Synthesis/Summary of Week’s Discussion on Building eHealth Capacity Bill Hersh (with copy and paste from others)

Given eHealth is essential for global health in the 21 st century Technology must be appropriate and contextual, which is not synonymous with “old” Information is care

New (key) principles Informatics is essential to health and economic development Need technology, human, and leadership capacity To develop capacity, need informatics leadership and training and development of regional centers of excellence Must make case to policy and political leaders and get buy-in of health care professionals Need not only training, but training the trainer Need forum for expertise to assemble political, business, health care, and technology leaders Must adhere to standards, best practices, and avoidance of siloed systems

Other emerging ideas Informatics is a means to an end, not an end in itself. Capacity building should be needs driven. A menu of common needs can be built up to assist countries in their eHealth capacity building strategies. There are different levels/types of informatics training required for different roles/positions. A list of Informatics Profiles should be built up with their corresponding competencies, training needs and resources available for the training. A National eHealth Assessment Methodology should be developed to allow a country to work through their needs & profiles to come up with a viable National eHealth Roadmap. Eventually this methodology could be embodied in a tool, e.g., a National eHealth Wizard (NEW). Leadership and advocacy are vital, and exposure to informatics concepts is key to building the necessary support amongst policy makers, "influentials" and change agents. Regional Informatics Centres of Excellence could provide sustained informatics activities to continue to drive eHealth developments.

Commissioned papers Educating the Health Informatics Workforce in the Global South by Judy Ozbolt, PhD, RN Determining Health Informatics Workforce Needs in Developing Economies by William Hersh et al. Developing Partnerships by William Tierney et al.

Educating the Health Informatics Workforce Environmental scan – already models of success –RAFT project in French-speaking African countries –10x10 translation in Latin America We must learn from and build on known successes

Determining Health Informatics Workforce Needs Training is one of the bottlenecks for clinical systems implementation Some topics mentioned were: competencies required by the workforce, number of trained people needed (which is related to the degree of development of information systems IMIA Working group on Education (WG1) recommendations, issued in year 2000, are being updated this year

Developing Partnerships Information is care Implementing eHealth → making (often radical) changes in systems of health care Partners → enlightened self-interest Eyes on the prize → long-term partnerships Build local capacity → avoid dependence Publicize and build on successful programs, methods, approaches, etc. Collaborate among countries, partnerships Be satisfied with small successes

Case studies Heard from diverse locations –South Africa –Turkey –Peru –Vietnam –Brazil

Lessons from case studies Need national policy and leadership Must have adequate infrastructure and awareness of eHealth “South” can become innovation leader due to lack of legacy systems and ability to leapfrog

2020 An educational program (meta-curriculum) –Scalable, adaptable/agile (to local conditions), affordable A set of educational resources –Portal to resources –A repository of resources A framework to develop local educational material (Wiki like approach) –Tool for the creation/adaptation/delivery of curricula A network /consortium –Academic sites –National/regional informatics associations (AMIA / IMIA, etc.) –Private/public organizations A permanent set of discussed cases –Including successes and failures (how the amino-acid have been combined) to create useful educational material

)Topic-specific short courses & modules (“Amino acids,“ “Bits and bytes”) 2)Introductory informatics courses for clinicians (similar to 10x10) 3)Higher-level informatics courses (Masters, PhD, etc) 20:20 Consortium (AMIA, IMIA, universities, others) Local Experts Financial & technical support Support for courses could include resources, curriculae, technical consultation, case studies and others Support for local experts could include support for communities of practice (national and regional organizations), faculty (e.g salary support, professional development, fellowships, grants), support for institutions (libraries, infrastructure, etc)

Financing – proper business model is essential Financing at a consortium level on a recurrent basis –Look also to Education, SciTech, Finance ministries To sponsor scholarships/fellowship (at an individual or group level) For Faculty time/course material production and updating to –develop materials or curricula –run courses To translate/localize the educational materials

Technology Human Capital Policy Hierarchy of needs

Moving forward From silos to systems Human as well as technology capacity Learning from past experience and mistakes Being evidence-driven Building research into operations to improve above Prioritizing local ownership and leadership, empowered by expertise from international leaders and organizations