capacity building in e-health & health informatics in developing countries “from silos to...
TRANSCRIPT
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Capacity Building in e-Health & HealthInformatics in Developing Countries
From Silos to Systems
Don E. Detmer, MDSenior Advisor, AMIA; Prof. Med. Ed., U Virginia
Edward Shortliffe, MD, PhD
President & CEO, AMIA
Barbara BrownDirector, Global Partnership Program
21 April, 2010
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e-Health & Health InformaticsCapacity-Building Conference 2008
Organized by the American Medical Informatics Association (AMIA) in activecollaboration with International Medical Informatics Association (IMIA)
(with support from Rockefeller Foundation & Bill & Melinda Gates Foundation)
Global South Country Perspectives Represented
Argentina
Brazil
South Africa
Thailand
Turkey
Uruguay including perspectives from Developing Countries:
Peru Vietnam
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The Rockefeller FoundationBellagio Center
20-25 July, 2008
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Bellagio - Summer 2008:
Three Themes plus Recommendations & a Call to Action
1) Identify & support local health workers & relevantexperts (worldwide),
2) Formalize partnerships with others, &
3) Build a collaborative AMIA Global Partnership Programfor Health Informatics * ^.
* Planning supported a grant from the Bill & Melinda Gates Foundation^ Spring 2010 - GPP being created as a non-profit entity related to AMIA
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Emerging Assumptions regardinge-Health Capacity-Building & Health
Informatics (1)
Access to sustained evidence-basedpublic health & health care services in
needed in many parts of the world.
To move from Silos to Systems for sustained improvement in publichealth & high quality care implies key inputs:
1) Electronic health records (EHRs) for planning, care, & evaluation,
2) Information & Communications Technology (ICT) for access &education, &
3) Multiple levels of workers having relevant informatics knowledge& skills.
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Emerging Assumptions regardinge-Health Capacity-Building &
Health Informatics (2)
The local health workers need to be networked over time with others(including professionals in other centers of excellence near & far).
Appropriate knowledge & skills can be enhanced through learning healthcare systems.
Some of these workers will become fully professional informaticiansintegrated into the global informatics community.
Viable sustained networks for personal development & professionalrecognition may mitigate brain drain.
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Terms: HICT
Human Factors
Cognition, change resistance, behavior, learning
Information
Knowledge, meaning, semantics
Communication
Speaking & listening for understanding
Technology Hardware, software
= Easier to More Difficult Adapted from Niland 10
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Working with others,
the AMIA Global Partnership Programseeks to address these needs.
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Planning the AMIA Global Partnership Program
Groups
Steering
Structure & Governance
Participants & Sites
Training Approaches &Content
Research & Evaluation
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AMIA Global Partnership Program Leadership
Program Leaders:
- Andrew Kanter & Ted Shortliffe, Pres/CEO, AMIA; (Bill Tierney)
- Don Detmer, Senior Advisor, AMIA & Chair Steering Committee;
- Barbara Brown, AMIA Director, GPP
AMIA GPP Committee Leaders-
Structure & Governance:
Antoine Geissbuhler (Chair) & Alvin Marcelo (Co-chair)
Participants & Sites:
Andy Kanter (Chair) & Fernn Quirs (Co-chair)
Training Approaches & Contents:Bill Hersh (Chair) & Paula Otero (Co-chair)
Research & Evaluation:
Chris Seebregts (Chair) & Chris Bailey (Co-chair)
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A warm Thank You to
AMIA GPP Committee membersSteering:
Walter Curioso, Antoine Geissbuhler, Lyn Hanmer, Bill Hersh, Andy Kanter,Alvaro Margolis, Paula Otero, Chris Seebregts, Chris Bailey, Luu Ngoc Hoat,Alvin Marcelo, (Bill Tierney)
Structure & Governance:
Maurice Mars, Alvaro Margolis, Najeeb Al-Shorbaji, Cindy Gadd, StephenSettimi
Participants & Sites:
NT Cheung, Marion Ball, Solomon Shiferaw, Hamish Fraser, Helen Ayles; BillTierney (Chair until 12/31/09),
Training Approaches & Contents:
Luu Ngoc Hoat, Alvaro Margolis, Peter Murray, Janise Richards, Lyn Hanmer
Research & Evaluation:
Rosemary Foster, Ghislain Khouematchoua, Heimar Marin,
Walter Curioso, Jorn Braa, Sundeep Sahay, Siaw-Teng Liaw
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And, Thank you toAMIA & AMIA GPP Staff
Barbara BrownMeryl Bloomrosen
Tia Abner
Ebele Okwumabua
Nancy Roslyn Rappaport
Elaine Steen
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Current Priorities
Formalize relevant Partnerships
Educate via AMIA 10x10 Program
Identify & collaborate with others on HIBBs
Mature a Global Informatics Network forInformatics Education & Training
Seek funding for Global Informatics Fellowships
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1) Now: US AMIA -10x10 or AMIA i10x10(http://www.amia.org/10x10/) Clinical, Public
Health, Translational Bioinformatics, Nursing
Informatics
2) Coming: Medical Sub-certification in AppliedClinical Informatics
Know what you are doing. Support formal
education/training in Applied Clinical Informatics.
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Health Informatics BuildingBlocks (HIBBs)
Goals Mechanism to coordinate & provide distance learning for informatics training
& education.
Collect, create, test & deploy appropriate informatics training content
Modular, adaptable, updatable
Catalyze & develop a sustainable pipeline of health care workers withinformatics skills applicable to their work at the grassroots levels
Concept A focused informatics training module designed to advance knowledge & skills
for individuals who use health information & communications (HICT) to providehealth care &/or public health services, make HICT-related policy decisions ormanage the HICT infrastructure for an organization.
Initial Funding Rockefeller Foundation project planning grant
eHealth Capacity Building Conference
Planning Meeting London, Wellcome Trust
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Health Informatics Building Blocks(HIBBs)
Short courses, webinars, learning packages (CDs)
Web-based E-Learning center
Learning modues for teaching in villages for local leaders or
citizens/patients & informal caregivers, &/or for health workers,&/or professionals, &/or policy leaders
Content
Basic IT, CT, & Informatics
Attitudes, Knowledge & Skills
Ex: DPRC certification & examination
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Digital Patient Record CertificationExamination and Study Guide*
Who should use DPRCcertification?
Any academic institutiontraining qualifiedhealthcare professionals
that will use a digitalinput device to managepatient records in a HIS& thereby can effect theoutcome of a patientstreatment or legal rights.
www.DPRCertification.com
* A collaboration between AMIA & CS Placement
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AMIA Global Partnership Program:HIBBs Development
Collaboration Example : Carl Leitner Intrahealth.orgTanzania 3 day training workshop with Univ. of Dar es Salaam April 2010
General topics appropriate for consideration as HIBBs:
The importance of using data standards System & database administration & backup
Using source control software to maintain large projects.
Public Health Informatics" topics:
Interoperability among HIS components (e.g. DHIS and iHRIS) Data ownership and access rights
Design and Development of public health data-portals
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AMIA GPP: Health InformationBuilding Blocks (HIBBs) Program
Currently Creating 3 Prototypes HIBBs
PLAN:1) Launch Prototypes at Medinfo (Cape Town, So. Africa 12-15 Sept 2010)
2) Field test after Medinfo as proof of concept.
We are building our HIBBs team & developing HIBBs specs with help frompartners like OpenMRS, Intrahealth, HMN, & others.
Funding - Rockefeller Foundation
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e-Health Capacity-Building & Health Informatics -
Conclusions
A useful vision & charge to action was developed at Bellagio in 2008
Essential elements for long term success in low resource environments willlikely entail:
1) A sufficient ICT infrastructure
2) Evolving health care processes based on evidence appropriate for the localculture
3) A fresh view toward educational preparation among health workers toinclude basics of ICT & informatics
4) Focused & sustained policy support at national / regional level
5) Ongoing applied (practical) research & development
6) A thriving global network among informaticians, includingtelemedicine/telehealth
7) AMIA working with IMIA seeks to be a key global partner for years to come.
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Thank you & best wishes.
Comments & Questions
[email protected]@amia.org