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Sutures

Therapeutic education enhanced

We saw that Morocco is the cradle of many great projects and initiatives : and despite the lack of funding, some are developed and implemented inside care centers – a great example is « Sutures », a project that originated inside a Moroccan healthcare association « Jiraha » and was developed and tested at the National Institute of Oncology.

National Institute of Oncology? Sutures? Jiraha?
The National Institute of Oncology (NIO) is the only Moroccan anticancer center to host and offer all the available treatments to fight against cancer. Founded in 1984, it is today at an advanced stage of its development and provides very specialized solutions (specialization of surgeons by organs for the surgery of digestive cancers for example)Since 2017, NIO has been developing its own hospital information system (IS), with the help of the company Enova.

Sutures is an application available to surgical staff to ease patient education. This project was born from the observation of a huge need for documentation and simplification of explanations for the patient, who already receives a substantial flow of information, but does not necessarily have the right support to assimilate them.A current project is to make it a module within NIO and its IS. Originally developed within the Jiraha associationwith personal funds, the company Enova got interested by the project. The solution, currently in beta testing, should be available and integrated in the first quarter of 2020.To find out more, click here. And finally, Jiraha. It is an association created by surgeons and engineers who are interested in cultural issues and innovation in healthcare. The goal is to break intellectual silos in medicine to generate new ideas.

The projects launched through Jiraha
Sutures is the last project conceived by the association. This application helps the surgeon to show an anatomical  2D-framework and to enable a personalized, real-time explanation to the patient. It is also possible to take screenshots to keep a BD type frame which can be annotated, attached to the patient’s file or delivered directly to the patient with annotations.
Before that, Jiraha had already launched another initiative, which was a platform to better manage weekly multidisciplinary consultation meetings (MCM) of doctors from several specialties, discussing and sharing about cancer patients. The first MCM at NIO took place about 9 years ago. At this time, there was no patient file, and it was difficult to keep track. With this solution, which is still used by some hospitals that do not have their own IS yet. 

« Lots of gadgets especially in mobile applications but low clinical interest on average. »
An effort at institutional level is underway, in particular for the digitization of the patient files, which is once again a prerequisite. However, we are still a long way off with many University Hospitals which are still on paper. Because of their wide autonomy, the University Hospitals make their own choice of IS, which results in great heterogeneity.An example : at Rabat’s Ibn Sina hospital, a steering committee was responsible for implementing a Spanish patient IS solution. The project was poorly prepared, with fluid workflows and repositories of unfinalized acts. Why? IT seen as a miracle solution to problems that are actually organizational, and that must be resolved before establishing an IT strategy.
The IS at the National Institute of Oncology project was carried out more efficiently and more fluidly. The NGO Lalla Salma, led by Princess Salma, has played a decisive role in the fight against cancer in Morocco. Thanks to high quality advice, digitalization was much more organized: the center notably has quantitative and soon qualitative dashboards.

What’s next?
There is currently a lot of reflexion about the « return to home », a practice that is still very widespread in Morocco is the Whatsapp discussion with patients (which is also a solution to the illiteracy situation since some patients can send voice messages).
Therapeutic education through digital, and post-operation tele-expertise for professionals located in isolated regions are also promising sectors.
Finally, multicentric databases, which can be used to share anonymized data on a subgroup of patients and can be used to promote research work.
To carry out these projects, it will be necessary to find funding solutions, and to think carefully about education in tools and adoption. The IRC website is a great resource concerning these topics and current innovation in the field of oncology.

This article is the fruit of my own analysis following a discussion with Dr. Amine Benkabbou, surgeon and co-founder of Sutures and Jiraha, whom I thank. I am ultimately accountable for this article’s content.

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