Mini University Presents
A Basic Operational Framework for eHealth and Telemedicine:
How to Get Started
Stephen SettimiSr. Fellow & Technical Advisor -USAID Global Health,
ICT/Knowledge [email protected]
http://www.usaid.gov/our_work/global_health/United States Agency for International Development
1300 Pennsylvania Avenue, NW 3.6.35Washington, DC 20523-3600
Tel. (202) 712-1292 Fax: (202) 216-3485Cell: 619-507-8311
"We are today where we planned to be yesterday."
05 Oct 2007
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Vocabulary for Discussion
• eHealth• Telemedicine• ICT (Information & Communication Technology)• Informatics• Databases• Resources• Stakeholders• Intellectual Capital• Capacity Building• Public Goods• Frameworks
Getting the Right Framework to Fit Right
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Country Focus
How do we put into place a Framework within the context of Country Z?
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Steps to Developing a Framework…
STEP #1 Identify opportunity inroads
STEP #2 Determine Probability of Success Identify the StakeholdersDetermine interest level of stakeholders
STEP #3 Assess the resource base
STEP #4 Develop tactics and strategy for success
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Identify Opportunity Inroads-or the Working Ecology
• Resource challenged environments– Low Doctor to Client ratio (e.g., 1: 1555 Pakistan)– High Rural Populations Levels (50% to 75%)– Low educational Level– Lack of Infrastructure
• Policy Supportive• Civil Society Supportive• Population Supportive• Private Sector Support
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Determine Probability of Success > Identify Stakeholders
> Assess the strength of the working relationship
ARBEF
CAMERWA
CHK
CNJ
CNLS
CPLS
FHI
GTZ
HIS -SISIntraHe
althMIGEPROF
MINALOC
MINEDUC
UNFPA
USAID
WHO
FP Priority Closest Entities
Wider gap = Under Utilization:HIS-SIS = high importanceHIS-SIS = low closeness
Narrower gap = High reliance factor:USAID = high importanceUSAID = high closeness
Assess likelihood of success by using Social Network Mapping for any given initiative: e.g., an eHealth Telemedicine program.
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Update:Status Report
STEP #1 Identify opportunity inroads STEP #2 Determine Probability of Success
Identify the StakeholdersDetermine interest level of stakeholders
STEP #3 Assess the resource base
STEP #4 Develop strategy and tactics for success
Stop
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
4 Requisite Resources
Material
Capital
Human
Informational
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Remember these 4 Requisite ResourcesRemember Resources are interdependent
4 Requisite Resources
Material
Capital
Human
Informational
Material
Human Capital
Information
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Information Resources
• Evidence that supports eHealth and Telemedicine programs
• Data that can drive processes• Social Networks• Other informational resources?
Resource challenged environmentsLow Doctor to Client ratio (e.g., 1: 1555 Pakistan)High Rural Populations Levels (50% to 75%)Low educational LevelLack of InfrastructureCOUPLED WITH….•High infant mortality •High maternal mortality •Low vaccination rates•Malnutrition•Frequent or extreme Epidemiological events
What processes can we drive with these data? Mother’s DOB and Natal Status Child’s DOB Location of Client (Patient) to nearest servicesWhat are Social Networks? Why are they informational
resources?
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Challenges toAcquiring Information Resource
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Human Capital Resource
ARBEF
CAMERWA
CHK
CNJ
CNLS
CPLS
FHI
GTZ
HIS -SISIntraHe
althMIGEPROF
MINALOC
MINEDUC
UNFPA
USAID
WHOKey Stakeholders
MIGEPROF CAMERWAARBEFHSIMINALOCMOHMINEDUC
* A hypothetical listing
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Challenges toAcquiring Human Capital
• Educational attainment level• Money for salaries• “Brain Drain” (attrition / retention)• Competing industries• Other?
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Update:Status Report
STEP #1 Identify opportunity inroads STEP #2 Determine Probability of Success
Identify the StakeholdersDetermine strength of relationship
STEP #3 Assess the resource baseInformationHumanCapitalMaterial
STEP #4 Develop tactics and strategy for success
Stop
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Capital Resource$
• Is Public Health a “Public Good”?• Who’s the public?• Does the public pay for this good?• Will those who pay for the good get value for the
good?• What if you can’t pay for the good?• What sources of finance are available to pay for
public goods?
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Material Resources
What physical resources would be required to implement eHealth or telemedicine programs?
a facility (building or virtual) computer telephones (land-lines or cell phones) electricity other devices
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Update:Status Report
Stop
STEP #1 Identify opportunity inroads STEP #2 Determine Probability of Success
Identify the StakeholdersDetermine strength of relationship
STEP #3 Assess the resource baseInformationHumanCapitalMaterial
STEP #4 Develop tactics and strategy for success
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
One Tactic: Create a Task Force from Stakeholders (both Current and Desired)
TASK FORCE
ARBEF
CAMERWAC
HK
CNJ CNLSCPLS
FHI
GTZ
HIS -SIS
IntraHealth
MIGEPROF
MINALOC
MINEDUC
UNFPA
USAID
WHO
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Tactic: Create a Task Force from Stakeholders (Current and Desired)
Task Force
ARBEF
CAMERWAC
HK
CNJ CNLSCPLS
FHI
GTZ
HIS -SIS
IntraHealth
MIGEPROF
MINALOC
MINEDUC
UNFPA
USAID
WHO
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Tactic: Create a Task Force from Stakeholders (Current and Desired)
TASK FORCE
ARBEF
CAMERWAC
HK
CNJ CNLSCPLS
FHI
GTZ
HIS -SIS
IntraHealth
MIGEPROF
MINALOC
MINEDUC
UNFPA
USAID
WHO
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Tactic: Create a Task Force from Stakeholders (Current and Desired)
TASK FORCE
ARBEF
CAMERWAC
HK
CNJ CNLSCPLS
FHI
GTZ
HIS -SIS
IntraHealth
MIGEPROF
MINALOC
MINEDUC
UNFPA
USAID
WHO
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Task Force Models
POLICY-MAKERS
CLINIC OR
HOSPITAL
DR or NURSE
PATIENT or
CLIENT
POLICY-MAKERS
CLINIC OR HOSPITAL
DR or NURSE
PATIENT or CLIENT
POLICY-MAKERS
CLINIC OR HOSPITAL
DR or NURSE
PATIENT or CLIENTPOLIC
Y-MAKE
RS
CLINIC OR
HOSPITAL
DR or NURSE
PATIENT or CLIEN
T
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
STEP #1 Identify opportunity inroads STEP #2 Determine Probability of Success
Identify the StakeholdersDetermine strength of relationship
STEP #3 Assess the resource baseInformationHumanCapitalMaterial
STEP #4 Develop tactics for success
SUMMARY Steps toward an eHealth Telemedicine Framework
Develop a tactics and strategy for success
A Basic Operational Framework for eHealth and Telemedicine: How to Get Started
Stephen SettimiSr. Fellow & Technical Advisor -USAID Global Health,
ICT/Knowledge [email protected]
http://www.usaid.gov/our_work/global_health/United States Agency for International Development
1300 Pennsylvania Avenue, NW 3.6.35Washington, DC 20523-3600
Tel. (202) 712-1292 Fax: (202) 216-3485Cell: 619-507-8311
"We are today where we planned to be yesterday."