In this interview with Pharmanews in Lagos, recently, Ezinne Anyanwu, managing director of Efferent Advisory Group, a health care management firm which aims to harness the power of technology to re-engineer clinical and operational process of the health care industry in Sub-Sahara Africa, speaks on the objectives of the Efferent Group and how the application of information technology (IT) can help enhance better treatment outcomes for patients. She also speaks on the challenges facing nursing practice and how nurses can be empowered to deliver better services to patients. Excerpts:
When was Efferent Group established and what are the objectives of the company?
The company was established in July, 2014 and we have our head office in Houston Texas, USA, as well as an office here in Lagos, Nigeria. That is the primary reason why I am here.
Prior to the opening of our office here in Lagos, I have been travelling a lot to the African region. My background is in health care, as you know. I started as a nurse in the USA. I worked for a government hospital in the US for years. It was from there that my interest grew from just caring for patients into management. This was because I realised that there were several processes in health care that could be improved. So, I decided to challenge myself to learn more. It was in the process of learning that technology became a part of my inquisition on how better care could be given to patients, and technology can be really helpful with that.
As I travelled to this region, I started to look at what could be done and I realised that just dedicating the knowledge I had acquired to improve various aspect of health care alone could help tremendously. It could help organisations improve their operations and understand what technology could really do to enhance their practice.
You started your career as a nursing assistant but today you are into health information technology consultancy. What prompted your exit from active nursing practice?
I just wanted to be part of the decision making body in the health sector. I had spent a lot of time at the bedside as a nurse. You were told what to do and sometimes you wondered if what you were asked to do made sense. I became very curious and always asked, why? I realised that sometimes there was no cogent reason why we were asked to practise in certain ways. It was in order to help limit the frustration in my department that I decided to join some of the management committees and from there I became a Charge Nurse. From there, I realised how technology was going to continue changing health care delivery and why health caregivers should key into it. Seeing where health care was going and how critical technology was going to be in it, I decided to follow the trend. That was what led to my transition from clinical bedside to health care management and information technology.
What is the relationship between health care and information technology and what are the ways IT can help improve health care delivery?
If you take a look at the average patient, you will realise that the two are connected. They are connected because the patient is connected to his mobile phone, to social networks, etc. He can buy things online and sell things online. The patients we have today are already using various technology platforms. So, why should health care be different?
Now, in some climes, people are using their mobile phones to check their vital signs, like blood pressure. Technology is already being widely used in other sectors; health care is the place where it is least used in this country and I think we are getting there and we have to get there. We have to keep up with the trend because, for there to be a good patient care outcome, we have to use technology to help us. We need to be able to get required data quickly, analyse it and act on it. In developed countries, long gone are the days of huge paper work in health facilities. If the right technology is applied, we will get better outcomes for our patients.
Technology is changing health care and we must stay with the trend. In Nigeria, health care delivery needs a lot of improvement and we can really use technology to improve our practice.
How can we avoid the abuse of technology in health care delivery? How, for example, do we avoid wrong self-medication which can have attendant negative consequences?
You are right – there is need to be careful. We are seeing those trends already where people just go online to get information on their symptoms, diagnose themselves and start treatment. This is because they are looking for more efficient ways of getting the care that they need. The fact is that when patients have a problem, they want prompt solution and care. If I have a health problem and I have two alternatives of either going to sit down in the hospital for hours waiting to see a physician whose treatment I might not be satisfied with, or to go online to get the best advice from a variety of practitioners on my health condition. I would probably settle for the later.
Therefore, as clinicians, we really have to ensure we satisfy our patients’ needs for prompt and quality care when they need it. Physicians need to keep pace with their patients. We can also adopt the use of the various mobile platforms so that we can relate better with our patients and respond to them promptly which will prevent the issue of them going online to get solution to their problems. Moreover, we can’t even control what is online, but we can control and manage our patients better when they come to us. So, we need to use technology to optimise their access to us so that, when they get information online, they can discuss it with us and thus get advice on how to apply it appropriately.
Efferent Advisory Group is well established in the US. What prompted your interest to come into the Nigerian market?
First, the US market is quite saturated and I really want us to drive change and drive value where it is needed most; and I think there is so much to be done in the health care space of Nigeria. Nigeria is big. West Africa and African market by extension is huge and there is a lot that is needed to be done in these markets. We want to bring the best value to these markets and for me, personally, this is home. With everything I’ve learnt, I feel strongly that, as a Nigerian woman, the best is for me to bring that knowledge back home and try to make a difference.
You have practised nursing in the US and since you arrived, you have not only observed the practice here, you have also interacted with the practitioners. How far behind are we when you compare nursing practice between Nigeria and USA?
I think we have to start from empowerment. I recently interacted with some nurses at a Pharmanews training programme and it was an amazing experience for me. The knowledge is there and I think part of the required resource is there but we just have to put all together and empower the practitioners and bring back the passion into nursing. I think that starts with leadership. There must be conscious efforts for organisational change to occur. We need mindset change to occur. We need more training and re-training. I think it really starts with leadership. A lot can be done by good leadership to bring back the passion into nursing. We need the leadership to identify the needs of nursing and nurses and meet those needs and automatically the passion will come back.
Nurses are usually the first to attend to patients when they get to hospitals and for patients who are on admission, nurses spend more time with them than other health care givers. This entails a lot of interaction between patients and nurses, thus making good human relation a very important attribute for nurses. This good human relation skill is sometimes found to be lacking in some nurses, why is this so and is it a skill that can be inculcated in nurses through training?
Absolutely, it is a skill that can be learnt. It is in fact a very important skill that is embedded in nursing practice. Nursing practice required holistic care of the patients and good human relation is indeed crucial to this care. I still think it has to start with good leadership direction. I have worked in organisations where if the standards set are not met, there are consequences for all involved and when the standards are met there are incentives and rewards. But what is common in most organisations is that there are consequences and punishments when standards are not met, but no incentives or rewards when standards are met or even surpassed. This is not good enough. So leadership can influence the desirable changes we want from the nurses and for our health care sector. Our nurses have needs that are hindering them. We need to identify and meet these needs. When we are able to do that, we shall get the best from them.