Advancing eHealth 2016Report of the African eHealth Forum

8 - 9 September 2016 • Sandton

African Centre for eHealth Excellence

Strategic Themes

For more information about the African Centre for eHealth Excellence (Acfee) and the African eHealth Forum (AeF), go to acfee.org. To access eHealth News Africa (eHNA), go to ehna.org.

You can contact Acfee directly at:

African Centre for eHealth Excellence P O Box 822 Kimberley8300South Africa

info@acfee.org

+27 53 832 2655

ISBN 978-0-620-67607-6

© African Centre for eHealth Excellence

Reproduction is authorised provided the source is acknowledged as “Advancing eHealth 2016, African eHealth Forum, African Centre for eHealth Excellence, November 2016”

Design by The Repro Man

Published 30 November 2016

Acfee thanks the members of its expanding Advisory Board for the leadership and inspiration provided to

advance eHealth for healthy Africans.

Contents

1. Foreword 2

2. Executive Summary 3

3. Introduction 4 3.1 eHealth’s role in Africa 4 3.2 Acfee’s purpose 4 3.3 Acfee’s Advisory Board 4 3.4 The African eHealth Forum 6 3.5 Collaboration Context 6 4. Core Themes 6 4.1 Overview 6 4.2 Country priorities 7 4.3 Acfee priorities 7 4.4 Partner contributions 8 5. Acfee’s eHealth Action Plan 12 5.1 Main Theme 12 5.2 Acfee progress 12 5.3 Next steps for Acfee 12

6. Annexe 13 6.1 Advisory Board 13 6.2 Attendance List 14

Advancing eHealth in Africa

AeFAfrican eHealth Forum

1. ForewordAfrican health is on the move and so is its eHealth. In the year since I was elected as Chairperson of the Advisory Board of the African Centre for eHealth Excellence (Acfee), my colleagues and I have seen promising new initiatives and technologies appear. They present exciting opportunities for improving African health, but at the same time bring fresh complexity, challenges and risks. Acfee and its Advisory Board have an important, expanding role to help shape how we embrace eHealth and its value for Africa.

The second annual African eHealth Forum (AeF) showed tangible progress on Acfee’s initiatives. It dealt with concrete discussions on actions needed by African countries to secure benefits from their eHealth investments, with particular emphasis on how Acfee and its partners can support countries to share good practice and use-cases to develop sound:

o eHealth strategyo eHealth governance o eHealth regulationo eHealth cyber-securityo eHealth impact.

Deliberations considered how efforts in these five areas could provide a constructive path for countries to follow to address the many common goals and challenges we identified in AeF 2015.

Over the next year Acfee’s priorities will include a focus on human capital development, with partners in Africa and abroad. As the proverb reminds us, “Knowledge is a garden. If it is not cultivated, it cannot be harvested”.

We are reminded that our focus needs to be firmly rooted in how eHealth investments will improve the lives of Africa’s clients, build healthy communities, and support our health workers in their daily endeavours.

DR. GERALD GWINJIChairperson, Acfee Advisory BoardHealth & Child Care Permanent Secretary, ZimbabweBrigadier General (Retired), Zimbabwe

2.

2. Executive SummaryThe African eHealth Forum is where Acfee’s management team consults with its Advisory Board, industry partners and other stakeholders, to exchange their experiences of eHealth in Africa to seek better ways ahead. The second one took place in Sandton, South Africa on 8 and 9 September 2016. It’s main finding is that eHealth initiatives are expanding in African countries, though its impact on health systems strengthening and transformation, and ultimately its contribution ot healthy Africans, is less certain.

Forum findings are divided into two parts. One is for countries; the other is for Acfee’s priorities and medium-term action plan.

For countries, the Advisory Board identified five eHealth priorities:

• eHealth strategy• eHealth governance • eHealth regulation• eHealth cyber-security• eHealth impact.

These extend across all eHealth programmes and projects and represent a necessary development in eHealth’s foundations.

For Acfee’s action plan, the AeF proposed that Acfee focus its efforts to support countries eHealth strengtheing, in order to provide a strong foundation for expanding productive eHealth initiatives. Acfee will provide appropriate methodologies, information and support for countries for each of these priorities.

Recommendations include that Acfee should establish and support:

• Country and regional economic community eHealth Strategies• Expansion of eHealthALIVE Southern Africa into other regions, to strengthen stakeholder engagement to address priority eHealth issues• Expand eHealth News Africa (eHNA) for sharing information, particularly evidence of lessons learned and good practice use-cases• Expand partnerships for formal learning, including expanding its engagement with interested universities and utilising eLearning to accelerate deployment of learning opportunities• Develop position papers on the five eHealth priorities identified.

Photos of some of the Aef 2016 participants

3.

Dr. Lynette Moretlo Molefi,Board Member InternationalSociety of eHealth and Telemedicine • South Africa

Prof. Peter Nyasulu,Acfee Executive Director and Monash South Africa Public Health Professor • Africa

Prof. Keith Househam,Independent Management Consultant and Management Coach, • South Africa

Dr. Eddie Mukooyo,Assistant Commissioner of Health Services • Uganda

Mr Calle Hedberg (Left)HISP-SA Strategic Advisor• South Africa

Dr. Sean Broomhead, (Right)Acfee Chairman• Africa

Mr Tom Jones, (Left)Acfee Director of Strategy and Impact • Africa

Mr Clyde Lewis, (Right)GE Healthcare Marketing• Africa

Mr Charles R. Parisot,GE Healthcare • Global

Mr Daniel Murenzi,eHealth and informatics Lead • East African Community Secretariat

Dr. Simon Zwane,Permanent Secretary of Health • Swaziland

Dr. Ousmane Ly,Acfee Executive Director and Director General of eHealth• Mali

3. Introduction3.1 eHealth’s role in AfricaSuccessful eHealth connects us with our information in ways that transform what we expect from our health service environment. It changes how we protect our health, how we expect care should be delivered, how we interact with our health workers and how health workers interact with one another. It also helps us reconsider how we respond to numerous service delivery challenges and constraints.

3.2 Acfee’s purpose

To realise a vision of healthier Africans, health systems must be strengthened. eHealth is a key enabler in achieving this goal1, though to be successful, eHealth needs to deliver more benefits for people. Unlocking this transformation potential and developing it with African countries is Acfee’s main goal.

Acfee has embarked on a journey to develop eHealth’s capacity and leadership for African countries to support improved health outcomes for their people. Its entry point for achieving this is direct strengthening of countries’ eHealth strategies and implementation plans, supporting capacity and leadership development for sustainability and success.

Figure 1: How Acfee supports eHealth for Healthy Africans

The African Union (AU) 2063 vision2 calls for action. It envisages “an integrated, prosperous and peaceful Africa, driven by its own citizens and representing a dynamic force in the global arena.” The importance of rekindling “African solidarity and unity of purpose”3 is a key element and healthy Africans will be essential. eHealth has a substantial role in achieving this vision.

Acfee supports eHealth progress by building a solid strategic foundation, supported by skills transfer to build local capability, regional support and long term sustainability.

1 Resolution AFR/RC60/WP/3, Malabo, Equatorial Guinea, 30 Aug to 3 Sep 20102 http://agenda2063.au.int/en/vision 3 Agenda 2063, The Africa We Want, African Union Commission, Second Edition, August 2014, http://agenda2063.au.int/en/sites/default/files/ agenda2063_popular_version_05092014_EN.pdf

4.

Development of regional support structures is a key focus, with a model under development with the East African Regional Economic Community (EAC). It builds on Acfee’s well-developed relationships with countries’ health ministries and academia, and Regional Economic Communities (RECs). Acfee’s eHealth strengthening plans are being developed in consultation and with their support.

The strategy is to strengthen organisations that develop and provide services and then connect these services to individuals to meet their needs. Achieving this needs numerous challenging issues to be addressed, such as boosting connectivity, human capacity, user engagement, regulations and security, standards and interoperability for adequate sharing and securing benefits from rapidly evolving innovation.

Figure 2: Acfee’s Role in eHealth

3.3 Acfee’s Advisory Board

Acfee is guided by its Advisory Board4 , which includes sitting Health Permanent Secretaries from a number of African countries. Acfee utilises the knowledge emerging from numerous engagements and information collection activities to build tools. These tools help actors engaging in Africa’s eHealth development to succeed.

Acfee’s Advisory Board members are:

1. Dr. Gerald Gwinji, Health Permanent Secretary, Zimbabwe (Advisory Board Chairperson)2. Dr. Lukwago Asuman, Health Permanent Secretary, Uganda 3. Dr. Addis Tamire Woldemariam, Director General, Ministry of Health, Ethiopia4. Dr. Simon Zwane, Health Permanent Secretary, Swaziland 5. Dr. Ebenezer Appiah, Denkyira Director General of Health, Ghana6. Dr. Shenaaz El-Halabi, Health Permanent Secretary, Botswana 7. Dr. Andreas Mwoombola, Health Permanent Secretary, Namibia8. Mr. Onesmus Kamau, Head, eHealth Development Unit, Kenya 9. Dr. Bakary Diarra, Health Permanent Secretary, Mali10. Mr Daniel Murenzi, eHealth and Informatics officer, East African Community11. Dr. Lynette Moretlo Molefi, Board Member, International Society for Telemedicine and eHealth, South Africa12. Prof. Keith Househam, Independent Management Consultant and Management Coach, previous Director General of Health, Western Cape Province, South Africa 13. Prof. Walinjom Fombad Tenjericha Muna, President, WHO Technical Advisory Group on eHealth (eTAG), based in Cameroon.

4 http://acfee.org/advisory • eHealth News Africa: https://ehna.acfee.org

5.

ACFEE’SRole

SuccessfulConnections

TransformHealth

Services

Positive interactionsfor patients

Countriessupporting

eachother

StrengthenOrganisations

RapidlyEvolving

innovation

3.4 The African eHealth Forum (AeF)

The dynamics of better access to information affect our relationships and our practices, shift power, roles and participation, and create new opportunities for service transformation. Acfee hosts the African eHealth Forum, and the dialogue with its Advisory Board, in order to:

• Obtain guidance from eminent African health leaders to ensure that Acfee’s priorities are aligned to Africa’s health sector needs • Clarify priorities, goals and challenges for eHealth in Africa • Provide a mechanism for bringing together leaders in health and eHealth in Africa.

These fall within Acfee’s three main themes: Discover, Learn, Lead.

This second AeF followed on from the first eHealthALIVE 2016 event for Southern Africa. The conference helped to clarify many of AeF’s eHealth priorities. It is available on eHealth News Africa5, Acfee’s daily blog and eHealth information repository. Advancing eHealth in Africa6 is the report from Acfee’s first African eHealth Forum consultation between Acfee and it’s Advisory Board.

In addition to Acfee’s Advisory Board, the representatives from GE Healthcare and Health Information Systems Program South Africa (HISP-SA) and HISP Namibia attended AeF 2016 too. GE Healthcare and HISP-SA provided detailed presentations on important eHealth issues.

3.5 Collaboration context

Partnership and support for Acfee’s eHealth aligns with the Paris Declaration on Aid Effectiveness and the Accra Agenda for Action7 to:

• Quicken countries’ pace on successful eHealth investment • Strengthen partner countries’ national development strategies and associated operational frameworks for eHealth• Increase alignment of aid with partner countries’ priorities, systems and procedures and help to strengthen and sustain their capacities• Enhance donors’ and partner countries’ respective accountability to their citizens and parliaments for their development policies, strategies and performance of eHealth investment• Define measures and standards of performance and accountability of partner country systems in public financial management, procurement, fiduciary safeguards for eHealth in line with broadly accepted good practices and their quick and widespread application• Overcome weaknesses in partner countries’ institutional capacities to develop and implement results-driven national eHealth strategies• Adapt and apply to countries’ differing health, healthcare and eHealth situations and readiness by supporting countries directly• Specify indicators, timetable and targets to manage performance and minimise risks• Monitor and evaluate implementation using Acfee’s socio-economic and financial evaluation eHealth Impact (eHI) methodologies and models.

4. Core themes4.1 Overview

An over-riding theme emerging from AeF 2016 deliberations is for Acfee to expand its role to advance eHealth in Africa. This was well articulated by the Advisory Board members and provided as a compass for Acfee’s activities.

The Advisory Board members supported Acfee’s focus on health and healthcare priorities and emphasised eHealth’s role as a component in an ecosystem of complementary efforts driving two interrelated processes:

• Health systems strengthening • Health systems transformation.

5 https://ehna.acfee.org/

6 Advancing eHealth in Africa, Report of the African eHealth Forum, Cape Town, African Centre of eHealth Excellence, 8 September 2015, ISBN 978-0-620-67607-6, http://gstatic.acfee.org/resources/docs/ar15.pdf

7 http://www.oecd.org/dac/effectiveness/34428351.pdf 6.

4.2 Country priorities

The AB recognises the challenges of moving from eHealth strategy to implementation. A solution can include a more effective process that includes a firm link to health and healthcare strategy, eHealth plans and programmes, business cases, procurement, implementation, operation and Monitoring and Evaluation (M&E), then a loop back to eHealth strategy. Acfee will set out the loop for AB members to consider.

Members recommended that Acfee provide technical support for countries to develop and refine their eHealth strategies, in line with good practice and global standards. Specific attention should be played to developing content on the other priorities identified by the AeF: governance, regulation, cyber-security and impact. Other emerging priorities discussed at AeF 2016 are shown in the table below:

4.3 Acfee priorities

Top priorities proposed by the AeF are summarised in the table below:

7.

Cyber-security

Priority Discussion

Cloud computing

eHealth surveillance

Members proposed that Acfee co-ordinates data on cyber-security threats and initiatives to combat them. The aim is to learn from global experiences.

Acfee’s eHealth News Africa (eHNA) team routinely collects information from reports and initiatives for many countries, both in and beyond Africa. Selected parts of this information will be synthesised in a report for Acfee’s Advisory Board by early December 2016. Cyber-threats and cyber-security are increasing in sophistication, so Acfee will update the report to reflect new information and insights. When the document is finalised with the Advisory Board, it will be disseminated to all African countries.

While the cloud offers valuable efficiency gains for Africa’s health systems, it also poses challenges for compliance with its health systems policies on the ownership and location of health information. The aim is to learn from global experiences.

Acfee’s eHNA team already collects reports and research about the cloud, and this information will be collated to summarise the pros and cons to support Advisory Board members in their deliberations on cloud policies and options. When the document is finalised with the Advisory Board, it will be disseminated to all African countries.

HISP’s planned eHealth surveillance initiative in West Africa offers considerable potential for health benefits. Like all eHealth, realising these is challenging.

Acfee’s eHealth impact and benefits realisation research and expertise can be a constructive source for HISP’s initiative. This will be explored over the next few months.

Establish Acfee technical working groups for Interoperability (IOp) and support an IOp workshop and development programme in an African country

IOp strategies, polices and plans are increasingly important for Africa’s eHealth. Acfee can facilitate countries to acquire and develop their IOp case by preparing rigorous use-cases. The approach is to work with Integrating the Healthcare Enterprise (IHE) to begin with small, focused IOp use-cases. Uganda has offered to start the process. Acfee will develop the arrangement. Six steps proposed by GE Healthcare and IHE are:

1. Interested Acfee Advisory Board members mandate ACFEE to establish collaboration with IHE Services2. Each Acfee member designates up to three delegates to participate3. A series of hands-on workshops as face to face and teleconferences organised with IHE experts4. Acfee members and delegates develop their national use-case document and IOp specifications5. Acfee members and delegates organise review sessions in their country with their stakeholders6. Each Acfee member manages their process for additional use cases.

Priority Discussion

4.4 Partner contributions

HISP-SA

HISP’s Vincent Shaw, Calle Hedberg and Lavinia Shikongo presented on surveillance and its role in global health security.

Finance is available for many countries in East and West Africa from the CDC Global Health Security Project and the E8 Malaria Elimination Project to build integrated databases for cross-border management of hotspots. The overall aims of both projects are to strengthen vital event registration and contribute to developing EHRs and expanded eHealth.

The International Health Regulations (IHR) 20058 set the standards as:

• Foster global partnerships• Strengthen national disease prevention, surveillance, control and response systems • Strengthen public health security in travel and transport • Strengthen WHO global alert and response systems • Strengthen the management of specific risks • Sustain rights, obligations and procedures • Conduct studies and monitor progress.

8 www.who.int/ihr/publications/9789241596664/en

8.

Engage professional bodies

Acfee and HISP are both developing eHealth curricula as part of their goals to expand human eHealth capacity. There’s merit in sharing their initiatives and seeking topics for close collaboration. Both organisations will explore these opportunities over the next few months.

Acfee’s eHealth advocacy role should extend to engaging with health professional bodies across Africa. One way to achieve this is to include them in the material disseminated to Africa’s health ministries planned for 2017.

The East African Community (EAC) has numerous centres of excellence, including eHealth. Many of its initiatives overlap Acfee’s, so collaboration should benefit both organisations. This will be explored with EAC.

The AU and NEPAD have several eHealth initiatives. Acfee’s eHealth advocacy role can help both organisations by providing information from its eHealth knowledge base drawn from eHNA.

Collaborate with regional bodies

Develop eHealth curricula alongside HISP’s curriculum initiatives

There are twelve strategies aiming to deal with four challenges of governance and leadership; data management, inadequate capacity and low awareness:

Dealing with too many reporting systems creates obstacles. Moving forward, HISP emphasises changes such as:

• Better health data governance with a Health Information System Co-ordinating Committee• Strong government leadership• Reposition the HMIS/EPI unit• Create a central data warehouse with defined speciality databases• Develop a clear data flow policy• Develop defined national minimum indicator sets• Promote use of DHIS2 platform for management of all routine health data.

9.

Strategy Description Long Term Outcome

1

2

3

4

5

6

7

8

9

10

11

12

Comprehensive National Biosafety and Biosecurity System

Prevent antimicrobial resistance

Prevent zoonotic diseases

Strengthen immunization programs

Strengthen surveillance systems

Strengthen Laboratory Systems

Strengthen information systems and reporting

Stregthen workforce deployment

Strengthen Emergency managementand Emergency Operations Centres

Linking Public Health and Law Enforcement and Multi-sectoral Rapid Response

Improve Medical Countermeasuresand Personnel Deployment

Strengthen and revitalize the Public Health System

National bio-safety and biosecurity system in place

Prevent the emergence and spread of antimicrobial drug resistant organisms

Minimize the emergence and spread of emerging zoonotic diseases

Reduced number and magitude of vaccine preventable disease outbreaks

Intergrated real time surveillance to detect and control infectious disease outbreaks

Improved timeliness and reporting and improved lab information systems

Timely and accurate disease reproting

Increased numbers of trained physicians, veterinarians, biostatistic, labratory scientists

EOC functioning

Demonstrate capability of multi-sectoral rapid response annually

Improving access to countermeasures on a global scale

Strong PH systems and functions to provide prevention and protection services

An integrated disease surveillance system needs:

• Statutory notifiable diseases, typically 30 to 100• EPI case investigations sub-set• Adverse effects of vaccinations, such as anti-vaxxers and hostiles• Other conditions requiring targeted prevention measures• Congenital disorders, including links to NMC: Zika• Maternal deaths• Serious nosocomial events.

Information system components needed to manage disease outbreaks include:

• Continuous analysis of cases with thresholds and triggers• Declaring outbreaks and interventions: IDSR or humans?• Survey data of EPI including HPV, ANC-HIV and fac surveys• Research data for prioritization and planning• Outbreak response activity tracking• Frequent demands for needs assessments• Frequent demands for use of funds and resources• Post-outbreak efficiency analysis• Long-term trend analysis and predicting future outbreaks.

To support these needs, HISP is developing its organisational capacity and reach by:

• Building technical, public health and operational capacity• Standardising engagement and contracting processes• Improving coordination between HISP entities.

PATH Report9: “The HISP nodes are a powerful network for amplifying capacity building and extending the overall HISP team to countries and regions; however, the network could be better utilized by clarifying roles”

To support this, HISP entities in Africa and other LMICs are beginning to collaborate in the newly formed HISP Partnerships Organisation (HPO). It can:

• Support organisational development and management of HISP entities• Collaborate and share resources• Create a formal mechanism discussing, articulating and shaping HIS development strategy• Setting standards for the provision of HIS services to stakeholders.

Increasing demands and resources available for health information systems development can build from:

• Stronger local HISP teams• Increased sharing of skilled resources• Increased collaboration amongst HISP teams• Recognition that HISP team members often stay support HISP beyond duration of specific projects, even without funding flows and re nationally embedded in the health sector• CDC/USAID funding needs clear contractual arrangements between HISP entities that are easily initiated and maintained.

These changes underpin HISP’s aim “to support the formation of strong local hubs of health information systems (HIS) practitioners, capable of providing effective, high quality support for health information systems development (HISD), especially, but not necessarily exclusively, around the use of the DHIS.”

GE Healthcare

GE presentation, Takeaways on Standards and Interoperability from eHealth Alive 2016 Proposed next steps for ACFEE, was by Charles Parisot, of IHE and GE.

eHealth programmes do not control IOp well. There are several reasons:

• It is seen as a technical problem, not important for policy setting, so system and applications vendors are left to figure it out with ICT deployment staff, but, there are policy implications• Specification of the technical details of the flow of information between different eHealth systems is very technical, complex, with standards difficult to choose, but there are ways to simplify it.

9 http://www.mn.uio.no/ifi/english/research/networks/hisp/hisp-assessment-report.pdf

10.

An effective IOP can:

• Enable procurement of the IT systems from different vendors or open source, initially and over time so dealing with replacement and future proofing)• Support consistent security and privacy, with policies simpler to deploy when relying on the same IOp technical measures• Ensure that quality in exchange and information reduces finger pointing between care providers and health policy makers and systems buyers and vendors• Reduce costs and project risks by building gateways, which is complex and needs constant investments to implement proprietary and ad-hoc interoperability specifications and maintain competences.

Mr Parisot explained that gaining control of IOP needs health systems to:

• Detail information flows between different eHealth systems, it is very complex and manageable if it focuses on a use case as a description on an IOp problem• Standards are difficult to choose, so use profiles when available, and profile standards if not available, such as SNOMED value sets• Mandate profiles and standards in a meaningful and actionable way in the context of a use case and develop national IOp specifications to record selected profiles and standards and add national extensions if needed• Ensure ownership and sustainability to demonstrate the value• Build an IOP culture with a national IOp centre to: o Turn policy priorities as use cases into profile and standards-based IOp specifications o Offer test tools and organise conformity assessments, but no product offerings because of conflicts of interests.

For metadata, XDS comprises document class, patients’ IDs, authors, facilities, date of service and repository ID. It connects patients’ information, registries, repositories and document sources. There are numerous profiles and standards that can combine with the XDS standard. Examples presented include:

• Security and privacy: o Audit Trail and Node Authentication (ATNA) for basic security functions, centralised audit trail, authentication of systems not users, optional encryption for transport connections, and required by IHE for all XDS implementations o XUA: Cross-enterprise User Assertion for attributes of Users, such as user role, requesting health information to enable authentication in a distributed system o Basic Patient Privacy Consent (BPPC) provides a mechanism to record patients’ privacy consents, and a method to enforce the privacy consent appropriate to the use.

• Other profiles to be combined with XDS for patient identification are: o Patient Identifier Cross-referencing (PIX) for managing multiple local patient IDs as a look- up service for cross references and support for Master Patient Index (MPI) o Patient Demographics Query (PDQ) to find Patient ID based on name, birthdate, sex and other demographics o Consistent Time (CT) to synchronise all systems to a common time, and needed for audit trail and access rights

11.

Advancing eHealth in Africa 12.

• Profiles to be combined with XDS to define document content formats and XDS extensions for specific applications: o XDS-MS for Medical Summaries o XPHR: Exchange of Personal Health Record Content o PRE/DIS/PADV for Prescription/Dispensation/Advice o EDR for Emergency Department Referral o XDS-SD for Scanned Documents o XDS-Lab for Lab Reports o XDS-I for DICOM Images o XDS can share documents with any content.

Mr Parisot recommended a roadmap for IOp strengthening and suggested a role for Acfee to support countries as they embark on it. This was supported by the AeF.

5. Acfee’s eHealth Action Plan5.1 Main Theme

We all know the saying that “the best way to eat an elephant is one bite at a time”. There’s less guidance on which bites to take first. For Acfee and it’s ambitious eHealth intentions in Africa, the Advisory Board plays a critical role in helping plan this complex and challenging meal.

5.2 Acfee progress

Acfee has been collecting information on a wide range of eHealth form African countries and across the world as part of its eHealth News Africa (eHNA) service. These provide a valuable source of information to support the six initiatives. As eHealth develops and new information, insights and experiences become available, these will supplement Acfee’s initial support and provide a dialogue with Advisory Board members.

Other African countries can be part of this too. Acfee will advise each country’s permanent secretary in their health ministries and offer them the opportunity to participate in the AeF’s sic initiatives, so enable all-Africa to advance their eHealth together and share their experiences.

5.3 Next steps for Acfee

Suggested Next Steps for Acfee are:

1. Select Acfee members relevant priority use cases

o Seeds from the national governance and collaborative process o Pick two or three use cases o Document these two or three use cases

2. Develop national architecture alternatives and IOp specifications o Develop alternative architectures based on country plans o Develop, review and adopt IOp specifications for the above two or three use cases o Include national extensions, if needed o Establish test tools with IHE support to produce an IHE package for each Acfee member as a test for virtual machine for conformity testing.

3. Develop position papers on five priority eHealth topics

o eHealth strategy o eHealth governance o eHealth regulation o eHealth cyber-security o eHealth impact.

6. Annexe6.1 Acfee’s Advisory Board

Advancing eHealth in Africa13.

Advancing eHealth in Africa 14.

6.2 AeF Attendance List

Acfee Advisory Board Members and Dignitaries

Dr. Gerald Gwinji, Health Permanent Secretary, Zimbabwe (Advisory Board Chairperson)Dr. Lynette Moretlo Molefi, Board Member, International Society for Telemedicine and eHealth, South AfricaDr. Simon Zwane, Health Permanent Secretary, Swaziland Prof. Keith Househam, Independent Management Consultant and Management Coach, previous Director General of Health, Western Cape Province, South Africa Mr Daniel Murenzi, eHealth and Informatics officer, East African CommunityDr. Eddie Mukooyo, Assistant Commission of Health Services, Ministry of Health, Uganda Dr. Andreas Mwoombola, Health Permanent Secretary, NamibiaMr. Mbulelo Cabuko, Director Health Information Systems, South Africa

Acfee Team Members Dr. Séan Broomhead, Acfee ChairpersonDr. Ousmane Ly, Acfee Executive Director and Director General of eHealth, Mali Prof. Peter Nyasulu, Acfee Executive Director and Head of School of Public Health, Monash South AfricaMr. Tom Jones, Acfee Director of Strategy and Impact Mrs. Lesley Dobson, Acfee Director of International Relations

Representatives of Industry Partners

Mr. Charles R. Parisot, GE HealthcareMr. Clyde Lewis, Marketing Director Africa, GE HealthcareDr. Vincent Shaw, Executive Director, HISP-SAMr. Calle Hedberg, Strategic Advisor, HISP-SADr. Gugulethu Ngubane, Chief Operating Officer, HISP-SAMs. Lavinia Shikongo, Country Lead, HISP-NamibiaDr Mohammed Jeenah, Director Training Mentoring and Support, HISP-SA

Apologies

Mr. Onesmus Kamau, Head, eHealth Development Unit, Kenya Dr. Addis Tamire Woldemariam, Director General, Ministry of Health, EthiopiaProf. Walinjom Fombad Tenjericha Muna, President, WHO Technical Advisory Group on eHealth (eTAG), based in Cameroon.Dr. Shenaaz El-Halabi, Health Permanent Secretary, BotswanaDr. Bakary Diarra, Health Permanent Secretary, MaliDr. Ebenezer Appiah, Denkyira Director General of Health, Ghana

Reproduction is authorised provided the source is acknowledged as “Advancing eHealth 2016, African eHealth Forum, African Centre for eHealth

Excellence, November 2016”

ISBN 978-0-620-67607-6