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Regional Development Forum for the Arab States, Khartoum Sudan, 29 Jan 2017 Right to Health Right to Technology Information and Communication Technology for Health Presented by: Dr. Naeema H. Al Gasseer WHO Representative for Health & Head of Mission Innovation and eHealth regional support: Dr Ahmed Mandil , Coordinator, Research Development and Innovation ([email protected]) Eng Mohamed Nour, Officer, Innovation and eHealth ([email protected]) 1| Critical totohave thethe rightright policies in placein
Critical have policies place Leave No One Behind Universal entitlement to (essential) health services Adequate funding for health (in particular public) Better use of available funds (efficient, equitable) ICT technology is key for enabling development across all SDGs 2| Health &e is electronic technology eHealth = ICT + Health
a state of complete physical, mental and social well-being, and not the mere absence of disease or infirmity WHO Constitution, 1948 eHealth: use of Information and Communication Technologies for health eHealth: use of Information and Communication Technologies for health WHO, Report of Global Observatory for health, 2006 WHO, Report of Global Observatory for health, 2006 3| 3 Contexts: Social determinants of health & Primary Health Care
4| 4 Challenges for adopting & implementing eHealth initiatives Lack of skilled and experienced professionals Lack of electronic health records Weak connectivity and ICT infrastructure System damages during disasters Limited political commitment/awareness Lack of leadership and multi-sectoral coordination Privacy, security, confidentiality Limited resources for capacity-building Cultural and Behavioral factors 5|
5 6| Findings 2016 7| eHealth Vision Support to: establish and implement a national eHealth vision that responds to health and development goals aiming to add value in the form of improved efficiency, effectiveness, quality, sustainability, safety and/or affordability the deployment of suitable Information and communication Technologies in achieving the Strategic Development Goals for Fairer, safer and healthier world by 2030
8| 8 Why is eHealth Required? Benefits 9| Optimizing health care process (less time, better quality) Improving service delivery (reduced cost, more efficiency)
Boosting access to services and knowledge (remote areas services) Measuring health outcomes (progress with evidence) Empowering individuals (innovative culture) Supporting decision with evidence Saving lives (.. Story of Bill Taylor: EHR to follow.) 9 Electronic Health Records EHR, A Life or death decision: the happy story of Bill Taylor Information recorded timely Information sharing when it counts most When at risk, service provider access to patients information could be life-saving Source: YouTube, National eHealth services in Australia https://youtu.be/ODgjGfC4opE?t=1 10 |
10 eHealth Applications: e-Systems Health Information Systems: facilitate gathering, aggregation and analysis of data from multiple sources to report on situations, improve decision making, policy development 11 | Civil Registration & Vital Statistics Systems: registration of births, deaths, causes of death; generating trends over time; allowing for inter and intra-country comparisons, evidencebased decision making, rational resource allocation 11 Types of Information Systems
Nature of information Wisdom Knowledge Information Data 12 | Source: http://www.conceptdraw.com/examples/types-of-information-system-in-diagram 12 Scope of mHealth Applications
13 | Behavior Change Communication Data Collection and Surveillance Finance Logistics Service Delivery 13 ICT initiatives for EMRO Strategic Priorities (2012-2016) 1. Health systems development & strengthening (HSD) Universal Health Coverage (UHC), portal: http://apps.who.int/gho/cabinet/uhc.jsp ehealth to reduce cost, improve services and extend health support to non-covered population 14 |
14 ICT initiatives for EMRO Strategic Priorities (2012-2016) 2. Reproductive, maternal, neonatal, child, adolescent health and nutrition (RMNCH) 15 | MOH web-sites for providing RMNCH information mHealth for vaccine campaign/community mobilization (AFG, PAK, MOR) eLearning (MOR, TUN, YEM) Telemedicine network, Major maternity hospital (MOR, TUN, LEB) MCH data collection through Internet (PAK, DJI, YEM, AFG, MOR)
15 ICT initiatives for EMRO Strategic Priorities (2012-2016) 2. Reproductive, maternal, neonatal, child health and nutrition (Continued) 16 | WHO Anthro: software for assessing growth and development of children Monitoring of CoIA RMNCH indicators e-nutrition surveillance: a regional nutritional surveillance system, web-enabled (AFG, PAK, BAH, PAL, SUD and UNRWA ) Screening of malnourished children at health and primary health care facilities. 16
ICT initiatives for EMRO Strategic Priorities (2012-2016) 2. Reproductive, maternal, neonatal, child health and nutrition (Continued) 17 | Success Story in El-Nuzha Clinic Pilot, UNRWA eHealth, Jordan 17 ICT initiatives for EMRO Strategic Priorities (2012-2016) 3. Non-communicable diseases & mental health Governance Risk factors Health care Surveillance
Regional NCD framework 18 | e-STEPS: non-communicable disease risk factor surveillance E-learning (cancer registry, others) Be Mobile Be Healthy initiative mHealth Tobacco cessation (TUN) mDiabetes (EGY) mTB-Tobacco (EGY) 18
ICT initiatives for EMRO Strategic Priorities (2012-2016) 4. Communicable diseases (prevention & control) (Continued) 61stst session of WHO Eastern Mediterranean Regional Committee, October 2014 Resolution no EM RC 61/ R.2 No. of cases 140 120 100 80 died
survived 60 40 20 0 Week of onset 19 | Criticized WHO response to Ebola virus emphasized the need for good Information Systems 19
ICT initiatives for EMRO Strategic Priorities (2012-2016) 5. Emergency preparedness and response 20 | Learning from Ebola: readiness for outbreaks and emergencies https://www.youtube.com/watch?v=BWobe-25kpc&feature=youtu.be 20 Global eHealth Observatory Product of 2015 Atlas of eHealth Country Profiles Foci of the Survey: 1. 2. 3. 4. 5. 6.
7. 8. 21 | eHealth Foundations Legal frameworks for eHealth Telehealth Electronic Health Records (EHRs) Use of eLearning in health sciences mHealth Social media Big data 21 in Support of Universal Health Coverage Atlas of eHealth Country Profiles: The Use of eHealth eHealth Applications: e-Records
Electronic Medical Records (EMR): capture, store and share Information between health care providers within the organization supporting the delivery of service Electronic Health Records (EHR): capture, store, access and share summary information for a patient between health care organizations and providers Personal Heath Records (PHR): Health records created and maintained by a proactive individual to manage her/his own health Birth / Death Records: which feed the Civil Registration & Vital Statistics system 22 | 22 eHealth Applications: e-Learning & Practice eLearning: use of ICT for health-sciences education (medicine, nursing, pharmacy, dentistry, allied health sciences, etc.)
Telemedicine (telehealth): practice of medicine at a distance eSurveillance: observing and monitoring of specific measures, including continuous collection, analysis and interpretation of risk factors and outcomes (morbidity and mortality) measures Most recently: mHealth: use of mobile technology for medical and public health practices, including health promotion and education, data gathering, treatment support 23 | 23 Global eHealth Observatory Product of 2015 Atlas of eHealth Country Profiles Scopes of the survey study 1. eHealth Foundations 2. Legal frameworks for eHealth
3. Telehealth 4. Electronic Health Records (EHRs) 5. Use of eLearning in health sciences 6. mHealth 7. Social media 8. Big data 24 | Atlas of eHealth Country Profiles: The Use of eHealth in Support of Universal24 Health Coverage Be [email protected] Be Mobile (BHBM) mHealth Initiatives mDiabetes mCessation mWellness mDiet mCancer
mAlcohol 25 | 25 mHealth in the EMR Pilot Countries: globally, regionally Brunei Costa Rica Egypt (mDiabetes) Moldova Norway Russian Federation Philippines Senegal Suriname
Tunisia (mCessation) United Kingdom Zambia 26 | 26 Electronic Health Records EHR, A Life or death decision: Missing the story of Bill Taylor Im Dr Do you have a history of ..? What medication ..? ..?? When at risk, lack of service provider access to patients information could cost him his life Source :YouTube, National eHealth services in Australia: https://youtu.be/ODgjGfC4opE?t=1
27 | 27 WHO-ITU NATIONAL E-HEALTH STRATEGY TOOLKIT 28 | 28 How to develop a National eHealth Strategy National eHealth Strategy Toolkit vision Directions
Monitoring & evaluation Action plan Time Time Quality Quality Fund Fund h healt ncy
t n e i t Pa ice efficie rv Se By 2020, we need to. Step-by-step approach to achieve results Full version, English: ttp://apps.who.int/iris/bitstream/10665/75211/1/9789241548465_eng.pdf Full version Arabic: http://apps.who.int/iris/bitstream/10665/75211/14/9789246548460_ara.pdf 29 |
29 eHealth Required Components Building Blocks of The National eHealth Environment 1 Governance Leadership and Governance Leadership and Services and Applications Services and Applications Strategy and Strategy and investment investment Standards & interoperability Standards & interoperability Legislation,
Legislation, Policy and Policy and Compliance Compliance Infrastructure Infrastructure 30 | 30 Workforce Workforce
Possible linkages between health systems functions and IHR Core capacities Health system functions IHR Core Capacities Leadership and governance 2. Coordination, NFP Comms 1. National legislation 3. Surveillance Financing Medical products vaccines and technologies
4. Response 5. Preparedness 6. Risk Comms Information Health workforce 7. Human Resources 8. Laboratory 9. PoE Service delivery 31 | 10. Hazards (Zoo, FS, Ch, Rad)
Monitoring and measuring health determinants/barriers to improve health and access to health services Monitoring Health in All Policies Social determinants impacts on health equity What factors in broader society are impacting health equity, and what is being done to address this? 32 |
32 | Monitoring intersectoral factors influencing univeral health coverage Social determinants impact on coverage inequalities What factors in broader society are contributing to incomplete coverage of health services, and what is being done to address this? Monitoring
health status and coverage Health outcomes for health status or coverage by socioeconomic position How large are health inequalities between social groups? Monitoring health for the SDGs WHO proposed health and health-related Sustainable Development Goals (SDGs) Global Health Observatory (GHO) data, World Health Statistics 2016
http://www.who.int/gho/publications/world_health_statistics/2016/en/ 33 | 33 Towards UHC for SDGs and rights to ICT 34 | 34
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