commission on information and accountability for women’s and … · 2012-12-07 · commission on...

Commission on Information and Accountability for Women’s and Children’s Health

Recommendation 3 - Innovation and eHealth

Regional Workshop Guatemala, 21- 23 October 2012

Dr Veronique Thouvenot

Innovation through IT for Accountability

Recommendation 3

“By 2015, all countries in the Global Strategy for Women's and

Children's Health have integrated the use of Information and

Communication Technologies in their national health information

systems and health infrastructure.”

Indicators

• 50 COIA Countries have developed a National eHealth Strategy and 25

countries have a National eHealth Plan in place.

• Web Based Reporting in place in all districts

Self-Assessment Tool

Innovation and eHealth Highly adequate Adequate Present but not adequate

Not adequate at all

3 2 1 0

1 Policy A national eHealth strategy or policy has been developed, including the use of ICT for MNCH

National eHealth strategy adopted; projects and priorities aligned; includes MNCH

National plan developed; projects are linked

National eHealth planning is at early stages; projects depend on sponsors

Planning specific to vertical projects, not led by MOH; projects depend on sponsors

2 Infrastructure There are electronic communication channels (Internet, broadband, and mobile) available for health reporting in urban, district and rural areas

Broadband connectivity, fixed and mobile available in urban areas

Internet and mobile connectivity available, some high-speed

Mobile connectivity is available in district and some rural areas

Limited or no connectivity at district and rural levels

3 Services eHealth services and applications are used to improve measurement, reporting and performance of information systems (e.g., reporting on maternal mortality)

Information can be shared and consolidated at national level

Information systems coverage and data sharing is improved

There are multiple systems of reporting and feedback with limited data sharing

ICT supports specific projects or vertical programs, with no data sharing possible

4 Standards There are commonly agreed interoperability requirements or standards for eHealth services and applications

National standards coordination and compliance mechanisms are in place

Initial coordination mechanism established, some standards agreed

Limited standards coordination; few standards agreed

No standards available

5 Governance There is a national coordination mechanism for eHealth, with stakeholder involvement (health and non-health) in planning and implementation.

Active coordinating mechanism in place, with MOH leadership and stakeholder engagement

Coordinating committee exists, but not all stakeholders are represented and meetings are irregular

There is no formal committee, there are informal contacts between agencies to resolve problems

There is no coordination leading to problems of inconsistency, duplication and inefficiencies

6 Protection Data protection, legislation and regulatory frameworks exist for sharing health information.

Comprehensive legislation and policies exist for data protection and sharing; compliance is enforced

Legislation and policies exist for data protection and sharing; compliance not enforced

Legislation or policies exist, but incomplete and may constrain information sharing

Legislation or policies exist, but not specific to health

ITU Telecommunication Development Bureau

International Telecommunication Union

UN Specialized Agency in Charge of ICTs

Presentation

ITU ICT Applications Strategies and

Resources

www.itu.int

Development

ICT Applica-tions

E-health

5

e-Applications: A Priority for Development

Electrnic health (e-health) is : • The ITU Plenipotentiary Conference 2010 in

Guadalajara, Mexico adopted a new Resolution that

calls on ITU to give priority consideration to the

expansion of telecommunication/ICT initiatives for e-

health. (Resolution PP-183, Guadalajara, 2010)

• A new Resolution on e-health was also adopted in

2010 at the World Telecommunication

Development Conference on Improving access to

healthcare services by using information and

communication technologies. (Resolution WTDC-65,

Hyderabad, 2010)

• Equity/Gender

Facilitating e-health infrastructure planning

6

• A report entitled Scaling e-Health services in

step with ICT transformation was published to

provide guidance to e-Health planners on which

e-Health services can be deployed immediately

with available infrastructure and which additional

services can be added as the infrastructure is

transformed.

• The report is available at: http://www.itu.int/ITU-

D/cyb/app/e-health.html

http://www.itu.int/ITU-D/cyb/app/e-health.html





Facilitating e-health Standardization

7

• ITU’s Standardization Sector has released a

Technology Watch Report that looks to the

future of e-health.

• The report observes that e-health development

will require more universal e-health

interoperability standards, and strategies to

overcome technical infrastructure barriers and

address privacy, security, and other legal

requirements.

• The report is available: http://www.itu.int/en/ITU-

T/techwatch/Pages/ehealth-standards.aspx

http://www.itu.int/en/ITU-T/techwatch/Pages/ehealth-standards.aspx





Technical countries assistance

8

• Conducted a “Country Assessment

and Feasibility study” in Nepal to

identify potential scalable and

sustainable Mobile e-Health

(mHealth) services for improved

health outcomes from 25th April-7th

May 2011.

• 3 concept notes were proposed for

possible mHealth projects

eHealth and Innovation

What Technologies?

• Radios

• TV

• PC - Internet

• Mobiles: mHealth

• GIS

• Cloud Solutions

• Nanotechnologies

Mobile-cellular subscriptions, 2011

Fixed (wired)-Broadband subscriptions

per 100 inhabitants, 2011

Technologies?


Current situation and main gaps

Current situation Main gaps

• The promise of ICT has not been realized to

create health benefit

• Lack of coherent strategies/roadmaps

• There are multiple small activities, pilot

projects

• Inadequate sharing of information

• Limited development of lessons learned

• Poor guidance for countries wishing to

accelerate ICT innovations

• eHealth and mHealth are fragmented • Lack of interoperability

• eHealth is multidisciplinary and bigger than the

health sector

• Lack of multi-stakeholder integration

Way to move forward

Multi-sector engagement to develop strategies

e.g. mobile phone and internet service providers, ministries of ICT, ministries of finance, national

statistics offices, national broadband networks, telecommunication regulatory authorities, health

insurance , product developers, private sector...

Consolidated WHO – ITU - IWG Workplan

Priority Activity I

Catalysing development and dissemination of ICT tools that will accelerate the implementation of the

recommendations of the Commission

• Propose readily-usable ICT tools and services for

MNCH

• Technical Report on ICT tools and services

for MNCH

• Facilitate technical assistance in response to countries'

request/needs for project support

• MNCH ICT Experts Roster

• Expertise provided for replication and reuse of

existing tools and knowledge

Priority Activity II

Bringing together multiple stakeholders across sectors to develop country led “national eHealth strategies”

and mobilize resources to implement them

• Develop tools, supporting materials, experts roster, to

support National eHealth Strategies development

• Assessment Checklist Tool

• WHO-ITU National eHealth Strategy

Toolkit

• Supporting materials on Interoperability

• Learning materials on national eHealth

Planning

• Expertise for national eHealth Planning

• National eHealth Planning Portal

Priority Activity III

Develop mechanism for fast tracking innovations and sharing with other countries with special focus on

South-South cooperation

• Develop an MNCH ICT Knowledge Management

Platform

• e-Repository of MNCH projects, tools and best practices

• Facilitate Knowledge Sharing of ICT MNCH tools • Virtual MNCH ICT Information Sharing Group and Webinars

Consolidated WHO – ITU - IWG Workplan

WHO-ITU National eHealth Strategy Toolkit

December 2011

• Technical Report on ICT tools and services for MNCH

December 2012

• e-Repository of MNCH eHealth projects, tools and best

practices

2013 - 2014

National eHealth Strategy Toolkit

The “National eHealth Strategy Toolkit” is a resource for developing or

revitalizing a country’s eHealth strategy.

The Toolkit provides a framework and method for the development of a

national eHealth vision, action plan and monitoring framework.

Available at: http://www.itu.int/ITU-D/cyb/app/e-health.html






eHealth components

Health Information System Example A Set of Complex Sub Systems of

Medical Record Systems and Aggregate/Indicator-based Systems

Systems

Modified after Health Metrics Network, 2007.

HIS Sub Systems

Data

Warehouse

Monitoring

Evaluation

Research

Extract, transform and load data into central location

Census Vital Event Registry

Surveys Health Events & Risks

Health Service Records

Resource Tracking

Policies

Resources

Processes

Information

Services

Allocated Length-Of-Stay Utilization

0

100

200

300

400

500

600

700

Pa

tie

nts

Status 143 221 412 574 325 172 68 145

25% 50% 75% 100% 125% 150% 175% 200%

Allocated Length-Of-Stay Utilization

0

100

200

300

400

500

600

700

Pa

tie

nts

Status 143 221 412 574 325 172 68 145

25% 50% 75% 100% 125% 150% 175% 200%

DRG Cost Variance

-40%

-30%

-20%

-10%

0%

10%

20%

30%

40%

Variance 10% 4% -20% -21% 30% 8% 10% -17% -28% -13%

B02 E02 E04 E15 H01 H02 H03 H04 H10 J03

DRG Cost Variance

-40%

-30%

-20%

-10%

0%

10%

20%

30%

40%

Variance 10% 4% -20% -21% 30% 8% 10% -17% -28% -13%

B02 E02 E04 E15 H01 H02 H03 H04 H10 J03

Data Collection Forms & Methods

Statistical

Systems

Financial

Systems

Need for Data Consistency

Paper-based System

Electronic System

Need for

Standards

Need for Interoperability

Indicator-based Records

Individual/Patient Records

Registries Diagnostics/Images

Records

Strategy and Plan of Action on eHealth

(PAHO/WHO Document; CD51/13 Eng. 1 August 2011)

2011 - 2017

• Electronic medical records

• TeleHealth

• mHealth

• eLearning

• Continuing education

• Interoperability and standardization

National eHealth strategies

Innovation through IT for MNCH Selection of illustrative MNCH eHealth projects

Guatemala: TulaSalud

http://www.tulasalud.org

Peru: WAWARED

http://www.wawared.andeanquipu.org/

Mexico: AMENECE

http://www.salud.carlosslim.org

http://www.tulasalud.org/

http://www.wawared.andeanquipu.org/

http://www.salud.carlosslim.org/

TulaSalud – Coban

Alta Verapaz

n

Recommendation 3

“By 2015, all countries in the Global Strategy for Women's and Children's Health have

integrated the use of Information and Communication Technologies in their national health

information systems and health infrastructure.”

Progress towards the Commission’s Recommendations

Telecom 2011

http://www.itu.int/ITU-D/cyb/events/2011/Telecom11/e-health/index.phtml























Commission on Information and Accountability for Women’s and Children’s Health


www.who.int/topics/millennium_development_goals/accountability

_commission/en/

THANK YOU

Dr Véronique Thouvenot [email protected]

http://www.who.int/topics/millennium_development_goals/accountability_commission/en/

http://www.who.int/topics/millennium_development_goals/accountability_commission/en/

mailto:[email protected]

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