Conference on ehealthstrategy 18 March 2015 Chaophaya Park Hotel Bangkok, Thailand 1
Objectives and Expectations To introduce the joint WHO-ITU National ehealth Strategy To discuss the components of a ehealth Strategy To develop a common understanding of the application of ehealth Strategy to Thai healthcare system 2
Relevance of ehealthto Health Systems Strengthening 3
Four Relevant Documents for Discussion on Health Information Systems, ehealth, and prioritization of Health Data 4
ehealthresolutions WHA58.28 1 2005: The adoption of Recognized resolution the on value ehealth that by 58th ICT World bring to Health health Assembly Source: http://www.who.int/healthacademy/media/wha58-28-en.pdf 5
ehealthresolutions WHA66.24 1 Recognized the value of adoption of standards for 2013: Adoption of resolution on ehealth Standardization and Interoperability by 66 th World interoperability Health Assembly and Health on the Internet Source: http://apps.who.int/gb/ebwha/pdf_files/wha66/a66_r24-en.pdf 6
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2 WHO Global Fund GAVI UNFPA World Bank UNAIDS UNICEF Gates Foundation 8
highlights the following key points Increase Levels and Efficiency of Investments in Health Information Develop Common Data Architecture Strengthen Performance Monitoring and Evaluation Increase Data Access and Use 9
Keeping Promises, Measuring Results: Commission on Information and Accountability for Women s and Children s Health (WHO Publication; ISBN 978 92 4 156432 8) 3 10
Commission's 10 Recommendations Better information for better results 1. Vital events: calls for an information system for registration of births, deaths and causes of death 2. Health indicators 3. Innovation: calls for integrated the use of Information and Communication Technologies in their national health information systems and health infrastructure 11
Strategy and Plan of Action on ehealth (PAHO/WHO Document; CD51/13 Eng. 1 August 2011) 4 12
Strategy and Plan of Action for ehealth (2012-2017) ehealth Strategy addresses the use of ICTs for better health information systems with emphasis to: electronic medical records telehealth mhealth elearning continuing education interoperability and standardization 13
Sense of Urgency The Need for implementation of Standards for Interoperable Health Information Systems through Multisectoral engagement to strengthen Health Information Systems 14
Sense of Urgency HIS are essential for rapid detection and containment of infectious diseases, respond to health emergencies, and delivery of healthcare to population at all levels Fragmented HIS pose threat to health care delivery Country obligations to timely reporting of data to international institutions need reliable HIS Multiple sectors within countries depend on accurate and timely health information for decision making 15
Health Systems in the Context of National and Sub-national Health Information Systems A Complex Landscape 16
Unpaking Health Information Systems The Functional Blocks and The Primary Engines (sub processes) 17
700 600 500 400 300 200 100 700 600 500 400 300 200 100 Allocated Length-Of-Stay Utilization Allocated Length-Of-Stay Utilization 0 25% 50% 75% 100% 125% 150% 175% 200% 0 Status25% 143 50% 221 75% 412 100% 574 125% 325 150% 172 175% 68 200% 145 Status 143 221 412 574 325 172 68 145 An Example of Health Information System Data Sources Integrated Health Information System Census Individual Records Dashboard, Reports, Queries, Events & Alerts HIS Actors Using Evidence for Decision Making Civil Registration Population Surveys Service Records Resource Records Extract and Integrate Data Integrated Data Repository Patients Patients Senior Country Official National Public Health Official International M&E Officer District Health Manager Senior Country Official Facility Health Officer Routine and Non-Routine Data Collection Activities Civil Society Policies, Resources and Processes 18 Courtesy: HMN
Country HIS Data Sources 19 Courtesy: HMN
Country HIS Data Management Data Management 20 Courtesy: HMN
Example of HIS Data Sources Many Producers and Consumers of HIS Data Ministries of Health, Finance, Education, Labour, Local Health Governments, Private Health Sector, Insurance Providers, Development Partners, etc Courtesy: HMN, 2007 21
Health Information System: A Set of Complex Sub Systems HIS Sub Systems 700 Allocated Length-Of-Stay Utilization Allocated Length-Of-Stay Utilization 40% 30% 30% Monitoring Evaluation Research Patients Patients 700 600 600 500 500 400 400 300 300 200 200 100 100 0 25% 50% 75% 100% 125% 150% 175% 200% 0 Status25% 143 50% 221 75% 412 100% 574 125% 325 150% 172 175% 68 200% 145 20% 20% 10% 10% 0% 0% -10% -10% -20% -20% -30% -30% -40% B02 E02 E04 E15 H01 H02 H03 H04 H10 J03-40% Variance B02 10% E02 4% -20% E15-21% H01 30% H02 8% 10% H04-17% H10-28% J03-13 E04 H03 Information Services Policy Status 143 221 412 574 325 172 68 145 Variance 10% 4% -20% -21% 30% 8% 10% -17% -28% -13% Extract, transform and load data into warehouse Resources Census Vital Event Registry Surveys Health Events & Risks Health Service Records Resource Tracking Data Warehouse Processes Statistical Systems Data Collection Forms & Methods Financial Systems Modified after Health Metrics Network, 2007. 22
Infrastructure Human Resources Information and Knowledge Resources Financial Resources Stewardship Functions Conceptual Functional Elements of Country HIS Health Facility- Based Services Diagnostic Services Environmental (Monitoring) Services Communitybased Services Health Commodities 23 Courtesy: HMN
Relating HIS Functional Elements to HIS Primary Engines (sub processes) Environmental Monitoring System Patient Management System Asset Management System Alert and Response System Knowledge Management System Census System Financial Management System Diagnostics Management System Requirements Disease Surveillance System Human Resources Management System Supply Chain Management System 24 Courtesy: HMN
25 Supply Chain Management System
Supply Chain Information System 26
General State of Health Information Systems Need for Interoperability and interoperable data standards Indicator-based Records Individual/Patient Records Lack of Reliable & Timely Data Exchange Registries Diagnostics/Images Records 27
ehealth 28
ehealth ehealth o Effective use of ICT to provide and support health service delivery Key Elements of ehealth o Policy, Infrastructure, Services, Standards, Governance, Protection 29
ehealthinnovation Areas -Examples o Electronic Medical Records o Electronic Health Records o Personal Health Records o Telemedicine (telehealth) o Electronic Medication Services o Health Knowledge Resources o Mobile Health o Mobile Health o Decision Support Systems o Chronic Disease Management Services o Patient, and Clinical management Systems, o Distance Learning for health Professionals (elearning) o Health Information Systems 30
Rapid Data Collection Efforts Surv eilla nce Logb ook Surveillance Tool Data Transfer Data Collection 31
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Transmitting digital images facilitate the interchange of information between digital imaging computer systems in medical environments Source: http://medical.nema.org/standard.html; Accessed August 6, 2012 35
Role of Multi-sectors in Strengthening ehealthsystem and Services 44
Dependencies of ehealthsystems & services ehealth data Use for Better Health Outcomes Stakeholder Alignment ehealth Governance ehealth Policy and Planning Need for Multi-sectoral Engagement ehealth Domain Experts Information & Communication Technology Human Resources for ehealth ehealth Financing 45
Multi-sectoral Engagement Examples of Partners within ehealth Landscape Ministry of Health Ministry of Finance Ministry of Education Ministry of Labor Ministry of ICT/Telecommunications Ministry of Infrastructure Private Health Sector Donors and Implementing Partners Coordination is essential to owning and sustaining Health Information Systems at National and Sub-national Levels 46
Alignment of ehealthstakeholders and existing strategies 47
Alignment of Stakeholders ehealth relevant stakeholders (stakeholder s positions vary depending on the model) Better Health Outcomes Value Chain of Solutions driven by Public Private Partnerships 48
Alignment of Strategies ehealth relevant strategies (strategies may vary depending on the country) Better Health Outcomes Value Chain of Solutions driven by Public Private Partnerships 49
Alignment of Efforts Health Science Health Impact ehealth Strategic Approach Effective Healthcare Delivery Human Capacity Sustainable Approach 50
Key Messages 51