Developing eHealth Strategy for India Need of the hour

3rd International Conference on Transforming Healthcare with IT 31st Aug.-1st Sep. 2012 Hyderabad, India

Developing eHealth Strategy for IndiaNeed of the hour

Prof. S. K. Mishra, MS, FACSDept. of Endocrine Surgery

&School of Telemedicine & Biomedical Informatics

SGPGIMS, Lucknow


Agenda

• Introduction• Need and Justification of developing ehealth policy• Global Scenario• Indian Scenario– Standardization of IT infrastructure of health– National Task Force

• WHO/ITU National Strategy Toolkit


Introduction

• eHealth an important tool having potiental in achieving the goal of “health for all”.

• eHealth reduces healthcare cost• ehealth expanded services to un-served

region• eHealth needs to be integrated in healthcare

system both in practical and policy sense

Source: Telehealth policy: Looking for global commentary;Richart E Scott et. al.; J. Telemedicine and Telecare 2002; 8 (suppl. 3): s3.55-57


• eHealth policy is concerned with solutions that support capacity building and provide services that improve health outcomes.

• It is a set of statements, directives, regulations, laws, and judicial interpretations that direct and manage the life cycle of eHealth

• Socio-economic, financial & cultural, Institutional conditions, Human and material resources, Organizational and managerial models defines policy boundaries

eHealth Policy

Source: Telehealth policy: Looking for global commentary;Richart E Scott et. al.; J. Telemedicine and Telecare 2002; 8 (suppl. 3): s3.55-57


Need and Justification of developing ehealth policy

• Advances in ICT continue to outpace the development of supportive policies, infrastructure & user acceptance of eHealth

• Successful pilot projects have not translated into adoption in health system

• Government expenditure and business rules are dictated through policies

• Industry growth is heavily dependent on government policy• Barriers like Interoperability, legal, security & ethical issues can

only be addressed by a set of rules and standards at national level

• Need of development of National eHealth Policy in Global Context


Status of eHealth around the world

Source: http://www.who.int/goe/publications/goe_telemedicine_2010.pdf


Policy Document

• Malaysia; 1997 Telemedicine Act1

• Malaysia; 2000 Telehealth policy statement• Well defined e-health policy or clear policy activity :

Australia, Canada, China, Croatia, Denmark, Finland, Iran, Malaysia, Malta, New Zealand, Russia, Singapore, South Korea, Sweden, Taiwan, Tanzania, Thailand, UK, USA and Vietnam etc.2

1. http://unpan1.un.org/intradoc/groups/public/documents/APCITY/UNPAN025631.pdf2. Source: Telehealth policy: Looking for global commentary;Richart E Scott et. al.; J. Telemedicine and Telecare 2002; 8 (suppl. 3): s3.55-57


Adoption of eHealth policy

Source: http://www.who.int/goe/publications/goe_telemedicine_2010.pdf


The Rockefeller Foundation The initiative would improve the quality, equity, and

cost-effectiveness of health care in the "Global South"—a term for developing countries.

It would do this by using information and communication technologies (ICT) to improve and expand diagnostic, treatment, preventive, and monitoring capabilities, as well as user awareness and access.

Source: www.ehealth-connection.org/


PAHO – Pan African Health Organisation Argentina takes steps in establishing a national eHealth Strategy

• Experts from the Ministry of Health of Argentina, Hospital Italiano and universities, among others, stressed the need to establish an eHealth plan for the country, during a meeting organized by the Pan American Health Organization in Buenos Aires.

• The discussion highlighted the need of eHealth experts in the nation and public policies that support the sustainability and viability of projects, such as the creation of a unique electronic medical records and telemedicine.

Source: http://new.paho.org/index.php


UGANDA eHealth Policy

• Widely consultative and participatory with involvement of all stakeholders to ensure ownership, shared responsibility successful implementation.

• Provides a framework for eHealth implementation by all stakeholders in collaboration with other Sectors

• eHealth is in line with existing policies eg Poverty Eradication Action Plan (PEAP), National health Policy, Health Sector strategic Plan I & II and National ICT policy

http://www.who.int/workforcealliance/forum/SBW_eHEALTH%20POLICY%20AND%20eLEARNING.pdf


COCIR eHealth Toolkit for an accelerated deployment and better use of eHealth

• European Coordination Committee of the Radiological, Electromedical and Healthcare IT Industry

• In 2007, COCIR developed 10 recommendations to accelerate the deployment of eHealth

• Three priorities for deployment– Develop an innovative sustainable business model– Foster standards and interoperability– Enable market development

Source: http://www.cocir.org


National E-Health Strategy Australia's Policy

Source: www.ahmac.gov.au


CUBA

• National health telematics network - INFOMED (www.sld.cu)

• Building a National eHealth Capacity Additional eHealth applications already functioning include specialized networks in nephrology, intensive care, cardiology, and pharmacies, and there is a growing electronic publishing capacity.

• Future applications include a national health economy management system and a hospital-level management system (digital diagnostic results, inventories, accounting, etc.) Source: www.medicc.org/mediccreview/articles/mr_42.pdf

http://www.sld.cu/


WHO/ITU eHealth Strategy Toolkit

Source: www.who.int/entity/ehealth/brochure.pdf


WHO-ITU effort to support National e-Health Roadmaps

• The health care, telecommunication and finance sectors have to work together in developing national e-Health strategies.

• Develop resource materials building on relative competencies of each of the two organisations.

• Deploy approaches to support the development of new national eHealth strategies or the update of existing plans to reflect experience or emerging challenges in the domain of eHealth.

• Approaches will ensure country ownership of the process and therefore sustainability

Source: http://www.itu.int/ITU-D/cyb/events/2011/Telecom11/e-health/Presentations/tuesday1-%20WHO&ITU%20eHealth%20National%20Strategy%20Toolkit.pdf


National eHealth Strategy ToolKit

• Methodology to assess actual Health System Status, Needs and Action Priorities

• An integrated Action Framework covering: Infrastructure, Applications, Funding,

• Governance, Legal and policy, Workforce, Standards and interoperability, etc.

• Guidance on how to set eHealth targets, benefits and Performance Indicators

Source: http://www.itu.int/ITU-D/cyb/events/2011/Telecom11/e-health/Presentations/tuesday1-%20WHO&ITU%20eHealth%20National%20Strategy%20Toolkit.pdf


eHealth Policy Issues

• Policy Objectives– Coordination and Collaboration, – Connectivity and Infra-structure, – Human Resource Development, – Content– Provision of Health Information and Services– Financing Mechanism and Sustainability – Research

• Organizational Structures Institutional Framework• Expected Cost and Benefits of the Policy• Monitoring and evaluationSource: http://www.itu.int/ITU-D/cyb/events/2011/Telecom11/e-health/Presentations

/tuesday1-%20WHO&ITU%20eHealth%20National%20Strategy%20Toolkit.pdf


Global Elements

• Network• Inter-Jurisdictional Practice• Diffusion of ehealth addressing the digital divide• Integration into existing system• Handling innovation at different levels• Policy Goal Setting • Evaluation & Research• Investment• Ethical IssuesScope of Policy Issues for eHealth: Results from a Structured Review; Shariq Khoja et. al. Bellagio, Italy,

July 13-Aug, 8, 2008 source: www.ehealth-connect.org


Planning for eHealth Policy Success

• Global eHealth Convention• eHealth Policy Toolkit• eHealth Education• National eHealth Councils• Stake Holders

Source: ww.who.int/ehealth


eHealth Challenges -I

• Coordination is not easy due to fragmented donor driven projects leading to duplication, equipment incompatibility

• Integration of ICT into budgets of the service delivery programs in the health system affecting sustainability

• Connectivity available even in remote areas but very expensive.

• Hardware like computers limited.Source: http://www.who.int/workforcealliance/forum/SBW_eHEALTH%20POLICY%20AND%20eLEARNING.pdf


eHealth Challenges - II

• Very few ICT professionals/Technicians to maintain equipment and support/ train the users.

• Inadequate band width and irregular power supply or lack of it.

• Regulatory framework to ensure confidentiality and win the trust of patients

• Embracing ICT is a process of cultural transformation which takes place very slowlySource: http://www.who.int/workforcealliance/forum/SBW_eHEALTH%20POLICY%20AND%20eLEARNING.pdf


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School of Telemedicine & Biomedical Informatics, Lucknow, India

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www.sgpgi-telemedicine.org | www.nrct.in | www.stbmi.ac.in

Thank YouContact: [email protected]

Developing eHealth Strategy for India Need of the hour

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