From Epidemic Preparedness to Chronic Disease Management Aisha Walcott-Bryant, PhD Research Scientist Manager Cognitive Healthcare Kenya Research Lab

Healthcare Challenges in Africa 1 2 Africa’s Population Growth Dual Disease Burden >30x European population growth rate >2x World population growth rate By 2030, NCDs will contribute to over 60% of total national mortality in Kenya Deaths #People 300,000 250,000 200,000 150,000 100,000 50,000 5B 4B 3B 2B 1B Communicable Non-Communicable Africa Europe Injuries Year 1950 1975 2000 2025 2050 2100 2010 2015 2020 2025 2030 Source: UN Source: WHO

Healthcare Challenges in Africa 1 2 Africa’s Population Growth Dual Disease Burden >30x European population growth rate >2x World population growth rate By 2030, NCDs will contribute to over 60% of total national mortality in Kenya Deaths “Colliding epidemics of NCDs and infectious diseases” [Levitt et. Al. 2011] #People 300,000 250,000 200,000 150,000 100,000 50,000 5B 4B 3B 2B 1B Communicable Non-Communicable Africa Europe Injuries Year 1950 1975 2000 2025 2050 2100 2010 2015 2020 2025 2030 Source: UN Source: WHO

Outline Epidemic Preparedness System Chronic Illness Management Platform

2014 Ebola Outbreak Data Challenges Many organizations operating in the response Limited data sharing infrastructure Delays in data for decision making Funded by USAID

System Goals Integrate community and health system data Improve timeliness of data analysis for decision making Evidence-based decision support for resource allocation Funded by USAID

Epidemic Preparedness System Disease Surveillance Community Messaging Bringing data into meaningful knowledge graph semantically linking disparate data sets including geo-spatial data Categorization of short mixed language community messages using advanced Natural Language Processing and analytics Funded by USAID

Outline Epidemic Preparedness System Chronic Illness Management Platform

Chronic Illness and NCD Management in Kenya Hypertension Study 2016 IBM Research – Kenya Health Federation Field Studies at Health Centers Pharmacist, Pharmacy Technician, Nurse, Automated Machine Doctor, Nurse 18 private healthcare institutions in Kenya 18 Facilities – 18 Guidelines European Society of Cardiologists, American Heart Association, UK NICE guidelines, … Pharmacists and traditional practitioners are a major source of healthcare for many households Limited ongoing support for patients at home Care Planning Post Consultation Pharmaceutical Dispensing Patient Patient Surveillance and Triage Adherence Support Doctor, Nurse, CHW, Pharmacist, System CHW, Health Kiosk, At-home Monitoring Devices

Issues With Adherence Globally, there is less than 50% adherence rate to medication Challenges for Patients and Healthcare Providers in Africa: Complex multi morbidity Polypharmacy Life-long medication access Adverse drug reactions Health literacy and education

Medication Measurements Outreach Approach – Life-long Support for the Management of Chronic Illnesses in Africa Medication Cognitive Decision Support for Healthcare Providers To address medication challenges Chronic Illness Management Platform Cognitive Health Analytics Engine Measurements Outreach IoT and Medical Devices Support for regular measurements Health coaching for self management Patient Outreach Supporting care plan adherence Planning triage and surveillance

Current Status Medication, Outreach, and Measurement prototypes under testing in lab environment Prospective studies Local partners to deploy and test the Chronic Illness Management Platform in Kenya Research studies How do we move patient interaction and access to the health system toward the community level?  How do we empower patients to manage their own condition over their lifetimes?  How do we develop intervention and disease management plans that include an individual’s context and the uniquely African context?  Models for sustainability and scalability