Major Agreements AeHIN General Meeting
Executive Summary Forty nine participants from fourteen countries and five development partners joined the 2nd AeHIN General Meeting at Pan Pacific Hotel Manila, Philippines. eHealth updates per country and the AeHIN Regional Strategic Plan 2012-2017 were presented. AeHIN challenges identified were: • lack of human resources and local technical capacity for eHealth, • poor collaboration among different sectors, • limited infrastructure, • lack of data appreciation and use for decision making, • and weak policy support are common challenges that AeHIN countries are facing.
Executive Summary In the country breakouts, the following activities under each SAP received the highest rankings from the participants: Leadership & Governance 1.1.1 Establish or support maintenance of fully functioning multi-sectoraleHealth/HIS/CRVS coordinating mechanisms in 20 countries Capacity Building 2.1.2 Engage multiple stakeholders to develop national competencies on eHealth/HIS/health informatics in low and middle income countries (e.g., connecting with IMIA Health Informatics Education Technical Working Group and UQ on 40-hour HIS short course, identifying sub national level capacity building institutions and programs) Peer Assistance/ Networking 3.1.1. Convene AeHIN General Meeting annually to facilitate knowledge exchange, networking, and to address common challenges Standards & Interoperability 4.2.2 Negotiate service agreements, provide access and training, and collaborate with SDOs to implement eHealth standards and stacks of standards to support national eHealth strategies and plans
Overview • AeHIN: A Network of Sharing, Learning, Volunteerism, and Friendship Summarized in four key definitions, countries shared how important they see AeHIN and its role in achieving better use of ICTs for better health. • AeHIN Challenges The open fora laid on the table, country and cross country issues and challenges. • Regional and In Country Priorities After presenting strategic action plans of the network, countries rank them based on priorities. Results are summarized to show regional and in country priorities.
Sharing AeHIN: A Network of Sharing, Learning, Volunteerism, and Friendship • Sharing A country may have the same problem as another. By listening to each other's experiences, eHealth professionals at AeHIN arrive at solutions without starting at square one. Tagged as “Adaptive Technical Assistance”, needs of each country could be linked to one another developing partners to see “value of resources in” and “values out of it”.
AeHIN: A Network of Sharing, Learning, Volunteerism, and Friendship • Learning • Learning Capacity building does not come cheap. Through AeHIN, members garner economies of skill that is powerful and influential in teaching “how to do things” and “how not to do things”. To achieve this, AeHIN’s focus should be on the major and most pressing problems of the region and the resources needed. There are a lot of capacity building activities and the challenge now is to choose on what area the network should walk on.
AeHIN: A Network of Sharing, Learning, Volunteerism, and Friendship • Volunteerism Despite the limited resources, AeHIN works out of passion. Individuals seek new ways in improving health care, seeing it as their own responsibility. The mantra is “provide what you can provide”. No one will say what is right or wrong. Members take the hard work to know what they need and own the available solution that will work best for them. • Volunteerism
AeHIN: A Network of Sharing, Learning, Volunteerism, and Friendship • Friendship • Friendship When we help friends, friends will help us. At AeHIN, members are passionate in the task ahead. They come together like working in a battle, pursuing through difficult agendas together that will eventually have a multiplier effect all throughout.
AeHIN Challenges Efficient Collection of Health Data Connecting Health Information Systems Aggregation of data from villages Enterprise Architecture is City Planning Responsible data collection Human Issue Rather than Technical
AeHIN Challenges • Efficient Collection of Health Data Countries admitted that they have difficulty in collecting birth and death data most especially in rural areas. The existing solution: biometrics and electronic chips which can be embedded in national IDs like what Indonesia and Thailand are doing. However more debate lies on health data’ security, privacy, and confidentiality. Efficient Collection of Health Data
AeHIN Challenges • Aggregation of data from villages District Health Information System was on spotlight. AeHIN Members in Bangladesh shared the coverage of DHIS in their country and its proven robustness in collecting data from villages and organizing it for use at different levels. However, more support is needed for internet connectivity at root level of submission and manpower to work on the data. OpenMRSwas also suggested as another way of data collection. Aggregation of data from villages
AeHIN Challenges • Connecting Health Information Systems The need: data dictionary and its accompanying semantic and syntactic definitions, understanding of the encounter and visit, and consideration of standards for terminology like ICD-10. The Integrating Healthcare Enterprise (IHE) was seen as a tool for interoperability to happen. Sustainability on the use of standards was and will always be an issue. Connecting Health Information Systems
AeHIN Challenges • Enterprise Architecture is City Planning Sustainability on the use of standards was and will always be an issue. To perform eHealth, EA shall be a consensus among countries. Models like Zachman, TOGAF, FEA, Gartner, and even hybrids of them are most useful only when tailor fit in a country’s context. Like city planning, EA thinks of the various components and how it will affect each other. Enterprise Architecture is City Planning
AeHIN Challenges • Responsible data collection Preserving the integrity and availability of data is a task. Primary health workers are seen as front liner in the system and are now very important in the data collection cycle. Responsible data collection
AeHIN Challenges • Human Issue Rather than Technical Telemedicine and Teleconsultation are largely driven by champions. Since technology can be outdated in a few years’ time, long term and sustainable eHealth solutions are anchored on vital workflows in health care setting. Human Issue Rather than Technical
Regional and In Country Priorities Dr. Alvin Marcelo, AeHIN Chair, presented specific strategic action plans (SAP) based on AeHIN’s four strategic thrusts. Countries ranked them based on their country’s priority. Results were summarized as: • Priority Action Plan for the Region (Regional Priorities) • Priority Action Plan for Each AeHIN Member Country. (In Country Priorities)
Regional Priorities Priority action plan for the region were ranked based on two factors: • the number of countries who considered the strategy as part of their priorities • and the average of priority ranking given they gave. The weight is based on the formula: (the no. of countries) x (1/average of the non-zero ranking point given).
Regional Priorities Top three priorities on each of the strategic thrust were listed. Inside the matrix are the ranks marked by the colored dots below per country. These were based on the weight of each country’s rank compared to the average rank they gave. The degree of priority denoted below start from 1 (orange) as the top priority and 12 (grey) as last priority. 1 2 3 4 5 6 7 8 10 11 12 13
Regional Priorities Legend:
Regional Priorities Legend:
Regional Priorities Legend:
Regional Priorities Legend:
In Country Priorities Countries rank SAP in each strategic thrust (ex. Leadership and Governance has twelve SAP to rank while Capacity Building has eight SAP to rank and so on). For every country, top three ranks were identified and plotted in the SAP matrix. Top priority is marked with an orange dot, 2nd priority with a blue dot, and third priority with a black dot. 1st Priority 2nd Priority 3rd Priority