Marco Carugi ITU-T SG13 vice-Chair, Q3/13 Rapporteur and FG M2M Service Layer vice-Chair

1. Joint ITU-WHO Workshop on e-Health Standards and Interoperability(Geneva, Switzerland, 26-27 April 2012) Session 7 chair’s notes from session 7 open discussion - inputs from meeting participants and action plan from WHO and ITU Marco Carugi ITU-T SG13 vice-Chair, Q3/13 Rapporteur and FG M2M Service Layer vice-Chair ZTE Corporation Marco.Carugi@zte.com.cn

2. Session 7 open discussion: inputs from meeting participants For SDOs: to coordinate with new HL7 initiative on Mobile E-health For SDO: to consider effective cost models for standards licensing (see also WHO initiatives) For Policy makers, Regulators: more awareness is needed; how to present them the work; security and privacy (this is also for governments) For technical community: to consider common evacuation methods in case of disasters (ITU-T CAP work, new ITU FG on Disaster Relief Systems, Network Resilience and Recovery ) For technical community: to consider open information exchange infrastructure addressing issues in the context of the global infrastructure to enable health information exchange

3. Inputs from meeting participants • For each stakeholder: to clarify own key reasons for non adoption of standards • For all stakeholders: to clarify what are/how they see their roles and responsibilities in the process and engage in those roles and responsibilities • For all stakeholders: to understand the value of health information • For all stakeholders: to share successful practices • WHO is preparing standards implementation practices • About the Standards Roadmap: it is useful, including for its impact on health; a suggested starting point are the HIS (Health Information System) elements for service life cycle and what standards are applicable there; it is necessary to identify the targeted services

4. Inputs from meeting participants • An effort for a converged view on data and information structure may be useful • More education is key • QoS aspects require more attention • A starting point are the functional features we can expect, but we should also maintain a fluid situation enabling continuous experimentation • To consider how to address the standards process recognizing that there are different national/regional situations and different issues

5. Inputs from meeting participants WHO: overall objective is universal access and management of information, addressing health requirements of individuals, enabling actions for health To create environment which enables effective implementation in specific situations Common approaches for the roadmap are an imperative To consider principles of interoperability without developing specific adapters for all standards

6. Inputs from meeting participants • Technical guidelines to implement services in specific situations: who will do that ? • At first an health expert group has to describe the service flows independently of specific technical aspects • WHO guidelines are offering guidance based on evidence, they do not propose a mandatory way, they can be/are adapted based on different factors • How to create at first the committment in countries to value the information exchange

7. Inputs from meeting participants • At country level: to learn by example, why to do, to identify criteria for standards selection. It is needed to identify the leading examples and share them. It is not necessarily easy to make choices by the country, WHO and others should help. Collaboration among countries should be promoted by ITU/WHO. • To move forward, it is needed to publish use cases from countries with success/failures • Collecting, disseminating and using information on different aspects in health sector is essential

8. Action plan from WHO (N. Al-Shorbaji) and ITU (R. Scholl) WHO-ITU Joint Report of this workshop WHO-ITU Joint Policy Brief about the value of standards and interoperability for the exchange of health information Creation of a Working Group to advice both WHO and ITU on future steps Work on a Roadmap about standards and interoperability adoption – which steps for the process, matrix of standards versus areas WHO-ITU collaboration with SDOs to create a portal with some level of information categorization Events for education on value of standards and interoperability Production of some literature on value of standards and interoperability (based on case studies etc.) NOTE: a collaboration initiative on ITS (Intelligent Transportation Systems) has been launched by ITU. Its Terms of Reference include requirements and gap analysis. The experience in this collaboration could help in setting up the E-Health collaboration between ITU, WHO and other SDOs.