Presentation on theme: "Improving access to healthcare services by using information and telecommunication technologies. Improving access to healthcare services by using information."— Presentation transcript:
Improving access to healthcare services by using information and telecommunication technologies. Improving access to healthcare services by using information and telecommunication technologies. Information Session on « Digital Health for Rural Communities: Potential, Trends and Challenges » ITU, Geneva, 17 September 2010 Prof. Leonid Androuchko ITU-D Study Group 2, Q14-3/2: Telecommunications for e-Health International University in Geneva
Health and ITU What are the relations between Health and ITU? What is the role of ITU?
What is eHealth? (1) The advances in medical science, biomedical engineering on one side and information and telecommunication technology on the other side are offering today wide opportunities for improving access to and quality of health care.
What is eHealth? (2) eHealth is an umbrella term for health-related activities, services and systems, carried out over a distance by means of information and telecommunication technologies.
International Telecommunication Union(1) The introduction of eHealth services in developing countries requires multidisciplinary collaboration, with active participation of both sectors:telecommunications and health care.
International Telecommunication Union (2) ITU is active in the field of Telemedicine/eHealth from 1994, when developing countries during the time of the First World Telecommunication Development Conference in Argentina asked ITU to study this question from the angle of interest of developing countries. From 1994 there are two streams of ITU complimenting activities: ITU/BDT Development Programs, ITU-Development Sector Study Group
International Telecommunication Union (3) From 1994 till 2010, ITU implemented a lot of pilot projects, missions, conferences and seminars in developing countries in order to demonstrate potential benefit of eHealth/telemedicine services and disseminate information on how to improve access to medical services for people living in rural areas. Resolution 41 of ITU World Telecommunication Development Conference, which took place in 2002 in Istanbul, Turkey, recommended to all countries to create national eHealth Committees or Task Forces for such cooperation and coordination.
WHO The World Health Assembly in May 2005 officially recognized eHealth and adopted Resolution WHA establishing eHealth Strategy for the World Health Organization.
ITU, WTDC 2010 Hyderabad,India Resolution (COM3/5) was approved on « Improving access to healthcare services by using information and communication technologies ».
ITU-D Study Group 2, Q-14 The main goal of the study is how to assist developing countries in the introduction of eHealth services and solutions, covering the technical part. This is the unique international study group in the ITU-D SG2, Q14 dealing with needs of developing countries.
How healthcare service in rural areas could be improved? eHealth or Telemedicine is the one practical solution which exists today. Access to healthcare services could be provided via telecommunication networks: fixed terrestrial network, mobile network, satellite network.
International Telecommunication Union Experience demonstrates that there is no single solution that will work in all settings. The complexity of technologies and the complexity of needs and demands of healthcare suggests the gradual introduction, testing and refining of new technologies.
Mobile telecommunication in developing countries The number of mobile phones in many developing countries is drastically increased during the last five years offering technical platform for many mobile eHealth services to be organized.
Mobile network coverage in selected countries (ITU, 2007) Combodia 87%, Gambia 85%, Guinea 80%, Kenya 77%, Pakistan 90%, Rwanda 90%, Senegal 85%, Togo 85%, Uganda 80%, Zimbabwe 75%.
Comparison of mobile and fixed phones (Source – ITU)
Mobile networks in selected developing countries (Source – ITU )
Mobile eHealth in rural areas There are two solutions: Mobile phone can be used for management and consultations related to medical services. Mobile eHealth care clinics/units traveling in rural areas from one village to another and connected to nearby hospital by wireless communication for consultations.
ITU-D Study Group 2, Q-14 It was decided to prepare the questionnaire and ask the opinion of medical staff in developing countries about Telemedicine and eHealth. It was also a question asking participants about their view with regard to the implementation of eHealth services.
ITU-D Study Group 2, Q-14 The study was done in the following countries: Pakistan, Uganda, Bhutan, Sri Lanka, Saudi Arabia and recently in Mongolia.
How developing countries are informed about eHealth? (1) The health care administrations in developing counreies are not well informed about potential benefit of eHealth services.
How developing countries are informed about eHealth? (2) The Telemedicine Group of ITU-D SG 2 made a study among medical staff in five countries and found the following level of information: Pakistan-61%, Mexico-18%, Uganda-73%, Bhutan-31% and Malaysia-66%. This average level is still low.
ITU-D Study Group 2, Q-14 In favor of eHealth services Uganda – 96.6% Pakistan – 86.5% Bhutan – 87.5% Sri Lanka – 81% Saudi Arabia – 90.7% Mongolia – 77%
What is it nesessary to speed up the implementation?
Why eHealth services are not implemented? Main obstacles : Lack of Government policy Lack of the knowledge about eHealth successful projects Lack of training at all levels
ITU Strategies for e-Health Provide tools for the development of national e-health strategies 1. Advance the establishment of ICT infrastructure 3. Promote cooperation among relevant stakeholders 4. Facilitate information exchange
1. Advancing ICT Infrastructure Connecting the unconnected remains a challenge: 27 High speed broadband connectivity, needed for key e-health applications, is expensive or unavailable High speed broadband connectivity, needed for key e-health applications, is expensive or unavailable Insufficient local content Traditional business models often do not support the needed investment Traditional business models often do not support the needed investment Few trained people in the required technologies
Wireless Broadband Initiative 28 Objective : Ambitious ITU initiative to expand broadband access in underserved areas of Africa ITUs initiative: ITU is working with governments and other partners Expected outcomes : Develop and deploy wireless networks Guarantee capacity for schools and hospitals Train local experts and build human capacity Develop ICT Applications: e-health, e-education, e-government
2. Providing Tools 29 Methodology to assess actual Health System Status, Needs and Action Priorities An integrated Action Framework covering: Infrastructure, Applications, Financing, Governance, Legal and policy, Human Capacity, Information quality Guidance on how to set eHealth targets, benefits and Key Performance Indicators Practical guidelines for the development of national e-Health strategies will developed in collaboration with WHO and the World Bank in 2010 The Guidelines for National e-Health Strategies :
Providing Tools (cont.) 30 Survey some of the major Tele-health initiatives in India comprising basic information about activities and infrastructure Practical guidelines to map e-Health infrastructure to desired outcomes G rouping of activities across care cycle within various services Map of Activities and diseases being addressed by those activities, correlated to corresponding infrastructure being utilized M ap the gaps between the desired and existing facilities as evidenced by some of the efforts Provide insights in terms of infrastructure planning for eHealth.
3. Promoting Cooperation 31 The introduction of e-Health applications requires multidisciplinary collaboration The introduction of e-Health applications requires multidisciplinary collaboration All countries to create national e-Health committees or Task Forces for cooperation and coordination All countries to create national e-Health committees or Task Forces for cooperation and coordination ITU facilitates the establishment of public-private partnerships ITU facilitates the establishment of public-private partnerships Based on Resolution 41 World Telecommunication Development Conference (Istanbul, 2002) Based on Resolution 41 World Telecommunication Development Conference (Istanbul, 2002)
32 Harness digital health care solutions for scaling up Interventions in even the most resource poor settings. Map the current state of play in this field ITU is co-chairing the DHI, a u nique, multi-stakeholder collaboration between the ICT and healthcare sectors : Develop an economic model for policy-makers and practitioners Cooperation: Digital Initiative (DHI) Put in place a partnership platform for fast and high impact country-specific projects of regional importance Put in place a partnership platform for fast and high impact country-specific projects of regional importance
33 ITU-D SG 2 Question 14-2/2: Telecommunications for e-Health ITU-T SG 16 Question 28/16: Multimedia Framework for e-Health Applications Study Groups (SG) dedicated to e-Health related issues : ITU-T SG 17 Question 9/17: Telebiometrics These Study Group Questions bring together ITU diverse members (government, industry, academics, other stakeholders) to lead the work (studies, recommendations, best practices) on diverse aspects of e-Health Cooperation: ITU Study Groups on e-Health
34 Mobile phones can be integrated into a computer system to create an integrated health care information system mHealth technology for rural areas can also include mobile healthcare units Goal: Promote the coordinated introduction of cost-effective mHealth applications in developing countries ITU Study Group 2, Q14 is discussing with members of industry and Research organizations to assit developing countries introducing mHealth solutions: Cooperation : SG2/Q14-2/2 m-Health support Provide tailored support to developing countries to transfer knowledge, build local capacities, implement feasibility studies and support elaboration of project proposals to deploy large-scale, simple and cost-effective mobile solutions for Health
35 Mobile clinics & Portable eHealth terminals Mobile Health Information Services Telemedicine services in remote areas (Telediagnostics, Teleconsultations, Telecare, etc.) Health Education (Health awareness campaigns, tips, quizzes, games, etc.) Health Data gathering (surveys, disease surveillance, research trials, etc.) Training for Health Workers Remote Patient Management & Monitoring (helpline, alerts, reminders, access to patient record, history, medication plan, tracking, Remote sensors, etc.) Dignostics and Treatment Decision Support Systems (2 ways SMS,, DSS software) Emergency Telemedicine services Cooperation :SG2/Q14-2/2 m-Health support
Remaining Challenges 36 Problems achieving interoperable e-Health applications and standardization Need for improved evidence of the economic and social benefits of e-Health Many pilots for e-Health projects exist, but scalability is an issue Improved communication between telecom and health sectors
37 Conclusions (1) The telecommunication and health care sectors have to work together in developing national e-Health strategies The telecommunication and health care sectors have to work together in developing national e-Health strategies Developing countries urgently need a strategic document – eHealth Master Plan and a Roadmap Successful e-Health services require commitment to promote national strategies and facilitate capacity building Successful e-Health services require commitment to promote national strategies and facilitate capacity building
Conclusion 2 Effective governance of eHealth requires codes, regulations, and standards to ensure satisfactions of the consumers. Issues include legal liability, ethical standards, privacy protection, and cultural and social standards.
Additional Resources ITU statistical database of ICT indicators per country and region (www.itu.int/ITU-D/ict/index.html)www.itu.int/ITU-D/ict/index.html Expert aid in drafting and implementing national e-Health projects (www.itu.int/ITU-D/projects/index.html)www.itu.int/ITU-D/projects/index.html Training opportunities (www.itu.int/ITU-D/hrd/tc/index.asp)www.itu.int/ITU-D/hrd/tc/index.asp Policy and regulatory reports and symposia (www.itu.int/ITU-D/treg/index.html)www.itu.int/ITU-D/treg/index.html Regional office in Addis Ababa to support Member States in Africa (www.itu.int/ITU-D/afr/CMS/index.asp)www.itu.int/ITU-D/afr/CMS/index.asp 39
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