Commission on Information and Accountability for Women’s and … · 2012-12-07 · Commission on...
Transcript of 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
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
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?
????
Innovation through IT for Accountability
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
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
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
Innovation through IT for Accountability
www.who.int/topics/millennium_development_goals/accountability
_commission/en/
THANK YOU
Dr Véronique Thouvenot [email protected]