11.05.2011 ARGOS Conference, Budapest 1 Towards a Transatlantic Observatory for Meeting Global...

11.05.2011 ARGOS Conference, Budapest 1

Towards a Transatlantic Observatory for Meeting Global Health Policy Challenges through ICT-

Enabled Solutions: Measuring adoption, usage and

benefits of eHealth

Karl A. Stroetmann


One of three ARGOS objectives

Measurement and benefits:

• “analyse current policy thinking,

• compare challenges and outcomes, and

• draft a roadmap towards

• developing advanced global approaches for these issues.”


The thrust for evidence-based policy

Evidence needed at the macro-level: Diffusion, usage (co-op with

OECD), and system benefits

Evidence needed at the micro-level: effective use and stakeholder

benefit assessment


European Policy Context

Measurement and assessment always key topics in policy papers:•eHealth Action Plan 2004

•Lisbon Strategy and i2010 strategic framework

•i2010 was initiated by the European Commission in 2005 to create a European Information Society for growth and employment


Europe 2020 Strategy & Digital Agenda

• The Europe 2020 Strategy: a new economic strategy for the EU

• Focus on “three mutually reinforcing priorities”:– Smart growth: developing an economy based on

knowledge and innovation (eHealth included)– Sustainable growth: promoting a more resource efficient,

greener and more competitive economy– Inclusive growth: fostering a high-employment economy

delivering social and territorial cohesion (eHealth included)

• Digital Agenda one of seven Flagships of the Europe 2020 Strategy

11.05.2011 ARGOS Conference, Budapest

USA Meaningful Use

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• 1998: National Committee on Vital and Health Statistics (NCVHS) concept paper “Assuring a Health Dimension for the National Information Infrastructure”

• 2004: creation of the Office of the National Coordinator (ONC) for Health Information Technology (HIT)

• ARRA legislation (American Recovery and Reinvestment Bill) incl. HITECH Act (Health IT for Economic and Clinical Health Act):– major policy initiatives to stimulate adoption and

“meaningful use” of health IT– triggered wide variety of comparative effectiveness health

research, incl. “Health IT Assessment Framework for Measurement”


Industry Perspective

• 2002: public-private collaborative Connecting for Health (organised by the private Markle Foundation) founded to improve patient care by promoting standards for electronic medical information – 2004: report detailing specific actions, e.g. engaging the

American public

• European-American Business Council (EABC) underlined the high importance of measuring eHealth diffusion and assessing its benefits

• World Economic Forum “Global Health Data Charter” (2011): evaluation as one of seven key enablers to “assess progress and accelerate improvement”

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The way forward: Policy perspective

EU, individual Member States, USA, OECD, WHO as well as industry realise– key relevance of health IT (HIT), eHealth, or ICT for health for

the future sustainability and service quality of our health systems,

– urgent need for common approaches towards measuring • (1) adoption, usage, system benefits as well as (2) individual

meaningful/effective use and stakeholder benefits

• thereby optimally contributing towards guiding, feedback/ controlling and improving policy development and implementation

Obvious opportunity to not only work together, but to achieve benefits for all (win-win) through synergies, learning together and exchanging experience.

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Strategy

To advance towards a trans-Atlantic and global collaboration, a few key strategic foci have been identified:

– Exploit the potential of existing activities

– Agree on policy priorities to facilitate moving towards a more standardised approach

– Explore opportunities for developing common methodologies and measures (with OECD + WHO)

– Conduct cross-country analyses and benchmarking of policies, achievements and lessons learned

– Support policy analysis through collection of an agreed core set of indicators and a new generation of metrics



Tactics

• Start small,

• go both for some low hanging fruit / immediately shared issues,

• and for essential methodological issues in need of a considerable cooperative effort,

• thereby having a view also on longer-term feasibility and viability.



Priority topics

• Identify common policy needs, ongoing activities, shareable experience

• Develop appropriate taxonomy(ies), methodology of data collection, e.g. modular survey instruments

• Harmonise benefit and cost measures and analysis methods/tools: – Identify relevance of RoI vs HTA (effectiveness) vs benefit/cost --

socio-economic impact/return (incl. soft factors e.g. “willingness to pay”)

• Refine set of indicators to measure ICT adoption; modes/purpose of effective and meaningful use; critical success factors; outcomes/impacts



Organisational context & structure

• Close trans-Atlantic, even global collaboration, leveraging on other regional (like European) or global (like by OECD or WHO) endeavours

• A European and a US organisation or agency may collaboratively take the lead, e.g. ONC and EC

• Establish an (EC-WHO-ITU-Commonwealth Fund-OECD-Business Industry) Advisory Committee

• Establish small expert (sub-)groups

– working offline, on-line and through an electronic discussion group.

– possibly follow-up meetings at EC or ONC quarters



Funding

• Shared funding from both sides of the Atlantic needs to be secured, perhaps from EC and ONC sources

• Unrestricted funding from private foundations may be applied for

• Other suggestions?


Process view & time table

(to be determined after further discussions and exchange)



Outlook

• This topical field has become a policy priority globally in recent years

• A growing number of international activities can be taken advantage of

• There is a strong felt trans-Atlantic need for stocktaking, identifying lessons learned, sharing of experience

• Many outstanding issues have reached a stage where international guidance and coordination will help further efforts, accelerate progress and save funds

Let us do it, do it together, establish a cross-Atlantic win-win venture!

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