MedTrack Your Cancer
“MEDTRACK” YOUR CANCER
A cursory look at cancer management in Ghana shows the challenges the citizens, healthcare providers and the entire ecosystem face in navigating the complexities of healthcare delivery. In sub-Saharan Africa, we have the triple burden of disease, i.e. infectious diseases, lifestyle diseases, and cancer. Cancer is gaining more prominence in this part of the world; while the Western world has to battle with the ever-changing mutations and improving outcomes using multivariate treatment options, Ghana has to deal with early reporting, early and accurate diagnosis, and appropriate treatment. The financial and infrastructural challenges mean many patients will fall outside this healthcare space. There are gaps all along the health care chain, with weaknesses identified both at policy and implementation levels.
Let us examine a typical Ghanaian case study. A 27-year-old, single, newly employed lady who just introduced her fiance to her parents identifies a lump in her left breast during a self-examination. She hopes it will resolve on its own; she is still young. Months go by, and the lump increases in size; she seeks a doctor’s consultation, who asks her to go for an ultrasound scan. The service is not available in the facility, so she gets it from a private facility in the city. However, the scan is incomplete; the sonographer can only identify the lesion and its dimensions but cannot stage it using the BIRADS (Breast Imaging Reporting and Data Systems), the internationally accepted means of reporting breast images. She is referred to the major Government hospital in the city, where she gets it done in 2 weeks. She is BIRADS IVa- which means her lump is likely malignant (contains cancer). The Doctor breaks the news to her and tells her she will require a biopsy (a piece of the lump taken out for examination); this will confirm the cancer. The biopsy is done and takes another two weeks, and the report confirms that she has Invasive Ductal carcinoma NST Grade 3, Triple Negative. KI 67>60% ( basically, she has aggressive cancer).
In addition to the stress, the uncertainty of her young union with her fiance, she has to move from her facility to the major center in the city for treatment. She had to undergo additional tests that confirmed the cancer had not spread from her breast. The oncology department reassesses her and her fitness for surgery with a series of examinations and scans, some done at the major centre and others done from private centres. She has the added burden of carrying all these test results for each consultation. After that, she starts chemotherapy, and while she gets fatigued often, losing her hair and mouth dryness, she has to repeat these tests before and after each cycle — she had six cycles.
After the sixth circle, she is transferred to see the Surgeons to prepare her for surgery; she needs surgery to remove the cancer from her body. One of her major frustrations is repeating herself and her health journey whenever she moves from one facility to another or even one department to another in the same hospital. She also has to find a filing system for her numerous lab and imaging reports. She got several reports mixed up and hence had to repeat so many investigations at a high personal cost. She underwent radiation therapy after her surgery.
Our case study patient is now cancer-free for the past three years; she is happily married. This story is one with a good ending. Unfortunately, there are several cases where the young woman dies after failing to follow up from the frustrations of the system and ends up with metastatic disease where the cancer spreads from the breast to other parts of the body or develops metastatic disease due to the delays and inefficiency of the system.
The Union of International Cancer Control launched City Cancer Challenge (C/Can) foundation in 2017 and the World Economic Forum in Davos, Switzerland, to support cities worldwide to improve access to equitable and quality health care. These are city-based partnerships and collaborations between private and public stakeholders in the ecosystem. Solutions are data-based and designed and implemented with the support of local, national, and international partners with a unique understanding of the local context.
C/Can offers a unique opportunity to fully appreciate and help solve Ghana’s extraordinary difficulties and the sub-region. Therefore, Kumasi is the selected city to help develop local solutions to these challenges as summarized below:
- Early detection and diagnosis
- Poor infrastructure at primary health care centers to assist diagnosis
- Fragmentation of healthcare with discordance at the different points of care.
- Repetitions and duplications of investigations make the service more expensive and cause delays in accessing the appropriate treatment.
- Geographical barriers in reaching the appropriate personnel and quality of health care and the required facilities to provide the health care
In solving these glaring problems facing the diagnosing and management of cancer patients in Kumasi, it will have to pool together all the local resources at the cities’ disposal and eliminate bottlenecks and geographical boundaries as much as possible to make the entire process very seamless. Essentially, we have to make Kumasi a “one giant cancer center”. All clinicians are involved in diagnosing and managing cancer patients and integrating all the laboratories and diagnostic centers onto one platform to make the workflow seamless, fast, digitized, and secure.
MedTrack is a cloud-based solution designed to integrate and digitize all health interactions within the ecosystem to make the information portable, transferable and interoperable. It has been in existence since 2018, forming partnerships with several local facilities in the health ecosystem, especially in Kumasi and Accra.
