Leaving the Bleeding Edge: An Industry Analysis of eSurveillance in Africa in Support of the African Surveillance Informatics Governing Board Público

Abstract

This report serves as background for the African Surveillance Informatics Governance Board (ASIGB) as its leaders set strategy. It utilizes business analysis frameworks and techniques to shed light on information and communications technology (ICT) as a tool to realize the disease surveillance goals of the 2005 International Heath Regulations (IHR) and Integrated Disease Surveillance and Response (IDSR).

The promise of eSurveillance and eHealth (especially under the IHR and IDSR) is tremendous, but the African eHealth industry is plagued by structural inefficiencies. The Diffusion of Innovation (DOI) model is used to explain many of the trends of eSurveillance. These structural inefficiencies are precipitously slowing the adoption of eSurveillance, and they weaken surveillance systems. If these inefficiencies continue, they seriously harm the utilization of ICT in public health as envisioned in WHO's 2005 directive on eHealth. While there are many organizations looking to ease these conditions, the amount of support for government in certain areas is lacking. Specifically, these areas lacking support are: ICT training for government workers, public informatics training for government public health leaders, change management support, evidence on the impact of design options, and general advocacy for the adoption of eHealth. These areas were identified by risk analysis for governments engaged in eHealth projects and a competitive analysis of organizations designed to support those governments.

In addressing these problems, this report reveals an unmet need of governments investing in eSurveillance: that of a permanent, participatory network of government experts in information communication technology (ICT) and public health. Such a body would strengthen eSurveillance in three ways: it can effectively influence key stakeholders in governments; it pools risks and resources; and it builds social avenues to promote other strategies, such as IDSR and IHR. An international coordinating body such as the ASIGB may be in a position to address this unmet need.

Table of Contents

EXECUTIVE SUMMARY 1
EXTENDED EXECUTIVE SUMMARY 4

INTRODUCTORY MATERIALS 15
TERMS OF REFERENCE 16
QUICK PRIMER ON ESURVEILLANCE AND EHEALTH 19

SECTION 1: BROAD INDUSTRY OVERVIEW 24
ESURVEILLANCE & IDSR: WHAT THE FUTURE MAY HOLD 25
DEFINITIONS OF ESURVEILLANCE AND EHEALTH 28
THE SCOPE OF THIS ANALYSIS 31
DETAILS ON THE STRUCTURE OF THE INDUSTRY 35

SECTION 2: EHEALTH INDUSTRY TRENDS 39
WHY EHEALTH IS GROWING 40
ANALYSIS FRAMEWORK: THE DIFFUSION OF INNOVATION (DOI) 42
TODAY'S EHEALTH INDUSTRY 44
THE SHORT-TERM FUTURE: TOMORROW'S EHEALTH INDUSTRY 49
INDUSTRY RISKS: A "GOLD RUSH" 53

SECTION 3: EHEALTH INDUSTRY 58
TREND ANALYSIS 58
PROFILE OF GOVERNMENT EHEALTH INVESTMENTS 59
THE BIGGEST RISKS IN ESURVEILLANCE INVESTMENT 62

SECTION 4: INDUSTRY GAP ANALYSIS 66
BRIDGING THE CHASM: ENABLING ORGANIZATIONS 67
RESULTS: GAPS IN THE INDUSTRY 72

SECTION 5: RESPONSES 74
POSSIBLE RESPONSES TO GAPS 75
EHEALTH NETWORKING: THE BASICS 77
ROLES OF A COORDINATING BODY 83
THE PROBLEMS THAT A STRONG NETWORK SOLVES 86

APPENDICES 90
APPENDIX 1: ANALYSIS OF OTHER RELATED EHEALTH COORDINATION ACTIVITES 91
A. SETTING STANDARDS 91
B. INVESTING IN TECHNOLOGY 94
APPENDIX 2: METHODOLOGIES 96
APPENDIX 3: LITERATURE REVIEW 100
APPENDIX 4: MARKET SIZING 103
APPENDIX 5: SOFTWARE FOR IDSR-RELATED TASKS 104
APPENDIX 6: FULL RISK PROFILES 109
APPENDIX 7: SECTOR ANALYSIS ON ENABLING ORGANIZATIONS 117
APPENDIX 8: REFERENCES 120

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Computer Science Political Science, International Law and Relations Health Sciences, Public Health
Palavra-chave	Public Health Informatics eHealth Africa Disease Surveillance Competitive Analysis Diffusion of Innovation Risk Management Public Health Networking Regional Disease Surveillance Network Industry Analysis
Committee Chair / Thesis Advisor	McNabb, Scott JN, Emory University
Partnering Agencies	International governmental organization (e.g., Agency for International Development, etc.) CDC

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