Professor of Anatomy and former Dean of the College of Medical Sciences, University of Jos, John Ogunranti, tells JUDE OWUAMANAM about his foray into electronic medicine practice
What is e-Medicine all about?
It is properly called electronic medicine. It involves the use of computers and information to study and practice medicine. The definition was first created and used by me in 2008 and demonstrated to the first audience at Imperial College, London which is the best medical technology institution worldwide. It was published in peer- reviewed top class academic journal of Medical Education in Edinburgh called Medical Teacher in 2009. Since then, it has become popular in the international scene in medical jargon.
Are you saying you are the first person to define and practice holistic electronic medicine?
Yes. There is nowhere in Africa where we have the best or the first in academic technology. Neither is there any place which is unique or the best in those areas. When we think we have one, it turns out to be fake. Some of us are fed up with this situation of consumerism and want it changed and have therefore dedicated our lives to be achievement oriented rather than qualification-without-achievement scenario which has pervaded Africa. It does not matter if we are able to achieve little in a world devoted to the West.
What do you mean by ‘qualification-without-achievement scenario?’
Africa and Africans are preoccupied with Europe-styled qualifications and are simply not bothered about providing achievement which matches the said qualifications. Hence, an African will show off a PhD from Harvard University but will provide no achievement when requested for in 10 or 20 years after the qualification. Qualifications are used to obtain jobs. Once a man has a job, his next focus is to use this job to begin to attain some feats. He begins by being the first to perform a particular feat in his home town, later local government, state, country and finally reaches the ultimate- the only one in the entire world. This is where Africa has remained totally a virgin land. Many African academics equate qualification with achievement.
What is the use of e-Medicine?
It is similar in use to two already well known methods of information technology which are: Electronic Learning or e-learning and Electronic Practice like in electronic banking which we are all so familiar with in Nigeria. As a matter of fact, Nigeria as a developing country, has benefitted in no small measure from ICT revolution in such a manner that even our government facilities and parastatals have become almost completely enveloped in the ICT practices. What we want to achieve is to include the practice and learning of medicine with this revolution.
In what ways?
Our doctors would be better trained if we use eMedicine to teach and train them. We all know that a doctor’s experience in practice helps him to become knowledgeable in his practice without which he ends up a quack. A three-year experience is nothing in medicine because you do not see much. But when backed up with electronic medicine, this becomes a great achievement.
A Yale robot was designed some years ago to teach medicine and clinical features of some diseases. It can mimick a few diseases and students can then use such sophisticated computer robot to study those features. But it is very expensive and only a few schools can afford it globally. Even then, it can teach only a few students at the same time. Our model of learning clinical features using the computer is completely virtual and inexpensive.
Electronic medicine can be conducted through the Internet, intranet and other networks to teach more students, mimic diseases, conduct laboratory and radiological investigations and perform post mortems.
How does it benefit the common man who only desires to be treated?
Aside from the fact that the modern patient gets the most modern and well educated doctors who do not make mistakes, this is where the second model of eMedicine comes in and that is in ePractice. Just like eBanking, patients do not need to carry too much identification materials when approaching a hospital for treatment. In fact they don’t need a card any longer if they can remember their names or patient’s number. When the officer logs into his data base, he obtains all the information about the medical history of the patients, case notes can be retrieved anywhere in the country where the network exists with ease and prescriptions made on them and then recorded for future retrieval.
Is there any such model anywhere in the world?
Not yet. But this is the model we presently propose for Nigeria. Just like in eBanking, it will cost very little or nothing. I proposed this model when I was dean of medicine at Jos in 2004.
What is the situation at the University of Jos Medical College now in view of your findings?
There is an electronic learning face of e-medicine.
I am the Principal of this Electronic School and it is the first in the entire world of medicine. It uses the method called IPEM meaning Integrated Procedural Electronic Medicine. This means all subjects in medicine are on this site and are all integrated- a process which has not been done in medical education. When a patient presents a problem, he does not say that his problem is in anatomy, so let him go to the anatomist for treatment, or to the microbiologist. The problems he will present as a patient are integrative of all the subjects of medicine and the practitioner must use all the subjects he had learnt in the medical school to tackle the problems. But unfortunately when a doctor is being trained, he is trained in various subjects separately and without integration. He is then supposed to integrate the subjects in his mind in order to practice on his patients.
What the website has been able to succeed in doing is to help the process of integration by providing links to all subjects on all pages of the site so that the user can perform the integration he needs in order to diagnose the problems of his patient and provide responsible treatment for the patient’s ailments.
The next part of the exercise is procedural medicine. Before now, it has been impossible for the would-be doctor to learn most of the procedures before his graduation. For example, if he is supposed to perform a procedure like setting up IV drip, he must first watch the procedure and be able to perform under supervision before he could do it himself without assistance.
In some modern universities, this is performed on a robot in a clinical examination laboratory. In yet others, reliance is placed on resident doctors to teach the clinical students under the supervision of the consultant. With the use of electronic means of learning, the student is able to open up his computer and see the procedure in question either on video or simulation or even on interactive procedures where he is allowed to perform the procedure virtually using his mouse and keyboard.
The computer can even provide his scores to determine whether he has learnt the procedure satisfactorily. Also, the computer can provide an assessment for examination scoring purposes so that students who do not know some procure cannot pass examination. This is to eliminate the old method in which students are only assessed on theory of practice and not the practical and then even obtain distinctions, only to come out of the medical school and become lousy practitioners.