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Reaching a Vision for eHealth Through Collaboration

Reaching a Vision for eHealth Through Collaboration. July 28, 2008. To the moon?. Ideas that stick are: Simple Unexpected Concrete Credible Emotional Stories.

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Reaching a Vision for eHealth Through Collaboration

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  1. Reaching a Vision for eHealth Through Collaboration July 28, 2008

  2. To the moon? • Ideas that stick are: • Simple • Unexpected • Concrete • Credible • Emotional • Stories “… I believe that this nation should commit itself to achieving the goal, before this decade is out, of landing a man on the moon and returning him safely to the earth. No single space project in this period will be more impressive to mankind, or more important for the long-range exploration of space; and none will be so difficult or expensive to accomplish… But in a very real sense, it will not be one man going to the moon--if we make this judgment affirmatively, it will be an entire nation. For all of us must work to put him there.” - John F. Kennedy, 1961 A telecom vision: We should be able to contact anyone, anywhere, at anytime, from anywhere. “Committed to connecting the world: By connecting the world and fulfilling everyone’s fundamental right to communicate, we strive to make the world a better and safer place.” - ITU

  3. A draft vision for eHealthOverall goal to improve health and quality of health-related information • Integrated eHealth systems for everyone, everywhere to improve access to quality health services, and allow for better health and well being of all citizens and better health systems management. • We believe eHealth should support: • Personal, family, community, public health services and preventative interventions, particularly in resource-poor environments • The most relevant health research, information and education, for health providers, researchers, policy makers and citizens • Appropriate, complete, consistent and interoperable health information systems, that integrate public health and clinical requirements for overall health systems management and stewardship. 1 2 3 Still an early draft; need your assistance defining effort Please comment at: www.ehealth-connection.org/wiki/

  4. “eHealth” a broad and diverse realm of efforts Different types of eHealth initiatives include, but not limited to: • Health information systems • Public health informatics: • Support for disease prevention • Disease and intervention surveillance (e.g. PDAs to community health workers for disease surveillance) • National health info systems to detect/track global threats to public health • Health and clinical informatics: • Electronic health records (EHR), electronic medical records (EMR), patient health records (PHR) • Decision support for healthcare professionals • Health system administration and operations • Pharmacy and supply chain management systems • Laboratory systems (e.g. electronic ordering, transmission processing) • Clinical administration software (e.g. billing) • Healthcare and expertise • Telemedicine / telehealth • Health research, advisories and education • eLearning for physician, nurse, healthcare personnel training • Access to research for healthcare personnel • Patient support and information (SMS reminders for drug compliance, online health information, etc.) • Decision support for healthcare professionals eHealth: the use of information and communication technologies (ICT) to improve health

  5. Variety of challenges to reaching visionBellagio a forum for vetting ideas Barriers and impediments to eHealth advancement Little capacity for developing and managing health information technology Prohibitive policy environment Optimal eHealth development path unclear • System is fragmented – donors and other stakeholders push for narrow, specific solutions without interoperability considerations • Leads to inefficient use of funds • Creates program stovepipes • Lack of private sector providers due to low market incentives threatens sustainability, independence Immaturity and youth of eHealth effort in developing countries Lack of awareness about value of eHealth and breadth of possible solutions Lack global forums with all relevant stakeholders in which to discuss progress, issues and learnings

  6. Bellagio organized around solution areas grounded in domains of eHealth applications • “Path to Interoperability” and “Unlocking the eHealth Market” support developing countries in finding optimal development path to maximize eHealth potential • “eHealth Policies” and “Capacity Building” address the enabling environment to lower the barriers and impedimentsto eHealth diffusion and advancement • “Electronic Health Records”, “mHealth”, “Public Health Informatics” and “Access to Information” provide grounding in applications that strengthen health systems Enablers Optimal development path Capacity building Policies Interop. Markets EHR mHealth PHI A2K eHealth applications

  7. Census Malaria TB HIV/ AIDS Hospital Health clinic Connected health information network will require interoperability across several dimensions Metcalfe’s Law Examples of dimensions to be addressed The value of a network (e.g. Telecomm) is proportional to the square of the number of users of the system (n²) Across programs Across geographies Across points of care Across technologies Community health worker Early stage of eHealth in much of developing countries is an advantage – possible to take action now

  8. Hypothesis: Collaborative action necessary for success • Collaboration can achieve synergy through united action • Branding: uniting all eHealth-related efforts to increase awareness • Funding coordination: drives alignment on key issues, reduces redundant activities • Mitigate HR constraint: limited group of experts in this field • Fostering spread of eHealth requires multiple, interconnected efforts • HCIT capacity building required to support many eHealth efforts • National policies needed to support all types of programs • Emerging platform technologies, e.g. mobile health, span multiple areas of focus public health, clinical and patient-centered informatics Multi-player, multi-sectoral initiative needed 1 2 • Ministries of health and other representatives of target countries • Private donors/foundations • Non-governmental organizations • Multilateral donor/aid organizations • Technology companies • Biopharmaceutical companies • Entrepreneurs • Research and academia • Others? 3

  9. Goal at Bellagio: engage stakeholders on collaborative action to address challenges facing eHealth efforts Key collaborative actions Enablers Cap. build. Policy Optimal development path Interop Market

  10. Many experts and decision-makers participating - sampleWho do you need to talk to and work with to push eHealth forward? Who’s missing? Academic D-tree International; Dimagi HISP UCSF Univ.of New South Wales/Chile University of Zimbabwe UW Google Vodafone Voxiva Microsoft Nokia Qualcomm Cisco/Nethope HIMSS Analytics Keiser Permanente GSM Association Misys TSI Health Policy Unit, MoH of Vietnam ZA Government WHO Donor Bill & Melinda Gates Foundation Carso Health Institute CGAP Global Fund IBM IDRC/ICT4D, Executive Director UNF United Nations Foundations US OGAC Cell Life CIDRZ, Zambia DataDyne Earth Institute Grameen Phone/MIT IMIA Medical Research Council Partners In Health Regenstrief Institute Satellife Karachi Kerrala Vital Wave Consulting American Public Health Association Corporate NGO Gov’t Other Multilateral

  11. One mission of Bellagio is to gain a deeper understanding of the global eHealth landscape • Much of the value of these sessions is informal • However, the collective intelligence on these issues and the possibility for partnership(s) is an important benefit • Three ways of obtaining your thoughts throughout this conference: • Online survey • Wiki • Working session on Thursday

  12. Feedback will be analyzed throughout Bellagio and synthesized results presented at subsequent sessions Monday Tuesday Wednesday Thursday Friday Rockefeller and BCG Welcome, recap of previous sessions (RF) Collaboration workshop led by Karl & Ticia Introductory presentation on collaborative effort and survey (BCG) Surveys analyzed and synthesized Synthesize findings from survey, wiki and workshop for next week’s intro session Distribute surveys Bellagio participants • Participants have three days to fill out survey • Target 30 minutes • Two methods: online (preferred) and paper • Due at 9 pm on Wednesday (Italy time) Wiki to collect input from both Bellagio participants and webcast viewers throughout the week

  13. Survey questions focused on the potential for eHealth Value of eHealth Share your thoughts on the broad vision for eHealth. In the context of the larger global health effort how important (1 – 5) is investing in eHealth to improve health in developing countries? Please explain your response. What are the fundamental eHealth applications for strengthening developing countries' health systems? Advancing eHealth What are the challenges facing the widespread adoption and use of eHealth in the developing world? What factors would enable eHealth to be implemented in these areas? Offer your ideas for specific solutions. Key players It is likely that many stakeholders will be necessary for these solutions. Please suggest your ideas for leaders in this area (both individuals and organizations). What resources would they contribute (e.g. funding, IP, expertise, time, staff)? What would be the nature of their engagement (e.g. consulting, leadership, donations in kind)? Many have suggested that some form of collaborative action is needed to most effectively address the need for eHealth in the developing world. Do you agree? What can be done to establish a successful collaboration?

  14. PHI Market Access IO EHR Capacity Policy Mobile Capacity IO PH Mobile EHR Policy Market Access Thank you for your engagement and hard work!

  15. Unused slides

  16. SNOMED HL7 v2.51 XML HTTP TCP IP Example: hierarchy of eHealth standards supported by communication standards Standard Term Description First use Systematized Nomenclature of Medicine Health Level Seven eXtensible Markup Language Hypertext Transfer Protocol Transmission Control Protocol Internet Protocol Systematically organized collection of medical terminology covering most areas of clinical information Enables the exchange, management and integration of healthcare information Facilitates sharing of structured data across different information systems Used to transfer or convey information on the World Wide Web Provides reliable, in-order delivery of a stream of bytes Data-oriented protocol used for communicating data across the internet 1987 2003 1997 1996 1974 1977 Informationstandards Communication standards 1. HL7 version 3 has not yet been widely adopted

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