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1、eHealth Trends and the Use of Standards and Guidelines Mr Mark LandryHealth Information Technical OfficerWorld Health Organization,Regional Office of the Western Pacific,Outline,IntroductionTrends in eHealthNext steps:identifying and implementing standardsFuture possibilities and potential impacts,e
2、Health:Using Information Communication Technology(ICT)such as computers,mobile devices,and satellite communications for health services and information,Health and eHealth,Health and eHealth are inseparable due to the fact that health is an information intensive sector.Health is a global concern that
3、 is trans-border by definition and affects the world population.Information technology and telecommunications(ICT)is a global issue especially with the emergence of the knowledge economy and the information society.This has required WHO to adopt global approaches to eHealth.,Why eHealth?,Health syst
4、ems unable to deliver high-quality,affordable services with universal accessIncreasing time and effort needed for acquiring information and data as well as for administration and documentationCritical health information buried in thick medical files and unsystematic data storage and retrieval system
5、Specialisation&Sub-specialisationNew DiseasesIncreasing support to eHealththe next breakthrough in health systems improvement,Global Cellular Subscriptions,2010 Key Global Statistics,Source:mHealth Alliance,Scope of eHealth Services and Applications,WHOs Response,Adoption of the World Health Assembl
6、y Resolution on eHealth(WHA58.21)in 2005 by WHO Member StatesThe eHealth resolution gave legitimacy to the concept itself but also defined:the scope of eHealththe potential stakeholdersthe role of governments and the private sectorthe need for legal,ethical and regulatory frameworks for its implemen
7、tationCatalyzed recognition of the role of eHealth in:strengthening health systemsimproving health servicesreaching out to remote communitiesenhancing the capacity of health workforcehealth promotion,eHealth Global Uptake,WHO Global Observatory of eHealth and the eHealth Intelligence Report:http:/ww
8、w.who.int/goe/ehir/en/First Global eHealth survey,2005:BenchmarkingComparison between countriesHard data and evidence on progress made.Second Global eHealth survey,2009:More in-depth analysisIncluded eight thematic areas:mHealth,Telemedicine,Management of patient information,Legal and ethical framew
9、orks for eHealth,eHealth policies,eHealth foundation actions,eLearning and country profiles.,Most Commonly Reported mHealth Initiatives in GOe,50%in emergency/disaster situations50%in health call centre or healthcare telephone helpline45%for surveillance programs40%for voice/text messages to achieve
10、 treatment complianceA number of countries highlighted using mHealth for HIV/AIDS and maternal health services,eHealth Value Stack,Source:mHealth Alliance,The Grand Challenges to eHealth,Organizational and governance challengesTechnical challengesFinancial challengesLegal and ethical challengesLocal
11、 challenges based on differences in healthcare systems,culture,economy,regulations,policies,ICT infrastructure,and human resources,Global and National Governance of eHealth,Code of ethicsMulti-sectoral coordinationHuman resources development StandardizationInteroperabilityCharters and frameworksColl
12、aboration and partnerships,Awareness and Accessamong eHealth End Users,Value of ICT in health not fully recognizedeHealth typically not high on national health prioritiesEvaluation of eHealth has concentrated mainly on pilot projectsThere is often a communications gap between health and ICT professi
13、onals China is a unique exceptionwith strong political will and excellent leadership to continue maximizing health outcomes with increasing use of eHealth solutionsChinas world-class eHealth solutions and outstanding experience should be shared with the rest of the world,Technical Competenciesof Hea
14、lth Professionals,Healthcare professionals usually do not receive ICT training.Their understanding of it comes late in their career.ICT professionals are mainly hardware and software engineers with little orientation on biomedical applications.There is a need for in-service training and continuous e
15、ducation are missing in the area of health informatics.This is challenged by having very few specialized health informatics programmes.Promote peer-to-peer learning and sharing within and between countries:China Health Informatics Society(CHIS)International Medical Informatics Association(IMIA):http
16、:/www.imia-medinfo.org,Standardization and Systems Interoperability Challenges,Fragmented efforts to develop eHealth applications in the absence of adequate governance,standards and national plans resulted in development of eHealth systems that cannot exchange data.These systems are mainly standalon
17、e and disintegrated,lacking unified coding schemes,following different or no standards which resulted in total lack of interoperability between them.,WHO eHealth Standardization Coordination Group(eHSCG),Platform to promote stronger coordination amongst the key players in all technical areas of eHea
18、lth standardization.Place for exchange of information on standards:Identify areas where further standardization is requiredProvide guidance for implementations and case studiesConsider the requirements for appropriate development paths for health profiles of existing standardsSupport activities to i
19、ncrease user awareness of the existing standards,and case studieseHealth Standards List:http:/www.who.int/ehscg/resources/en/ehscg_standards_list.pdf,Two Examples:HL7 and SDMX-HD,Health Level 7(HL7)Data exchange/messaging standard primarily for patient-based transactional systems within a health sys
20、temEMR,Laboratory,Rx,Billing,Immunization,maternal health,others,Statistical Data and Metadata Exchange Health Domain(SDMX-HD)Intended to be part of national HIS and M&E infrastructure strengthening strategy,facilitating seamless flow of information from facility to district,national,and internation
21、al levels Contains a data structure definition(DSD),which defines concepts,dimensions,attributes,code-lists and other artefacts necessary to describe the structure of dataDefines attributes of a data items,which reduces the negotiation required to exchange data between information systems,Public Hea
22、lth Informatics Innovations,Communication among geographically dispersed health workers and consumersStrengthening and streamlining data collectionImplementing standards and promoting interoperabilityDisease prevention via electronic health records and improved lab systemsData collection for researc
23、h and evaluation,WHO Collaborating Centre for Health Informatics,Work planning and application submission/review process underway now to establish the Chinese Centre for Health Statistics and Information(CHSI)as a new WHO Collaborating CentreAreas of focus may include:Improving vital statistics and
24、monitoring&evaluation systemsBuilding capacity in health informaticsDeveloping and implementing standardsEvaluating eHealth solutions and demonstrating successSharing and learning from experience in ChinaThe rest of the world is eager to learn more from China,Can eHealth Save Livesand Improve Health
25、?,YesCould be directly,could be indirectly,to the individual and to the society.Citizens,patientsHealthcare professionalsHealthcare providersGovernmentsBenefits are clear:To improve the quality and efficiency of healthcare;To expand access and contribute to equity/universal access;andTo contribute t
26、o reduction of cost of health services.,Future Possibilities in eHealth,Innovative tools remote diagnosis,medical consultation,just-in-time trainingHand-held ultrasound connected to phoneHolograms of blood cells using phone camera for malaria,HIV-AIDS,anaemia,clean waterPhones that listen to heart a
27、nd lung sounds,coughTransfer of images:cervical cancer diagnosis“Serious games”via handsets for training CHWDisaster relief communicationsConnect familiesAssist emergency relief workers,Future Possibilities(continued),Internet trends-peer to peer network,which allows individual computers to function
28、 as both server and client without central administratorClinical eHealth services-real-time medical consultationsBiotechnology and Nanotechnology-decoding of human genome,storing and interpreting genetic testing and evaluating treatment options,Thank You Mark LandryWorld Health Organization,Regional Office of the Western Pacific,
