While leading healthcare organisations around the world increasingly permit their physicians, administrators, nurses and information technology staff to work with smartphones, Nigerian hospitals still largely underutilise mobile communication technology, hurting access to patient-centric healthcare.
With smart devices, hospitals are improving the challenges faced in mobile communication infrastructure, data security, and compliance. They are better communicating with care team members, delivering real-time clinical information, receiving actionable information such as nurse call alerts and sharing protected health information.
When Spok, Inc. surveyed 460 healthcare professionals across the US for its 2019 annual report on Mobile Communication in Healthcare, it found that 90 percent of physicians were most often permitted to use mobile devices, followed by administrators 84 percent, nurses 79 percent, and IT staff 76 percent. The same is true of nonclinical staff that relies on a variety of devices to perform their work.
The report shows that smartphones are supported by 75 percent of organisations and at least one type of pager; 64 percent support Wi-Fi phones, 55 percent tablets, 19 percent voice badges, and 10 percent smart watches.
Sodipo Oluwajimi, vice-chairman, Lagos Medical Guild, says the challenge with the adoption in Nigeria has been lack of structure on how healthcare providers can use it in terms of scheduling clinical appointments, practice and sending health information, even though a large number of people use smart phones. It is an area, he says, needs to be established specifically to reach people in hard to reach places.
“One of the challenges is that there is no internet in some places and even when there is, it is easier to find internet connection and a phone than to find a healthcare provider in some parts of the country,” Sodipo notes.
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BusinessDay findings show that a handful of hospitals in metropolitan areas like Lagos have been adopting online applications to book appointments while some private hospitals have been using it to link healthcare providers with patients.
But the worry among professionals is first, protection of confidentiality. The other challenge has been the uncertainty of the competence level of the healthcare provider being linked with the patient.
According to Spok Inc., smart watches, voice badges, and encrypted pagers were the newest devices introduced. In 2017, encrypted pagers became a device option. Now, it is a device supported by 27 percent of organisations.
Though still the least-supported device in 2019, smart watches have seen steady increases since their introduction in 2015. In 2015, smart watch usage was supported by a mere 4 percent of organisations and has jumped to 10 percent in 2019.
Olatoke Oke, a consultant family physician and partner at Brookside Medical Practice in Lagos, affirms that some changes were being witnessed in Nigeria’s healthcare, with the development of mobile applications to aid some clinical processes.
“But we have to advance to where we are able to communicate different things to the patient. If there is a current outbreak of meningitis, for instance, you can inform your patient and tell them to come in for one thing or the other,” Oke says, “The hospitals in Nigeria are not quite there yet. There is a lot of underfunding.”
Personal health record apps for mobile devices, for instance, not only hold patient-entered information, such as health history and medication reminders, they also track triggers such as pollution, monitor respirations, sends alerts of impending asthma symptom among other functions.
In a 2019 study on Healthcare-related smartphone use among doctors in hospitals in Kaduna, the Department of Medicine, Kaduna State University found that 8.5 percent of 360 healthcare providers used electronic medical record a lot; 39.1 percent used it for differential diagnosis about a disease condition while 34.3 percent for indications for use of drugs.
Overall, 72.7 percent of respondents considered their smartphones to be very useful in the healthcare setting, while 13.4 percent believed their smartphones were less useful to their work.
Respondents younger than 40 years were, however, significantly more likely to consider their smartphones as very useful or invaluable than those aged 40 or above.
Similarly, newly qualified doctors including interns and graduate doctors were significantly more likely to judge their phones very useful or invaluable than other doctors who have been qualified for 10 years.
Asked about problems they encountered while using their phones in the course of work, 60 percent cited having to see many patients and lacking time as the most frequent barrier. Also, 44.2 percent and 23 percent said a reliable internet connection and data fees were barriers to optimal of use, respectively.
Doctors working in public hospitals are significantly more likely to cite lack of reliable internet as impediment to full use of their smartphones than those working in private hospitals.
According to the study, concern about being distracted was also 40 percent high, with reports that distraction among healthcare workers has led to medical errors due to mistakes and omissions. Anxiety about the reliability of information, although low, was more frequent and significant among newly qualified doctors and general practitioners.
“This can be remedied by developing an app that brings together sources and links to reliable information which hospitals, other institutions and doctors’ associations can subscribe to and make available to staff members at no or limited cost,” the study recommended.
