Power in the hands of patients: app innovations to make health systems more accountable

Friday, 24 March 2017

Without transparent and accountable health systems, patients are less able to take the proactive role that is needed for patient-centred care to be achieved.

National procurement and drug pricing systems that lack robust monitoring mechanisms can become open to corruption and exploitation, posing a significant challenge to the goal of patient-centred universal health coverage.

Alongside diverting funds away from care, limited transparency in health systems has a direct impact on the information a patient advocate can draw on to successfully hold governments to account. Insufficient patient information, based on opaque systems, greatly reduces patients’ ability to demand rights and make informed choices about care.

IAPO welcomes the work of the Open Society Foundations and the International Renaissance Foundation in searching for solutions to healthcare corruption through technology. In the two Foundations’ data hackathon last year, five teams from Ukraine and Kyrgyzstan – made up of coders, journalists and activists – came together to find innovative ways of tackling the lack of transparency and accountability in public drug procurement systems.

Across the two and a half day hackathon, teams came up with a range of innovations. One developed a tool, WikiLiky, to allow patients to monitor medicine supplies in real-time. If a patient is told they need to buy a certain drug that they believe should be free, they can use the tool to check and hold the medical facility to account. The in Ukrainian health authority in the Sumy region has already started to incorporate this tool into its system.

Another team sought to address the challenge of price monitoring in Kyrgyzstan, in a search to fool-proof the process against human error and inconsistencies. If the name of a drug is inaccurately spelt in multiple ways it is hard to track prices, which can result in murky systems that are susceptible to procurement abuses. The team redesigned part of the government’s e-procurement platform, Codifier, to create standardised and consistent drug names and dosages.

This redesign, which is due to launch later in 2017, will allow the Kyrgyz Republic’s Health Ministry and Mandatory Health Insurance Fund to better track drug prices. Crucially however, it will also provide patient advocates and other activists with the tools to independently monitor drug prices and procurement themselves and therefore to hold the government to account.

Similar efforts to increase transparency in drug prices have been developing globally. In India, the National Pharmaceutical Pricing Authority (NPPA) launched a mobile app in August last year that seeks to provide live information on drug prices. The app, ‘Pharma Sahi Daam’, lists the NPPA’s maximum retail price of scheduled drugs, helping patients access the right medicines at the right prices.

As patient advocates we need to collaborate with innovators and governments to find practical solutions that put the power firmly in the hands of patients. Through platforms and tools that open up scrutiny and accountability of public procurement systems, patients and advocates can play an invaluable part in fighting healthcare corruption.

A strong patient advocate is an informed patient advocate, which is why we need to build robust cross-sector partnerships that allow us to push for transparency innovations, through which we can monitor and hold institutions to account.

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