Could BLOCKCHAIN technology be a solution for digital health in South Africa?

Moderator: Vanessa Carter
Date: 8 August 2019
20:30 – 21:30 (SAST)
How to participate

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Join us for a 60-minute Twitter chat on the 8th of August between 20:30-21:30 SAST. Everyone is welcome to participate during the Q&A session including doctors, nurses, entrepreneurs, policymakers, patients, academics, pharma, medical educators, students, payers, IT developers, journalists, data scientists, civil society, NPO’s, researchers, etc. both locally and globally. The transcript will be recorded and made publicly available afterwards by Symplur Analytics.


20:30: 5-minute introductions and welcome. Questions start thereafter.

T1: What are the most secure and efficient systems for storing digital health records currently?
T2: What improvements could be made to the storage and sharing of healthcare data both locally and globally?
T3: What are the pros and cons of using blockchain for healthcare?
T4: Are there any good examples of how blockchain technology has been successfully used for healthcare?
T5: Why should LMIC’s like South Africa explore technologies like blockchain to develop their eHealth systems?

21:30: CLOSING (CT): What other thoughts would you like to add?

Start your answers with T1, T2, T3, T4 or CT
 for transcript purposes.
Answer only after the moderator prompts. Questions will be prompted every 10 minutes, but keep answers coming using the relevant T and number. Both panel guests and the public are encouraged to answer. Use the #hcsmSA hashtag in all your tweets so that you are visible to others in the chat and on the transcript.

Video credit: The Medical Futurist, Dr Bertalan Mesko – “What the hell is blockchain?”

Gabrielle Lobban – @Zumbudda

It was not long ago that I was in the ER with my daughter at eleven o’clock at night and it was the second private hospital that I had visited that night. The first one showed very little sign of life at the ER desk despite the fact that there were a few people in the waiting area. Based on previous experience at this hospital, I decided to go to another hospital in the area even though it was not part of the same private hospital group. At the second hospital, the ER was very busy but my daughter was triaged within 10 minutes and saw a doctor within half an hour. My decision to change hospitals was based on past experience and waiting five hours in the ER to see a doctor for a non-emergency, despite the ER having a few patients in the waiting area. My daughter has acute attacks periodically which appear to be related to her appendix and since these occur after consulting hours, I tend to make a “quick” visit to the local ER to check there is nothing more sinister happening. The only problem with changing hospitals is that medical records do not travel from one hospital group to another.

At this stage of my life, I consider myself well educated and experienced enough to make good decisions. I have also been in the healthcare industry for over 25 years and understand the workings of a hospital, especially ER. So based on this, it was easy for me to make an informed decision to move from one hospital to another.

During a health event, the patient is the medical record and in the ER, the staff generally rely on the patient to provide a verbal account of their current condition as well as their medical history. If the case is ongoing, like my daughter’s, this could include a few scraps of medical documentation, some dated test results and an X-ray image. The frustration I have is that sometimes I don’t remember to bring the documents with me in the heat of the moment and although these records are often out of date, they could provide some valuable background information to the problem.
With the first draft of the National Health Insurance (NHI) Bill under revision by the Department of Health (DoH) in South Africa, one wonders how the government will successfully transfer medical records from private to public sector facilities and ensure continuity of care. Healthcare data has become a lucrative commodity, and it stands to reason that this data would be closely guarded by private companies that have invested in the collection and management of this data.
For some time blockchain technology has been showcased primarily as a fintech solution, however, there are a number of companies that are applying blockchain solutions to healthcare innovation such as clinical trials and data access as well as insurance and medical records. Most recently, Facebook released their white paper for their new cryptocurrency project Libra. This is a blockchain-driven payment system which will allow people to buy things or send money with next to zero fees. This is going to be a game-changer in terms of blockchain technology as cryptocurrencies are set to become mainstream.

I became aware of blockchain some time ago when fintech companies started creating blockchain solutions which enabled digital remittance and cross-border transactions to reach the underbanked population. What drew me to the blockchain was the potential for patients to collect and safely share their healthcare data as and when required. In addition, they could monetise their data and earn digital currencies. If patients can access their own data and sell it on a safe network, this could revolutionise the pool of medical information available to researchers. However, after spending many hours at blockchain events and engaging with blockchain specialists, I have come to realise that blockchain and healthcare seldom meet in the same place. The reason for this is that healthcare is a complex industry and has many idiosyncrasies and the average blockchain solutionist tends to be a generalist and at best, a former patient. Added to this, the average healthcare practitioner has little or no knowledge of blockchain technology and is mildly aware of the practical benefits of data collection as a decentralised function. So I go back to my earlier question about how the DoH intends collecting public and private healthcare records for the NHI system.

I believe that blockchain technology can provide the mechanism to solve this problem, relying mainly on the patient to collect and manage their own health data thus ensuring accountability at the source. This information would be independently validated on the blockchain which would result in a permanent and immutable record on the chain.
It may take some time for the idea to evolve amongst the medical community but one fact remains clear. Medical data ultimately belongs to the patient. Ironically, we are all potential patients and being able to share our own medical records whether it be with a practitioner or for health research purposes, would directly benefit the individual as well as the community. The listeria outbreak is a recent example of where real-time reporting of disease symptoms could’ve saved lives if researchers and clinicians had access to this information. Antibiotic resistance reporting is critical to the safe delivery of care and could benefit from patients maintaining complete and up-to-date health records. Instead, many want medical record-keeping to remain centralised and siloed despite the fact that this will ultimately delay individualised treatment as well as potential lifesaving discoveries in the near future.

Gaby’s Bio
Gabrielle is no stranger to healthcare and innovation. Her family have been pioneers in the healthcare industry for over 40 years, introducing new products and technology to the South African market. She started her career in product marketing, working her way up in the family business, previously called OmniMed, which specialised in pharmaceuticals, medical devices and diagnostics. During this period, OmniMed launched international brands for B.Braun, Sanofi, and bioMerieux, before these companies came directly into South Africa. OmniMed also introduced the first IPL cosmetic and dermatology lasers as well as lasers for Lasik Eye Surgery. Doctors and surgeons were trained on these novel technologies long before they became popular. Later on, she moved to another equally innovative company called Litha Healthcare Group which was a shareholder in Biovac, the first local vaccine producer in South Africa. During this time Litha launched the first da Vinci Surgical Robot in South Africa which today, is still a new innovation in surgery. She served on the Executive of Litha Healthcare Group as well as the Generics and Biosimilar Medicines of South Africa, formerly known as the National Association of Pharmaceutical Manufacturers. 
After 25 years of marketing healthcare products, Gabrielle started a new chapter in her career with the launch of her own digital health company, Zumbudda. Back in 2014, experience had already shown that the digital health market was still in its infancy so Gabrielle set about doing what she does best, championing digital health technologies and systems through education and innovation. 

Gabrielle has received various awards and accolades, the latest being at the NTT Data Open Innovation Challenge held in March in Cape Town. She was selected as one of two finalists to represent the Gauteng Province, receiving the Judge’s Award for her Digital Health Innovation Model. Gabrielle has also been a resident at Gen Africa 22onSloane, Africa’s largest start-up campus, where Zumbudda was one of 50 businesses selected for the inaugural residency programme out of over 800 applicants. She has also been part of a healthcare blockchain working group and has become a blockchain enthusiast and activist.

Health Hashtags:

Healthcare Social Media (hcsm) trending hashtags related to Blockchain in Health:
#BlockchainHealthCongress #ConnectedHealth

Panel Guests
The chat session is open to everyone to participate, however, our panel experts and co-hosts bring a unique set of perspectives relating to the topic.

Manish Sharma – @msharmas
Manish is a digital health entrepreneur and found of HCITexperts in India. He has experience in various health IT companies offering services such as EHR, Patient Portals, Patient Kiosks, Mobility solutions for doctors, nurses and patients and remote monitoring frameworks. He has trained and lead teams to build digital health solutions for clients in India, South-East Asia, Africa, the Middle East & America. The HCITExperts‘ blog is an effort to form a collective of multi-disciplinary experts who share their expertise with startups in India to enable innovative solutions that improve enable healthcare delivery. It also offers the doorway to network with global experts to improve knowledge and solutions that can be implemented in India.

Gugulethu Nyathi – @RibbonPlatform
Gugu is a Co-Founder and CEO of Ribbon Blockchain (Pty) Ltd. Ribbon Blockchain enables crowdfunding for public healthcare programs, then distributes proceeds as incentives to patients and healthcare practitioners to encourage healthier lifestyles and quality healthcare delivery. The Incentives are distributed in DAI which is a US Dollar pegged stable coin cryptocurrency to enable non-volatility of incentives in countries with volatile currencies and economies.

Rehab For All – @RehabforAllSA
Rehab For All is a social development platform that aims to connect stakeholders towards creating a vibrant, supportive and innovative ecosystem around People With Disabilities in South Africa. It was founded by Nabeela Laher, a social innovation consultant and Physiotherapist for children with disabilities, following her experiences working across the healthcare and rehabilitation sector.

Dr Marietjie Botes – @Marietj72675939
Dr Botes is an attorney specialising in HealthCare and Life Sciences Law and regularly presents on topics such as data sharing and privacy in the context of European and South African privacy legislation. Dr Botes is passionate about genetic, genomic and stem cell research and has published widely on these topics. Her doctoral studies about informed consent for genomic research involving the San populations of southern Africa has won her research awards and resulted in visual communication tools to bridge scientific communication gaps.

Kreaan Singh – @SatoshiSingh
Kreaan is a co-founder of CoinEd, a leading education provider in the cryptocurrency and blockchain industry, whose clients include prominent schools around the continent and JSE-listed companies. He is also a co-founder of Blockstarters, an innovation hub for blockchain technology. Kreaan’s first exposure to the industry was in 2013, where, as a mechanical engineer, he realised the numerous possible applications of cryptocurrencies and blockchains, and decided to pursue this opportunity full time as an entrepreneur. He is also a regular speaker at high profile conferences such as AfricaCom and Seamless.

Johnathan Ried – @JohnathanReid
Johnathan is an Enterprise IT Architect at GE Healthcare in the UK. He is an enthusiastic and innovative IT professional with twenty-one years of increasing levels of responsibility within architecture, digital, information systems, data analytics and application development domains, seventeen years being in the commercial pharma and medical devices sector, including projects targeted at both developing and mature market environments. An active and recognised participant in healthcare technology-oriented social media forums. With a consistent track record of promotion, is dedicated to providing internal consultancy in a cost-effective, innovative and highly service-oriented way to meet the demanding needs of internal and external customers. Focused on applying innovative solutions and delivering architecture, governance, business process and information management guidance in support of the creation and development of internal enterprise and customer-facing solutions across a wide range of business software and services.

Marius Erasmus – @Mytech28114725 
Marius Erasmus has successfully designed and deployed technology solutions across Africa and the Middle East for more than 20 years. From Morocco, Israel, Libya and Lebanon to South Africa, covering much of sub-Saharan Africa. His clients are drawn from almost all verticals, from oil and gas, supply chain and transactional banking to healthcare and Identity Security solutions.
A dedicated technologist, his corporate thinking coupled with an entrepreneurial spirit provides the ideal platform for the creation of opportunities through the utilisation of advanced technologies. As a result, his holistic, future-proof business solutions for commercial and government sectors provide measurable gains in profitability through overall cost reduction and efficiency improvements.

David Kerr – @DJKerr88
David John Kerr is a Cloud Technology Specialist, having worked across Private Sector companies such as AWS and Microsoft and Public Sector entities such as NHS across the UK, along with a number of not-for-profit organisations, has always focused on the shift from ‘what is the matter with you?’ to ‘What matters to you?’


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