In Part 3 of our series Dr. Ahmed and Dr. Mativa of Aga Khan University and Hospitals speak to the value that millions of discretely housed patient records provide in advancing medical research in the region and the global impact they will have in identifying best practices for the treatment of regional diseases and chronic conditions.
Title: Making a Global Impact through Industry-leading Research Efforts
Guests: Dr. K. Nadeem Ahmed Chief Medical Information Officer, Aga Khan University
Dr. Boniface Mativa, Acting Chief Medical Officer, Aga Khan University Hospital Nairobi
Host: Christine Parent, Associate Vice President, MEDITECH
Dr. Mativa: For me, this will add great value to our medical training. It will add great value to our patient care processes. It will add great value to research and innovation, which should impact the region way beyond the organization. For me, this indeed is very key and is going to be a huge huge leap towards accomplishing what our mission and vision is as an organization.
Christine: Welcome to another episode of MEDITECH Podcast. Today, we conclude our discussion with Dr. Nadeem Ahmed, CMIO of the Aga Khan University and Hospitals and Dr. Boniface Mativa, acting CMO at Aga Khan University Hospital, Nairobi. Last time, Dr. Ahmed and Dr. Mativa discussed the role their EHR deployment will play in providing equitable access to care. In this episode, we will extend that conversation to discuss the EHR's role in supporting world-class research both within the region and globally. Welcome gentlemen, it's great to have you back.
Dr. Ahmed, one of the areas you noted earlier was the value of leveraging Expanse as a research tool. Can you expand on that?
Dr. Ahmed: Sure. Absolutely. Going on that concept of the data, yes, having it presented to the physician and then as the physician and or nurse or other care provider is engaging with the patient and putting more data into the system. Now we have a mine of data, like the diamond in the rough, if you will. How can we then ask other organizations that are doing research in the lower middle income countries to say, "Look what is it that the patient population here is challenged with?"
Let me give you one small example to put in perspective. In these areas of the world, you would imagine that the predominant factor that is causing most mortality and much morbidity, it's not cancer, it's infections. The global COVID pandemic has certainly humbled all of us to understand how infections can just completely stagnate the economy. Countries such as Kenya and Pakistan. This is an ongoing challenge. It is not new. They have had local epidemics, outbreaks of infections in these regions for many years because they don't have the infrastructure of clean water or sanitary enhancements that other developed countries have. When you're looking at that data, you're looking at it saying, "Oh wow, we need to do something about this," because we can now clearly see that the data is supporting that new infections. Of course, COVID is the recent one that we are all familiar with, but there's others that are unique to certain areas. For example, if you go and you talk about Dengue Fever, or if you're talking about Malaria, or if you're talking about other infectious ideologies. That's a conversation I don't have too much in the US. In East Africa and Pakistan, it's very much a real thing and the data would support it.
When other pharmaceutical companies are talking about, well we want to research a new medication that might help these infections, they may be developed in the West because we know how research infrastructure is not based out of East Africa, right? It's not based out of South Asia. It's based out of many western countries. Now, they can see the data we would share with them and they say, "Oh, we have some medications that might help your regions because we're developing it here."
Connecting again, when I said it earlier, I really meant it. We're looking at healthcare on a global scale and how we are really helping each other, not just our neighbors, not just our patients in front of us, but really the broader global community. Again, the EHR would be that basis of being able to capture the data, refine it, and then being able to present it not just for study for research but also for other research that is happening outside of our institution and bringing in funding through research through studies that would need to be performed. We see EHR as a catalyst to further enable a lot of the strong work that is already happening in this part of the world. It is very much a catalyst and a tool to help us do things on a much larger scale.
Christine: Dr. Mativa, do you have anything to add regarding the value of this medical research?
Dr. Mativa: We are now a medical college as part of the Aga Khan University. You can appreciate how much we require to have quality information as a basis for teaching and research. This, again, becomes a key context where EHR will help us to create a wholesome reference or repository of information that can form. For example, important databases for conditions of disease, important databases for patient cohorts with similar conditions that can then become an important reference for research and education as it were.
Of course, we also appreciate what that will mean in terms of providing information to third-party users, for example, we provide a lot of returns to the Ministry of Health. We provide medical reports to our clientele. We provide a lot of reports that support medical legal cases whenever they arise in our case. We are certain that quality data that will be made possible by the EHR will become a key way to leading us to improving the quality and kind of support we give to our patients in the long run.
Christine: To stay on the theme of technologies, Dr. Ahmed, what digital technologies best align where you want to go as an organization and leading research institution and what are you most excited about?
Dr. Ahmed: I think the bottom line is when it comes to connectivity and when it comes to data and being able to have the transparency of that data, there is so much you can do. Now that you have the information there, as I mentioned earlier, we can put it in a reportable fashion. We do the data analytics. We take the noise. We make music out of it, if you will. That is the type of work that must be done once the EHR has been deployed and we start capturing this data, we refine it, and we say, "Oh, this is what we need to do and now we focus our efforts." We can say, "What's the next project? Well, where is the challenge? The data will help us define that. We look at the weakest link and we strengthen it and over time the organization as a whole becomes stronger and stronger, our patient populations become healthier and healthier.
At the end of the day, I am excited by just the vast potential we have in using technologies, digital technologies to improve the bottom line which is healthcare for our patients, healthcare for our regions.
Christine: Dr. Mativa, anything further to add on digital technology?
Dr. Mativa: I look at it as an opportunity to improve the overall environment. Once we improve the overall environment and position ourselves way above the competition by setting the pace in the region in terms of information management, I see us creating a very attractive environment that will probably bring to us the best research minds, the best clinical care minds, as well as attracting collaborations in terms of research, and all these. For me, this will add great value to our medical training. It will add great value to our patient care processes. It will add great value to research and innovation. We should impact the region way beyond the organization. For me, this indeed is very key and is going to be a huge huge leap towards accomplishing what our mission and vision is as an organization.
Christine: Dr. Ahmed, how do you see this model extending to other regions?
Dr. Ahmed: Nairobi is our pivotal first hospital system to Go-LIVE with the Electronic Health Record, but we are not doing anything without a broader vision. All of the work that's happening in Nairobi with the clinical content, the workflows, data itself, and how it's being collected and presented is being done with the global impact in mind. We are creating a standard within AKU and we're calling it a global standard but at the end of the day it's an enterprise standard to our network but it is global, right? Because it will extend to Karachi, which is the next hospital which is across an ocean. It's a different country, a different culture, they speak different native languages there, yet we have a health care standard. Who can say that? Not many.
I'm very excited about that and that we're building this standard in Nairobi at such a high level that a country across the ocean will also benefit from this work. Then, this will come to Tanzania. This will go to Uganda. It'll go to Afghanistan. It'll go to Tajikistan. Where Aga Khan University has its presence, we will establish that standard starting in Nairobi. This will be extended beyond. When we talk about, how do I see this model extending? It is a very direct extension. That standard we're hoping, will not deviate too much.
Of course, there will be things specific to Nairobi. Of course, there will be things that are different specific to Karachi and other cities as they join but the bulk of the work and the bulk of the care will be at a high standard which are again credentialing bodies will audit and hold us to account. We are more than that. We would be more than happy to do that to say, "Yes, we are operating at a very high standard across all of our hospitals." If you go to one hospital in Nairobi, or you go to the one in Tanzania, or you go to the one in Karachi, you're getting the same level of care as if you're going to the one in New York or Washington DC or anywhere else. This is really the vision that we have.
Christine: I'd like to thank Dr. Mativa and Dr. Ahmed for a fascinating conversation today. I have to applaud the Aga Khan University and Hospitals as truly a trailblazer in healthcare globally and look forward to your journey as you progress. At the very end of our podcast, we ask a fun or personal question. How did you end up at the Aga Khan? Is there something personal or something that you want to share with us?
Dr. Mativa: I know, I qualified in the 90's as a clinician as a medical doctor. I began working in the public health sector in Kenya which is quite a challenging place to work in terms of poor infrastructure, poor supplies, and everything. I worked there for a few years and went back to medical school for my postgraduate program and did my internal medicine. At the end of my post-graduate training, I was sure and I was certain that I needed a competitive environment that was well resourced, had the requisite technology, had the requisite resources for me to be able to make an impact.
As I graduated from medical school with my IMED, I was certain that I needed to find a place where I could fully develop, express, and utilize my skills. Looking around the market, at the time, I was certain that Aga Khan was a place to be. When I came here and began working again in 2009, I was sure I had found the right place because the organizational culture and organizational commitment towards improving itself for the purpose of serving the patient and community was remarkable. I resonated with it. We shared a lot of values with the organization.
Christine: Dr. Ahmed?
Dr. Ahmed: I came for the food. At the end of the day, Kenyan food, Pakistan food is just amazing. All joking aside, absolutely, that's actually true but the food is great. In addition, my wife was born in Uganda. I was born in Karachi. To me, it was a marriage made in heaven on so many levels. It only made sense. East Africa, Central Asia. Yes, be with an organization that can reflect that and again on a global scale.
As Dr. Mativa highlighted, I felt that this would be a wonderful challenge. Not only that, be able to use the skill sets. As you know, in my most recent life, I was involved in helping MEDITECH deploy the EHR throughout the United States and Canada and a little bit internationally. It's nice to, again, continue to work with MEDITECH. That's also very exciting. On a level that is much more engaged in East Africa and Central and South Asia, so that I can somewhat connect to my roots, as well. This is a wonderful adventure and I’m very excited to be part of a trailblazing organization working with leaders such as Dr. Mativa.
Christine: Thank you, Dr. Mativa and Dr. Ahmed. I really enjoyed our discussion. Thank you for taking the time to share your remarkable story and vision.
In our next episode, we'll chat with Jane Englebright, PhD, RN. As a nurse leader, Jane is committed to advancing nursing practice and easing the documentation burden for nurses and physicians so they can spend more time with patients. Stay informed and subscribe to MEDITECH Podcast and be sure to check out our resource page for links from this episode. We'll talk to you next time.