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Collaboration delivers a cloud-based system to support large-scale vaccination programs.
By Margaret Lindquist | November 2020
Even before COVID-19 became a global crisis, multiple African governments had implemented a variety of programs for health checks, testing, and public awareness that were originally developed during the 2014 Ebola pandemic. Now, a cloud-based system developed by Oracle and implemented in a philanthropic collaboration with the Tony Blair Institute for Global Change (TBI) is helping several African countries speed up data collection and vaccination administration programs to better monitor and combat a variety of diseases, including yellow fever, human papillomavirus, polio, and measles. The program oversaw the vaccination of 75,000 people within its first 10 days.
The cloud-based system eventually will manage the massive immunization program required when COVID-19 vaccines become generally available.
Through its collaboration with TBI and African nations, Oracle will donate its Oracle Health Management System to various African governments, free for the next 10 years. Ghana, Rwanda, and Sierra Leone will be the first to use the system, with the goal of eventually creating a unified, continent-wide system of digitized health records.
“Unlike the United States, where COVID-19 is probably top of mind, these countries are having to deal with many vaccines and many campaigns,” says Katherine Vandebelt, Oracle vice president for clinical innovation. “This provides them with an opportunity to better manage this in a much different way than they’ve ever been able to do before.”
Since COVID-19 was declared a pandemic, TBI has been providing African governments with tools and deploying teams to help governments procure supplies, test and screen patients, deploy contact tracing, and implement other healthcare measures.
Now, physicians and citizens in the participating countries are beginning to use the cloud-based Oracle Health Management System to support large-scale vaccine programs for diseases such as yellow fever, polio, and measles.
Once a COVID-19 vaccine becomes available, the Oracle Cloud system will be used in participating countries to coordinate scheduling and create records of vaccinations. Digital QR codes captured in the system will help Africa reopen its borders and economies by providing citizens with the proof of immunization, or “immunity pass,” they need to move freely for work and travel.
The Oracle Health Management System already is being used in the US to collect data and monitor patient symptoms and responses to early treatments for COVID-19, as well as provide the screening backbone and volunteer registry for the National Institutes of Health’s COVID-19 Prevention Network.
More broadly, the Oracle Healthcare Management System can help countries monitor the overall health of their populations by enabling millions of individuals and physicians to record and track healthcare data. By storing that data in the cloud, the problem of exchanging data among disparate systems goes away, says Oracle Executive Vice President Mike Sicilia, who oversees the group at Oracle that developed the system. Patients and providers can input vaccination records, symptoms, test results, and other relevant health information into a web-based app.
To date, there are millions of updates from US patients in the system, the vast majority of which were entered using a mobile device. In Africa, physicians and healthcare workers will be the main users of the system. Ghana President Nana Akufo-Addo has stated that the pandemic has made clear the need to digitize the country’s public health systems for the benefit of the country’s citizens.
“The vaccine administration system is available to every citizen,” Sicilia says. “This is available to countries around the world. And it’s designed to scale to each country’s entire population.”
Awo Ablo, executive director of external relations for TBI, says the COVID-19 pandemic and the adoption of a new digital framework for health monitoring may have opened the door for African countries to get ahead of the curve on digital health systems data.
“There’s a possibility of Africa leaping ahead. There's the opportunity for a great leap forward, if countries want to take it, to use technology not just for health, but to digitize the economy.”
“There’s a possibility of Africa leaping ahead. There’s the opportunity for a great leap forward, if countries want to take it, to use technology not just for health, but to digitize the economy,” Ablo says.
When government officials ask questions about such systems, they focus on data security and privacy, Oracle’s Vandebelt says. “That’s what Oracle does well,” she says. “Also, we’ve been continually utilizing external bodies to help determine that what we’re building is of the utmost security and has the necessary privacy controls.”
Another Oracle strength is developing systems at massive scale. Many countries’ existing systems “start to buckle” once they reach tens of thousands of records a day, Ablo says, but the Oracle system can integrate existing data and systems while giving countries the ability to scale.
TBI, a mission-driven not-for-profit, was established by former British Prime Minister Tony Blair in 2016. Its Government Advisory Practice helps the leaders of developing and emerging economies address some of the most difficult challenges in the world today to create more open and prosperous societies. TBI’s track record goes back to 2008, when Blair started the Tony Blair Africa Governance Initiative. He has worked closely with Oracle Chairman and CTO Larry Ellison on other pressing issues in Africa, such as agricultural transformation and access to electricity.
“The proposition Tony Blair has always made to governments is that he is there to back their reform ambitions and agenda, as long as those mean a better life for citizens and sustainable growth,” Ablo says. “It’s a relationship of trust, because we don’t come with an external agenda. Our interest is in nationally scaling concepts that work and that are future-facing.”
COVID-19 has been a catalyst for countries worldwide to rethink their national monitoring and registry systems, but the pandemic has also laid bare the fact that most countries weren’t prepared to handle a crisis of this magnitude. Africa’s ongoing struggles with diseases such as Ebola and malaria are further complicated by the inability to identify individuals in many parts of Africa, where government-issued digital IDs aren’t widespread. A resilient health system is the best defense against future pandemics, according to Rwanda President Paul Kagame, who has noted that Africa must be able to access a fair share of any vaccine once it’s available.
“We need systems that not only tell us what has happened in the form of medical records, but also make predictions about a patient’s journey of care, possible disease progression, etc.,” Oracle’s Sicilia says. While African governments work to implement broad-scale systems—not just for health management, but also for digital IDs—Oracle Healthcare Management System can integrate with biometric standards that allow fingerprint reading to be used for identification.
“When you can identify individuals, there are many benefits beyond healthcare,” Sicilia says. “You can start thinking about having them participate in the digital economy on a regular basis and making it easier for travel, voting—all these types of things that are difficult to do without some way to identify yourself.”
The most revolutionary part is the citizen engagement piece, whereby everyone involved—the patient, the doctor, the healthcare practitioner—sees the benefits of two-way communications.
“You don’t have to wait until the next appointment to talk about how you’re feeling or to tell your doctor that you’ve developed a new symptom,” Sicilia says. “This changes healthcare in a very positive way. We enable bidirectional conversations between patients and providers centered on real-world evidence. That evidence can come from patients’ input or directly from connected medical devices. We need to end the days of faxing medical records. Patients and providers need real-time, secure access to records no matter where they’re located.”
Photography: Tony Blair Institute for Global Change