On health and insurances tomorrow with Cécile Wendling

We are pleased to share with our readers yet another short but interesting interview conducted at the latest Global Forum with Dr. Cécile Wendling:

Please introduce yourself and tell us about your participation at Global Forum.

I’m the head of foresight at AXA and I’m also a researcher, an associate researcher at the center of sociology of organizations in Paris (Centre de sociologie des organisations (CNRS-SCIENCES PO PARIS) in sociology of risks and catastrophes). Today we are at the Global Forum and I will speak at the Digital Communities Session about the future of health, I will explain what are the new trends and I will talk about the health of tomorrow. For AXA it is very important to consider the role of Digital Communities. We think that there are a lot of people that are not covered by insurance today: most of the time they are too “rich” to have a public coverage and too “poor” to have a private coverage. But we think that these people could access insurance with digital tools.

How do you see the Health Sector develop in the next decades ?

The Health is going to be really revolutionized by Big Data first of all. There is a lot of Data Sets that we could not exploit before and that we will manage to use. This data is more and more “cross-sectorial”, so you can cross data of mobility with data of health etc.
Second, there will be new actors entering the game because there is a question of prevention and how well-being can enhance health. It is very important to know today which are the prevention tools that are working and those that are not working; one of the big issue is how do we measure the impact of prevention.
Third, the new tools can empower patients so that they can have more information about their disease and be a more active actor in their treatment . This is of course going to change the relationship between the patient and all the people around him.
Fourth, there will be a new way for people to share their problems and be insured globally. We see more and more start-ups who bring together people who share a disease but also share coverage. This is an ecosystem that is moving quite fast.

Could you please repeat the example of women selling mangoes that you gave us during the conference preparation meeting ?

Yes, it was about the fact that there are a lot of people that are not covered by the insurance. There is this example in Vietnam of women selling mangoes and water in front of bus stations and Bel – the group Bel – wanted them to sell their product La Vache qui rit® and the women refused at first. They were asked if there’s anything that’ll make them change their decision; the women set obtaining a coverage for accidents as a condition. Most of the time they arrive in the morning on a bicycle and if they have an accident it is the entire family who is at an income loss. Bel then promised to turn to an insurance company for a micro-insurance.

The example is very interesting because there is no contact between the insurance company and the women but it’s Bel who is embedding the insurance coverage into the program. This is also existing in Mexico with Oriflame. It is not only one story, there are many cases today. And we really think at AXA that this is the future of insurance, that we can embed the insurance for those people who have difficulty to access it.
Another example that I can give is parametric insurance in Africa that we are working on. It is very difficult to cover farmers of agriculturists if there is a drought for example and nobody insures them. There’s today satellite data that measures the level of humidity in the soil and as soon as the soil is under certain threshold of humidity an insurance system/ payment is triggered. Because of the satellite data and mobile payment we can reach people and afford to insure people we couldn’t before.

The future will certainly lie in the new tools for the better good of people.

Midwife Franka Cadée on her project and the new App.

GLOBAL FORUM 2016, organized by ITEMS, an international firm in Information & Communication Technologies strategies, just took place this past September. The WeObservatory is traditionally moderating the Digital Communities Session and we have had the chance to sit down and talk to some of the session’s speakers.

Here’s the interview with midwife, reasearcher and developer Franka Cadée on her project:

“My name is Franka Cadée, I am a Dutch midwife although not practicing any longer. I’m here at the Global Forum today to speak at the Digital Communities session about my twin2twin project.

I have developed a method where midwives can work together across cultures which is different from development aid. It’s a system whereby you learn from each other. I think we’ve learned through the ages that there are certain sides to development aid that simply do not work because it’s dominating from one culture to the other. So this is an answer to that.

What we are doing is working between midwives and at the beginning of the project try to see what the other culture has to offer: it’s like a barter system. We discuss with one another what we want from each other and then start a partnership. And the partnership is based on reciprocity, which means that you give and you learn how to receive and you learn how to give back, it has to be an equal exchange. So it has lots of challenges, but through those challenges you find that midwives really get to know each other. I also believe that by giving you actually gain power, you don’t gain power by only receiving – what I think is often wrong with development aid.

We do find that it is especially the “giving” aspect of the project that really makes the midwives feel strong; and strong midwives means that they work well and they take care of strong women that give birth.

We’ve developed a whole method that takes 4 years (although you can adapt it) with a series of workshops, people with similar interests are twinned with each other. We match people slightly on age, but mainly on interest so we have teacher midwives with teacher midwives, students with students, researchers with researchers. They work with each other and develop a small project together. What we’ve been fighting hard is the communication: language-wise it’s hard, cross-cultures it’s hard, but also Skype often doesn’t work or phoning is expensive, we’ve been using WhatsApp a lot, but that is also hard sometimes.

Getting the methodology across, how we work and when we meet has been hard to figure out.

So having a Mobile App for this is really fantastic.

It really helps the twins to understand what is the project, what is it about, what and when they can expect and we are hoping that they’ll be able to communicate through the App at some point.


Fo how long was the App idea around ?

It’s been around for about a year and a half, before that we did a book – that is outdated by now since we re-developed the methods. And in the last few months with the help of the WeObservatory it’s come to life. And it’s really amazing to see and I do believe that in certain countries midwives that don’t have good Internet access all the time can download the App when they do have access and have it on their phone.

Somehow it’s really inspiring to see it this way, it’s quite different having it for yourself than just only hearing about the methodology. Anyone who wants to do a twinning project can basically download the method.

You mentioned you are doing a PhD. Can you please talk about the research you’ve been doing ?

I’ve been researching twinning in general (every single article on twinning is in the App). People have twinned for ages since the Second World War. But what you find in Healthcare is very unclear. People don’t know what it is and what it stands for. I’ve done a concept analysis of the word twinning and it’s about to be published in a Journal called Globalization and Health. Basically we’ve come up with a new definition of what twining in Healthcare is and what are the basic ingredients of twinning in Healthcare. I’m also doing a study with all midwives who’ve done twinning, it’s about 50 people. I’m asking them what are the critical success factors in twinning. And I’m doing some work on network analysis and results of their projects . I hope that in the future we’ll be able to really compare the projects by their outcomes.”

Pan Milar: préparation à la naissance dans votre langue

Les cours de l’association Pan Milar à Lausanne offrent aux femmes migrantes du canton de Vaud en Suisse, des temps de partage dans tous les domaines de la périnatalité. Les rencontres sont animées par une sage-femme et des interprètes communautaires dans plus de 30 langues qui prennent le temps d’être à l’écoute des couples et de répondre à leurs besoins.

Après un an de travail sous la coordination de Stéphanie Pfister Boulenaz et Willemien Hulsbergen, avec un tout nouveau site web et une courte vidéo explicative , l’association Pan Milar facilite l’accès à leurs services aux femmes migrantes de toutes langues et origines. Une présentation des activités aura lieu le 7 Octobre 2016, à Genève, lors de la 6ème conférence annuelle de Giving Women, sur le thème des Femmes Migrantes: http://www.m2025-weobservatory.org/2016. Ce projet a été réalisé avec l’appui financier de Connecting Midwives.

Voir plus d’informations ici: http://www.m2025-weobservatory.org/sage-femmes-et-femmes-migrantes.html.”


New online course for the school of midwifery CASA in San Miguel de Allende, Mexico

The Foundation Millennia2025 recently launched its new online course on the topic of digital applications for maternal and children’s health. The course, available in Spanish only, is comprised of 8 modules of 30 minutes each, including an evaluation exercise. Developed with the support of the WeObservatory, with its partners CASA and Connecting Midwives, the course is dedicated to the students of the school of midwifery CASA, in San Miguel de Allende, meeting-with-the-midwivesMexico.  The initial version of this course –authored by Dr. Lilia Perez-Chavolla, Dr. Véronique Inès Thouvenot and Kate N. Frometa– was evaluated by CASA’s students and teachers in San Miguel de Allende and Mexico City, during a field trip in January 2015, and revised based on their feedback (photos of the field trip in our Photo Gallery)

The course’s 8 modules are currently available in PDF format directly on the WeObservatory site.

Starting in 2017, the Foundation plans to provide access to the modules from the WePromis platform: http://www.millennia2015.org/Millennia2025_Intelligence_Platform.

A detailed project description also on the WeObservaotory website.

Interview with nurse Claudia C. Bartz

To continue the tradition of Medetel interviews, here’s a most interesting discussion that we had with the very experienced nurse Claudia C. Bartz:

“I’m Claudia Bartz, I live in Wisconsin, US. My lifetime as a nurse includes a career in the US Army, I retired in 1999 and then I spent about 5 years at the University of Wisconsin at the College of Nursing, teaching a few semesters and I was project director on 4 grants. Then I met the person at the University who was working for the International Council of Nurses and we decided, back in 2005, that I would work with her and since I spent 10 years with ICN. It is a really fantastic opportunity to see the international side of nursing ! Then in 2009 I started managing the new ICN Telenursing network.

About the same time the ISfTeH invited the ICN CEO to give a plenary speach here at Medetel and David was unable to come and I ended up doing it instead of him. So that was my first introduction to Medetel and it was really great and from the start I found it was an organization open to nursing, partially because Frank Lievens is soliciting nurses and other professionals in addition to physicians and I’ve been coming every year ever since and presenting at least one paper.

Several years ago we started organizing virtual nursing sessions too and also during the year we had several educational sessions using the animated platform from the ISfTeH. So, it’s been really great, I really find it a very welcoming organization, I like the smallness of it and multidisciplinary nature. My primary wish would be that more nurses could attend, unfortunately they don’t have the money for registration and traveling.

Then I retired from ICN and University in 2015 and now I’m self-directed. I’ll plan to stay as the chair of the Telenursing working group, make a contribution as much as I can.

Why an interest in Telenursing ?

A long time ago, when I was working as a clinical nurse I worked in critical care. So you are exposed to more machinery there than in any other kind of care delivery and I was never frightened, I guess, by new technology. And with the army I lived in Belgium and Germany, Ethiopia … around the world pretty much and I’ve seen a lot. And as distance education became more popular I could see that there was an application already in existence for healthcare and so many opportunities, I just joined the stream. It just makes so much sense to me. Now especially I live in a rural area and so much education needs to be done and so many opportunities exist for distance education.

Please explain what is Telenursing in practice.

It’s like asking what’s nursing, depends on who you ask. Telehealth nursing is nursing practice that deals with people with healthcare needs or people with educational needs (such as nurses or families) over distances and barriers. In a city area a barrier might be not being able to get to a healthcare facility. Or another example: a nurse from Nigeria came to Medetel a few years ago and explained how she worked with the nursing minimum data set (you collect the minimum data on every client and you have an idea of the culture of the clients; he vital signs, their location, complaints). I was here at Medetel , she was presenting her work and I was just so excited to see that the idea of the minimum data made it all the way to Nigeria. It was so exciting how she was helping all these women stay at home and not have to go the whole distance to the care facility to get the treatment that she could deliver at their homes. To me that was really a neat example.

Please give a short resumé of your presentation about Telehealth Education for Nurses.

What I’m trying to differentiate is normal education that we all need (all healthcare providers) versus Telehealth education and it goes back to the definition. Some of my nurse colleagues say “every nurse uses at least a telephone, so every nurse is a Telenurse”. But I don’t really agree with that. I think the Telehealth nurse has a greater commitment to not only using the available technology but to pushing further so that more and new kinds of technology.

Telehealth education is of course more about the ICTs and the new ways they can be used to advance the healthcare but also the issue of Data. Because you are obviously generating even more data than before. You acquire it, you store it, you use it … who’s data is it? All the questions around the ethics of data are a big issue for automated systems.

I pointed out that Telehealth care providers need to be motivated to learn about new things and not think “this is what I trained with, this is where I’m staying”. To my knowledge we don’t really have any Telehealth for Nurses master’s program, where as there are plenty of nursing informatics master’s programs. But that’s another specialty and Telehealth nursing gets buried under it”.


Plus sur TAVIE-Femme

Le project infirmier TAVIE-Femme est lauréat du Prix Égalité Thérèse Casgrain 2016 dans la catégorie « Santé », ce qu’on a déjà brièvement mentionné dans la news précédente (en Anglais) et sur notre site web.  Voici, par ailleurs, un extrait du texte de soumission du projet qui illustre bien son objectif :

“La profession infirmière tire ses origines dans le prendre soin et l’accompagnement aux malades, aux démunis et aux personnes stigmatisées. Encore aujourd’hui sa raison d’être demeure la santé et le mieux-être des personnes et de leur famille. Ainsi, les infirmières et les infirmiers s’activent au quotidien à offrir des soins et des services de qualité aux communautés et dans les établissements de santé. Dans une ère d’avancées technologiques permettant d’offrir un soin en temps réel, la Chaire de recherche sur les nouvelles pratiques de soins infirmiers de l’Université de Montréal a développé un concept d’interventions infirmières virtuelles et une plateforme informatique appelés TAVIETM pour Traitement, Assistance Virtuelle Infirmière et Enseignement. Un soutien personnalisé est proposé aux personnes vivant avec une maladie chronique dans la prise en charge de leur condition de santé en ciblant leur capacité d’agir. Concrètement, ces interventions Web sont constituées de séances interactives à l’ordinateur ou sur tablette numérique et animées par une infirmière virtuelle qui engage la personne dans un processus d’apprentissage d’habiletés d’autogestion. Les interventions Web permettent de soutenir les personnes vivant avec une maladie chronique en leur offrant en tout temps un accès à de l’éducation personnalisée et à de l’information fiable et de qualité. Trop souvent, les informations sur la maladie et sur son traitement ne sont pas bien comprises par les patientes et les patients, fragilisant ainsi la prise en charge de la maladie et sa gestion. De plus, l’accès à l’information permet aux proches de mieux comprendre les aléas de la maladie et de démystifier les craintes entourant la maladie elle-même et ses conséquences et/ou ses risques.

VIH-TAVIE est une intervention infirmière virtuelle qui vise à soutenir les personnes vivant avec le VIH dans la prise des traitements antirétroviraux. Sachant que les femmes vivant avec le VIH doivent composer avec des défis spécifiques à leur genre et à leur condition de santé, notamment la planification et le suivi de grossesse, la Chaire de recherche sur les nouvelles pratiques de soins infirmiers de l’Université de Montréal a développé un TAVIE-Femme pour répondre à leurs besoins. L’objectif est de cibler la réalité unique de ces femmes pour optimiser leur santé mais aussi pour prévenir les risques de transmission du VIH au bébé”.