by Cornell SC Johnson College of Business, INSEAD and the World Intellectual Property Organization (WIPO). The country ranked 92nd from 129 countries in the index.

In terms of healthcare innovation, the report highlights Egypt’s improved screening for non-communicable diseases (NCD) and hepatitis C virus (HVC).

“From October 2018 to April 2019, the [Ministry of Health and Population] ran a large-scale HCV and NCD screening and treatment program for Egyptians aged 18 years and older,” the report explains in a chapter prepared by the ministry’s Hala Said, Aysam Salaheldein, Mostafa Monier Othman and Mohamed Hassany, as well as the World Health Organization’s Ahmed Sorour.

The campaign ran under the name “100 Million Healthy Lives” and aimed at eliminating HCV by 2030 and assess the prominence of NCDs in the country, supported by the president.

“Over 49.8 million people were screened and tested for NCDs and HCV, 2.2 million were referred for polymerase chain reaction (PCR) tests and 0.9 million started their first dose of HCV treatment,” the chapter states. The process included over 60,000 medical professionals and data entry staff in almost 5,800 screening sites (healthcare units, mobile clinics, government hospitals etc.).

The digital innovation behind it all
“The fragmentation of the Egyptian health system makes it difficult to detect service duplication, standardize services across different entities or stabilize pricing for services,” the study explains.

Therefore, the Ministry of Health and Population created a software solution for the screening, referral and treatment process of the examined citizens, providing instant reports derived from the data entries at every registered site. As the software updates every 10 minutes, it is able to detect which screening units did not complete any data entries within the last 15 minutes.

“This enables monitoring officers to overcome any obstacle or challenge that may be faced within these locations, such as technical issues related to the database, code debugging, internet accessibility or even lack of workforce motivation,” the authors explain.

The main gain of the software is the centralization of data – one standardized database accessible to different entities in which each patient has their own file. While the medical team screens the patient, he/she is either referred to a hospital where he can rely on his personal insurance scheme or – if uninsured – he/she is referred to a ministry-affiliated hospital, where financial coverage is available. Every stop the patient makes at a health institution is registered in the system and can be accessed from each referral site.

But can the system really handle this amount of data? According to the chapter, the software “allows access to 20,000 users at the same time, captures 750,000 screening transactions per day, and captures 47 screening transactions per second.”

Why is this software helpful?
“The technology system has capabilities that enable integrating the different entities, detecting fraud and ensuring efficient interventions,” according to the authors.

The software will be used to ensure efficient resource mobilization by understanding the needs of each region, governorate, district, city and village, and allows the ministry to efficiently target different areas with appropriate awareness campaigns and interventions.

The software also reveals correlation between diseases and related risk factors, such as a higher prevalence of high blood pressure in males and a higher prevalence of diabetes in females.

All this can lead to a country-wide health map matrix, enabling the detection of correlation between certain diseases and – for example – geographic areas, gender, age group or profession.

Accordingly, the data can be used in evidence-based decision-making and spread responsibility and authority across the Ministry of Health and Population.

But can the data be trusted?
“The system has built-in data validation rules to ensure the integrity and consistency of all data. This creates a closed-loop system for the screening process that includes data security, privacy, operation, analysis and decision-making,” the authors state.

Through training for operational and managerial teams, as well as steering committees, consistency, data flows, data analytics and data mining are enabled. The data quality is ensured by audits.

Moreover, the WHO conducted a verification report on the data quality, ensuring the transparency of the process.

Before the “100 Million Healthy Lives” campaign and the usage of the ministry’s software, the National Committee for Control of Viral Hepatitis (NCCVH) had a long process to detect and treat the disease, which included time-consuming and costly paperwork and accounted for 65% of the out of pocket cost to patients.

“Now, the process of approval is completely electronic and confirms the treatment regimen with no financial burden on the patient. The screening is free of charge and has eliminated out of pocket and catastrophic expenditures,” the chapter concludes.

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