Post on 02-Jan-2016
2bellagio intro deck v10 PVG 07.28.ppt
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
3bellagio intro deck v10 PVG 07.28.ppt
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.
Still an early draft; need your assistance defining effortPlease comment at: www.ehealth-connection.org/wiki/
1
2
3
4bellagio intro deck v10 PVG 07.28.ppt
“eHealth” a broad and diverse realm of efforts
eHealth:
the use of information and communication technologies (ICT) to improve health
Different types of eHealth initiatives include, but not limited to: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
5bellagio intro deck v10 PVG 07.28.ppt
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
6bellagio intro deck v10 PVG 07.28.ppt
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 impediments to eHealth diffusion and advancement
“Electronic Health Records”, “mHealth”, “Public Health Informatics” and “Access to Information” provide grounding in applications that strengthen health systems
EHR mHealth PHI A2K
Interop. Markets
Optimal development path
eHealth applications
PoliciesCapacity building
Enablers
7bellagio intro deck v10 PVG 07.28.ppt
Connected health information network will require interoperability across several dimensions
Across programs Across geographies
Across points of care Across technologies
Census
TB
Malaria
HIV/ AIDS
Hospital
Health clinic
Community health worker
Metcalfe’s LawMetcalfe’s Law Examples of dimensions to be addressedExamples 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)
Early stage of eHealth in much of developing countries is an advantage – possible to take action now
8bellagio intro deck v10 PVG 07.28.ppt
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
1
2
3
• Technology companies• Biopharmaceutical companies• Entrepreneurs• Research and academia• Others?
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
• Ministries of health and other representatives of target countries
• Private donors/foundations• Non-governmental organizations• Multilateral donor/aid organizations
9bellagio intro deck v10 PVG 07.28.ppt
Goal at Bellagio: engage stakeholders on collaborative action to address challenges facing eHealth efforts
Capacity building
• help countries build and sustain HR capacity to manage, maintain and develop eHealth solutions
Policy advocacy• develop enabling policy guidelines• advocate to and/or advise countries on policy development
Standards support
• identify/advocate/implement critical data standards to ensure data quality and interoperability
Funding coordination
• raise funds for eHealth, reduce redundant activities and increase pool of funding
• align funders on key issues (e.g. interop. standards), channel funding as needed
Market-making
• connect “buyers” and “sellers” of eHealth solutions– educate consumers on portfolio of available applications– aggregate demand for eHealth solutions– potentially provide base level of freeware / starter kits
Key collaborative actionsKey collaborative actions
Enablers
Policy
Cap. build.
Optimaldevelopment
path
Interop
Market
10bellagio intro deck v10 PVG 07.28.ppt
Many experts and decision-makers participating - sampleWho do you need to talk to and work with to push eHealth forward? Who’s missing?
Academic
Corporate
Donor
Other
NGO
Gov’t
Multilateral
Bill & Melinda Gates FoundationCarso Health InstituteCGAPGlobal FundIBMIDRC/ICT4D, Executive DirectorUNFUnited Nations FoundationsUS OGAC
Cell LifeCIDRZ, ZambiaDataDyneEarth InstituteGrameen Phone/MITIMIAMedical Research CouncilPartners In HealthRegenstrief InstituteSatellife
KarachiKerralaVital Wave ConsultingAmerican Public Health Association
D-tree International; DimagiHISPUCSFUniv.of New South Wales/ChileUniversity of ZimbabweUW
GoogleVodafoneVoxivaMicrosoftNokiaQualcommCisco/Nethope HIMSS AnalyticsKeiser PermanenteGSM AssociationMisysTSI
Health Policy Unit, MoH of VietnamZA Government
WHO
11bellagio intro deck v10 PVG 07.28.ppt
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
12bellagio intro deck v10 PVG 07.28.ppt
Bellagio participants
Feedback will be analyzed throughout Bellagio and synthesized results presented at subsequent sessions
Monday Tuesday Wednesday Thursday Friday
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)
Collaboration workshop led by
Karl & TiciaRockefeller and BCG
Welcome, recap of previous
sessions (RF)
Surveys analyzed and synthesized
Introductory presentation on
collaborative effort and survey
(BCG)
Distribute surveys
Synthesize findings from survey, wiki and workshop for next week’s intro
session
Wiki to collect input from both Bellagio participants and webcast viewers throughout the week
13bellagio intro deck v10 PVG 07.28.ppt
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?
14bellagio intro deck v10 PVG 07.28.ppt
Thank you for your engagement and hard work!
Capacity
IO
PH
Access
EHR
PolicyMarket
Mobile
Capacity
IO
PHI
Access
EHR
Policy
Market
Mobile
16bellagio intro deck v10 PVG 07.28.ppt
Co
mm
un
icat
ion
stan
dar
ds
Info
rmat
ion
stan
dar
ds
Example: hierarchy of eHealth standards supported by communication standards
SNOMED
TCP
XML
HL7 v2.51
IP
HTTP
TermTerm
Systematized Nomenclature of Medicine
Health Level Seven
eXtensible Markup Language
Hypertext Transfer Protocol
Transmission Control Protocol
Internet Protocol
DescriptionDescription
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
Standard Standard First useFirst use
1987
2003
1997
1996
1974
1977
1. HL7 version 3 has not yet been widely adopted