Students working to bring electronic health records to Ghana

May 09, 2014

By Greg Peters

Sarafina Kankam and Frank Gyamfi

While many sought out warmer climes for spring break, a pair of students from the University of Kansas Medical Center traveled to the Arizona desert, not to escape the icy grip of Old Man Winter, but to further their mission of bringing electronic health records to Africa.

Frank Gyamfi, a 2014 graduate in the Department of Health Information Management, and Sarafina Kankam, a second-year student in the School of Medicine, traveled to Arizona State University where they participated in the Clinton Global Initiative University. Gyamfi and Kankam, both of whom have ties to Ghana, have formed the Quality Healthcare for Africa Foundation in an effort to bring electronic medical record (EMR) keeping to the West African nation.

"It has always been my passion to go back to Ghana and help people improve their lives - to see them happy," says Gyamfi, who carried the School of Health Professions banner during KU's commencement and received the 2014 James P. Cooney Leadership Award. "I know if this is successful it will decrease the death rate in the country and eventually on the continent."

"Frank's leadership qualities have distinguished him far above his peers," says Norbert Belz, director of the Department of Health Information Management. "He is proactive, resourceful and perseveres. He has made significant contributions to the program, the community and the profession."

Clinton Global Initiative University

The Clinton Global Initiative University was started in 2007 as an offshoot of the Clinton Global Initiative. Its goal is to bring together the next generation of leaders from around the world to develop answers to pressing global issues.

More than 1,100 students attended this year's conference, which was led by President Bill Clinton, former secretary of state Hillary Clinton and their daughter, Chelsea Clinton. The conference focused on five areas of concern: public health; education; environment and climate change; peace and human rights; and poverty alleviation.

"The Clinton Conference changed the way I think," Gyamfi says. "It gave me more leadership experience and showed me new ways to approach my project and how to work with other people."

The idea to attend the Clinton Conference came from contacts that Kankam has on the Lawrence campus, where she excelled as an undergraduate. Kankam says they made contact with the conference's campus representative, who encouraged them to apply. Both Kankam and Gyamfi say the networking and exposure to mentors and leaders at the conference proved to be invaluable.

"We met with a lot of other students from around the world who had kind of similar projects," Kankam says. "We met some physicians from Greece, who want to bring EMRs to their country. They said having something like that would make their lives easier and would be helpful for their patients."

A key part of the conference was working with mentors who can help nurture the students ideas. Gyamfi met two mentors: Deogratias Niyizonkiza, a survivor of the genocide in Burundi, and Eric-Vincent Guichard, founder of Homestrings, an Africa-based enterprise helping Africans build the continent's economy.

"The Clinton Global Initiative University provided Frank with mentorship, project development training, knowledge, networking and leadership opportunities that have empowered him to move forward with the EHRs in Africa project," says Belz.

From Africa to America

Gyamfi was born in Ghana. His father had lived in Johnson County in the past, and he moved the family there in 2005. Gyamfi graduated from Johnson County Community College in 2012 and expects to receive his degree in health information management from KU in May.

"When I started, I wanted to be a pharmacist," he says. "I did my pre-pharmacy until 2011, and then I switched to health information management. A friend of mine said his aunt graduated in HIM in 2010 and had a lot of good things to say about the program, so I did some research, and then I realized it was the best fit for me."

Kankam' s parents are from Ghana, but she was raised in Lenexa and graduated from Bishop Miege High School before attending the University of Kansas, where she had a distinguished career, including receiving the 2012 Campanile Award given to a graduating senior who has displays remarkable leadership, character and respect for KU.

Kankam, who spent eight weeks at Vanderbilt last summer studying through the American Society of Hematology's Minority Medical Student Award Program, says she has been to Ghana twice. The first time was to meet relatives, and the second time was to do health care work.

"I spent the first couple of weeks in an orphanage where there were hundreds of kids," says Kankam, who as an undergraduate co-founded KU Project Africa, a nonprofit which raises money for orphanages and hospitals. "They really didn't have supplies like toothbrushes or toothpaste, so we donated all of that.

"A lot of the workers hadn't been paid in months," she adds. "That was really hard to see. We ended up giving them about $1,000 to help with their expenses."

Because of their ties to Ghana, the two families have been friends for a long time, so when Gyamfi had the idea to bring electronic health records to his home country it only seemed natural to reach out to Kankam. The two formed their foundation as a way to formalize efforts prior to applying to the Clinton Conference.

"Last fall, we (an HIM class) had a trip to Cerner for a tour and presentation, and during the presentation I asked them if they have any of their solutions in Africa," Gyamfi says. "They said only in Egypt, so I realized there could be opportunities for other African countries to have a system to improve their health care delivery."

Ghana

The Republic of Ghana is home to about 25 million people. The country's health care system has five levels of providers starting with health posts, which are the primary suppliers of care in rural areas, followed by health centers and clinics, district and regional hospitals and then tertiary hospitals.

In February, the minister of health announced that Ghana would be working with the World Health Organization to implement electronic medical records into the country's public hospitals. The system being introduced is called MedSpina, which was developed with Africa in mind and was tested for three years at the Diabetic Clinic of the Korle-Bu Teaching Hospital, considered the premier hospital in Ghana and affiliated with the medical school of the University of Ghana.

While some might see this as competition to QHA's plan, the announcement has not deterred Gyamfi and Kankam from proceeding with their efforts. The two say the government's plan targets larger health care facilities, and they hope to work with smaller, private hospitals to come up with solutions that can be scaled for each setting.

"Those types of companies are going for the bigger hospitals, so we can try to work on the back end" Kankam says. "We want to reach out to one of the private hospitals and say, 'Hey, we have this solution. It's going to help your practice have a better workflow, decrease readmission rates and improve health care outcomes,' then they're more likely to let us have a trial. So we're not really going to interfere with the government."

The plan

Gyamfi and Kankam have started circulating surveys to some of their targeted hospitals and clinics. To make sure the surveys get into the proper hands, Gyamfi has trusted the responsibility to two childhood friends, both of whom are doctors in Ghana.

The plan calls for the assessment to run through June, followed by planning, implementation and training phases, with a possible launch sometime in the next two years. While Gyamfi, Kankam and the foundation can do a lot from their home base in the United States, much of the burden of recruitment and communication in Ghana relies on the two doctors.

"This is why we have people on the ground working so they can take care of the work there, and hopefully we can do the implementation," Gyamfi says. "If we can find a vendor, then the vendor would provide consultants and super-users to do the implementation and training. During that time we will want to be there too, so hopefully we can take a vacation."

After finding a hospital that will accept Quality Healthcare for Africa's help, one of the first hurdles will be determining whether an affordable vendor can be found to provide an electronic health records system or if the foundation will need to create its own software solution using an open-platform approach where the records would be accessible via password-protected software on laptops, tablets, cellphones or other open platform electronic devices.

Kankam says their goal is to provide the entire package for the first hospital free of charge - a key component for establishing a track record in Ghana for the fledgling foundation.

"Ideally, at least for the first hospital, we would like to provide a lot of the funding," she says. "We wouldn't want them to pay for anything. That is why we're going to apply for grants and stuff. We hope that if we are able to implement it successfully in one hospital - and they are able to save more money and we prove through research that our solution will save hospitals money - then other hospitals will see that even if than even if they have to pay a little bit up front, in the end, it saves a lot of money."

The next steps

Gyamfi, who was elected president of his HIM class this year, graduates in May and hopes to find a job in health information management that will allow him to time to continue pursuing his dream - or at least with enough time off to travel to Africa now and again whenever need arises. Kankam has two more years of medical school and her residency. And although both have busy lives, they are each dedicated to seeing the plan grow.

"Frank is well respected by his peers and the faculty," says Belz. "He has developed into a true leader and will continue to make us proud."

After attending the Clinton Conference, Gyamfi and Kankam are as enthused and dedicated as they've ever been about their dream of bringing electronic medical records to Africa. Despite the challenges of working in a foreign country plagued by diseases that have been curtailed or eradicated in many developed nations, frequent electrical outages and spotty Internet connections in many rural locations, the pair is moving ahead with bringing health care aid to Ghana, and they don't plan to stop at EMRs.

"We want to start with electronic medical records, but eventually we hope to expand to a lot of medical devices," says Kankam. "There are a lot of medical devices that African hospitals need, but they can't afford, so we want to develop devices that are lower in cost for them. That's going to be years down the road, but that's where we hope it will go."

Categories: Featured, School of Medicine, School of Health Professions

Last modified: May 20, 2014
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