e Health Trends and the Use of St Standards and Guidelines d d d G id li Mr Mark Landry Health Information Technical Officer World Health Organization, Regional Office of the Western Pacific 1 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
Outline Outline � Introduction � Introduction e Health: � Trends in e Health Using Information g Communication � Next steps: using enterprise Technology (ICT) such as architectural approaches hit t l h computers, mobile devices, t bil d i and satellite and adhering to standards communications – for communications for � Future possibilities and health services and information potential impacts 2 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
Health and e Health Health and e Health � Health and eHealth are inseparable due to the fact that health is an information intensive sector. � Health is a global concern that is trans-border by definition and g y affects the world population. � Information technology and telecommunications (ICT) is a global Information technology and telecommunications (ICT) is a global issue especially with the emergence of the knowledge economy and the information society. � This has required WHO to adopt global approaches to e Health. 3 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
Why e Health? Why e Health? y � Health systems unable to deliver high-quality, affordable services with universal access affordable services with universal access � Increasing time and effort needed for acquiring information and data as well as for information and data as well as for administration and documentation � Critical health information buried in thick medical files and unsystematic data storage and retrieval system � Specialisation & Sub specialisation � Specialisation & Sub-specialisation � New Diseases � Increasing support to e Health…the next breakthrough in health systems improvement 4 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
Global Cellular Subscriptions Global Cellular Subscriptions 5 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
2010 Key Global Statistics 2010 Key Global Statistics y Hospita ls: mHealt h Apps: h Apps: 270,00 9,000 0 Midwives: Phone 1.9 Apps: pp million + 400,000 + Hospital Beds: Tablets: 20.9 million 12 million + Health Workers: Smartphones: 40 million+ 90 million Households: Feature Phones: 1.7 billion 4.4 billion Population: Mobile Subscriptions: 6.7 billion 5.3 billion Source: Courtesy to the mHealth Alliance for allowing WHO to reuse this graphic 6 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
WHO's Response WHO's Response p � Adoption of the World Health Assembly Resolution on e Health (WHA58.21) i in 2005 by WHO Member States 2005 b WHO M b St t � The e Health resolution gave legitimacy to the concept itself but also defined: defined: – the scope of e Health – the potential stakeholders – the role of governments and the private sector the role of governments and the private sector – the need for legal, ethical and regulatory frameworks for its implementation � Catalyzed recognition of the role of e Health in: – strengthening health systems – improving health services – reaching out to remote communities – enhancing the capacity of health workforce – health promotion 7 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
e Health Global Uptake e Health Global Uptake p � eHealth Intelligence Report : h http://www.who.int/goe/ehir/en/ // h i / / hi / / � WHO Global Observatory of e Health: http://www.who.int/goe/en/ � First Global e Health survey, 2005: – Benchmarking, country comparisons, evidence on progress � S � Second Global e Health survey, 2009: d Gl b l H lth 2009 – More in-depth analysis: – Eight thematic areas: m Health; Telemedicine; g Management of patient information; Legal and ethical frameworks for e Health; e Health policies; eHealth foundation actions; e Learning and country profiles. 8 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
Most Commonly Reported m Health Most Commonly Reported m Health Initiatives in GO e Initiatives in GO e Initiatives in GO e Initiatives in GO e � 50% in emergency/disaster situations g y � 50% in health call centre or healthcare telephone helpline h l li � 45% for surveillance programs 45% for surveillance programs � 40% for voice/text messages to achieve treatment compliance li � A number of countries highlighted using m Health � A number of countries highlighted using m Health for HIV/AIDS and maternal health services 9 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
e Health Value Stack e Health Value Stack Transformation Expert Systems Expert Systems viders Intelligent cross ‐ platform solutions Integration ts/prov o Decision Support Systems Decision Support Systems efits to Enhanced health, clinical and administrative decision ‐ making Transaction Management Systems g y icipant Bene Identity, security, audit; payments; health systems management Interaction Information Systems Parti Bi ‐ directional communication Information Communication Systems Health and wellness content; messaging Health and wellness content; messaging Time/Maturity of Services Source: mHealth Alliance 10 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
The Grand Challenges to e Health The Grand Challenges to e Health g � Organizational and governance challenges g g g � Technical challenges � Financial challenges � Legal and ethical challenges � � Local challenges based on differences in healthcare Local challenges based on differences in healthcare systems, culture, economy, regulations, policies, ICT infrastructure and human resources infrastructure, and human resources 11 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
Scope of e Health Services and Scope of e Health Services and Applications Applications Applications Applications HIS HIS Disasters Disasters e-Surveillance IHR Emergencies Obstetrics/ Obstetrics/ Gynaecology Gynaecology Society Research Dermatology Dermatology Journals Patients eHealth eHealth e-Learning e- -Care Care Governance Websites Nurses Health Radiology Radiology Radiology Radiology Training Training Pathology Pathology Pathology Pathology Professionals Course Electronic Electronic Referral Referral Health Health Systems Systems Records Records Records Records e- -Management Management 12 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
Technical Competencies Technical Competencies of Health Professionals of Health Professionals of Health Professionals of Health Professionals � Healthcare professionals usually do not receive ICT training. Their understanding of it comes late in their career. � ICT professionals are mainly hardware and software engineers p y g with little orientation on biomedical applications. � Need for more in-service training, short-courses in the area of Need for more in service training, short courses in the area of health informatics. � � Very few specialized health informatics programmes Very few specialized health informatics programmes. � Promote peer-to-peer learning and sharing within and between countries: countries: – International Medical Informatics Association (IMIA): http://www.imia-medinfo.org 13 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
Standardization and Systems Interoperability Standardization and Systems Interoperability Challenges Challenges Challenges Challenges � Fragmented efforts to develop e Health applications in the absence of adequate governance, standards and national plans resulted in development of e Health national plans resulted in development of e Health systems that cannot exchange data. � Th These systems are mainly standalone and t i l t d l d disintegrated, lacking unified coding schemes, following different or no standards which resulted in following different or no standards which resulted in total lack of interoperability between them. 14 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
Enterprise Architecture Enterprise Architecture p Ministry of Health Ministry of Health Health IT Vendors Health IT Vendors Lead Lead Analyze Design Develop Deploy Environment Specifications Iterative approach Testing Needs Needs Standards Standards Development tools Development tools Installation Installation Users Data model Network User training Processes Hardware/software Databases Budget and staff Requirements Interfaces Road maps Maintenance Proper planning � Expected solutions 15 | Asia-Pacific Advanced Network (APAN) 31st Meeting | February 23, 2011
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