ITU Telecommunication Development Bureau ICT Applica-tions E-health ITU ICT Applications Strategies and Resources Presentation ICT Applications and Cybersecurity Division International Telecommunication Union UN Specialized Agency in Charge of ICTs www.itu.int/itu-d/cyb/e-health

e-Applications: A Priority for Development The ITU Plenipotentiary Conference 2010 in Guadalajara, Mexico adopted a new Resolution that calls on ITU to give priority consideration to the expansion of telecommunication/ICT initiatives for e-health. (Resolution PP-183, Guadalajara, 2010) A new Resolution on e-health was also adopted in 2010 at the World Telecommunication Development Conference on Improving access to healthcare services by using information and communication technologies. (Resolution WTDC-65, Hyderabad, 2010) A new Resolution on e-government was also adopted in 2010 at the World Telecommunication Development Conference on More effective adoption of e-government services (Resolution WTDC-74, Hyderabad, 2010) Electrnic health (e-health) is : ITU-D’s ICT Applications and Cybersecurity Division has responsibility for implementation of Programme 3: Identified e-health, e-government and e-environment as the three priority domains for the ICT applications area

Facilitating national e-health planning A “National e-Health Strategy toolkit” was Developed that consists of a methodology and set of resources to guide country decision makers to develop their national e-Health strategy and roadmap. The toolkit will be made available March 2012 The toolkit will be followed by rollout activities to disseminate it and to work with countries towards having a national approach to using ICT for Health. 3

Documenting new ICT Applications M-Government Published a report with OECD on “Mobile Government for responsive governments and connected society” The report documents the use mobile technologies to enhance government’s performance, improve public service delivery, and engage citizens and civil society organizations in policy and decision making both in developed and developing countries, The report is available at: http://www.itu.int/ITU-D/cyb/app/m-gov.html . 4

Commission on Information and Accountability for Women and Children’s health ITU co-vice-chaired the Commission’s on Information and Accountability for Women and Children’s health that was set up by UN SG to propose a framework for global reporting, oversight and accountability on women's and children's health. ITU in collaboration with WHO provided a background paper on Information and Communication Technology’s contribution to accountability for women’s and children’s health and the role that ICT could play to enhance accountability for resources and results to fulfil MDG 4 and 5. The paper is available: http://www.everywomaneverychild.org/images/content/files/accountability_commission/ICT_for_Accountability.pdf ITU is also involved in the implementation of the work plan set by the Commission 5

Facilitating e-health infrastructure planning A report entitled Scaling e-Health services in step with ICT transformation was published to provide guidance to e-Health planners on which e-Health services can be deployed immediately with available infrastructure and which additional services can be added as the infrastructure is transformed. The report is available at: http://www.itu.int/ITU-D/cyb/app/e-health.html The scoping study: -Provides an initial outline of a general methodology for implementing ICTs in health -Aims to help developing countries avoid costly errors -Intends to enhance the efficiency of health systems and ultimately support the sustainable and effective use of such services 6

Facilitating e-health Standardization ITU’s Standardization Sector has released a Technology Watch Report that looks to the future of e-health. The report observes that e-health development will require more universal e-health interoperability standards, and strategies to overcome technical infrastructure barriers and address privacy, security, and other legal requirements. The report is available: http://www.itu.int/en/ITU-T/techwatch/Pages/ehealth-standards.aspx The scoping study: -Provides an initial outline of a general methodology for implementing ICTs in health -Aims to help developing countries avoid costly errors -Intends to enhance the efficiency of health systems and ultimately support the sustainable and effective use of such services 7

Facilitating e-health Standardization ITU Standardization and Development sectors are planning to strengthen their work on eHealth Standardization in collaboration with WHO and other international organizations. Some activities are already planned such as an international workshop on eHealth Standardization to take place around next April 2012. 8

Wireless Broadband Initiative ITU and WHO have been working together with the ICT industry on the African Health Infoway (AHI), as part of ITU’s Wireless Broadband Initiative. WHO will coordinate the development and installation of computer systems, while ITU facilitates the deployment of infrastructure in countries in collaboration with national telecommunication carriers, and other technology 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 We are launching an ambitious initiative to expand broadband access in Africa Each partner has an important role to play: Industry will develop networks, allocating some capacity for public use Governments will handle permits, licenses, policy and regulation And, ITU will assist countries with project management, capacity building 9

Technical countries assistance Conducted a “Country Assessment and Feasibility study” in Nepal to identify potential scalable and sustainable Mobile e-Health (mHealth) services for improved health outcomes from 25th April-7th May 2011. 3 concept notes were proposed for possible mHealth projects The scoping study: -Provides an initial outline of a general methodology for implementing ICTs in health -Aims to help developing countries avoid costly errors -Intends to enhance the efficiency of health systems and ultimately support the sustainable and effective use of such services 10

Facilitating e-health Information Sharing ITU co-organized with WHO an e-Health Pavilion during the ITU World Telecom 25-27 October 2011 where there was a very dynamic set of showcases and side talks from around the world The agenda and presentations are available: http://www.itu.int/ITU-D/cyb/events/2011/Telecom11/e-health/index.phtml 11

Facilitating e-health information sharing ITU organized many events about ICT Applications: Forum on Health Information Systems (HIS) jointly organized by ITU, USAID, WHO, DFID, NORAD in Manila, Philippines, 13-16 June 2011, Regional meeting on e-Health for Asia Pacific region in Tokyo, Japan that was hosted by the Ministry of Internal Affairs and Communications (MIC), 10-11 March 2011, WSIS C7 Facilitation meeting on e-Health held on the 18th May 2011 in Geneva Asia-Pacific Regional Forum on ICT Applications was held on 18-21 May 2011 in Bangkok, Thailand. The scoping study: -Provides an initial outline of a general methodology for implementing ICTs in health -Aims to help developing countries avoid costly errors -Intends to enhance the efficiency of health systems and ultimately support the sustainable and effective use of such services 12

Remaining Challenges Need for improved evidence of the economic and social benefits of e-Health Problems achieving interoperable e-Health applications Many pilots for e-Health projects exist, but scalability is an issue Improved communication between telecom and health sectors eHealth could make a huge contribution to maternal and child health and even immunization; but the message has not been accepted so far. 13

Conclusions/Key messages The introduction of e-Health applications requires multidisciplinary collaboration and the telecommunication and healthcare sectors have to work together Successful e-Health services require commitment to promote national strategies and facilitate capacity building Developing countries urgently need a strategic document – eHealth Master Plan and a Roadmap The telecommunication and health care sectors have to work together in developing national e-Health strategies Successful e-Health services require more than just technology: Committed policymakers who promote national strategies and facilitate capacity building are essential for the e-Health system to work in practice. Developing countries can not speed up the implementation of badly needed eHealth services without close cooperation with telecom sector. Developing countries urgently need a strategic document – eHealth Master Plan ITU-D is ready to assist its Member State in strengthening their in e-Health capacity to increase the impact and effectiveness of their investment in this field.

Enhanced Collaboration in Europe Region European Regional Initiative on E-Applications, Including E-Health (m-Health) Concept Presentation E-Applications E-Health M-Health Presentation Europe Coordination Unit and ICT Applications Division International Telecommunication Union www.itu.int/itu-d/eur www.itu.int/itu-d/cyb/e-health

European Regional Initiatives WTDC-10 Resolution 17 (Rev. Hyderabad, 2010) E-accessibility in Central and Eastern Europe (Internet and digital television) for blind people and people with visual impairment problems Digital broadcasting ICT applications, including e-health Standardized Process for Implementation Identification of the challenge at the RPM level WTDC decision on regional initiative Background Material Consultative Meeting Proposal of Project Document Feedback of Membership Implementation of Project

M-Health: Emerging Challenges Technology and Business Regulation and Policy Technical feasibility Standardization Interoperability, scalability Ubiquitous health services Nomad access, mobile voice, data National, regional, international Cloud computing ICT and Healthcare ecosystems User acceptance and demand New models for healthcare Reimbursement models Liability Service providers, network or infrastructure operators, manufacturers Policy makers and regulators: Telecom vs. Health regulation Definition of medical device certification, quality assurance Security and privacy issues Medical confidentiality Data protection and retention AAA: Authorization and authentication, accounting Universal service obligation Ubiquitous healthcare service

ITU Europe Regional Initiative on E-applications, including E-health Focus: Europe Region (43 Countries) Objective: To share best practices in the implementation of e-applications, including e-health. Expected results : Faster and easier storage of, transmission of and access to medical data and health-related information for healthcare providers and professionals, citizens/patients, academics, researchers, policy-makers and others Capacity building and improved delivery of healthcare services, particularly in rural and remote areas Reduction of operational and administrative costs in implementing healthcare services

Proposed Way Forward for 2012 Preliminary Web Research on e-Health and m-Health in Europe Track One Track Two Technology and Business Concept Paper Legal and Regulatory Issues Fundraising Partnership Building Increased Participation and Scale up of Activities Elaboration of the Project Document Background Paper Technology and Business Background Paper Legal and regulation ITU Experts Group Meeting of Regional Initiative for Europe on ICT Applications, in particular e-Health: m-Health: Towards Care, Cure and Prevention (25-26 September, Geneva) Workshop Report and Publication Review of the Project Document

Phase Two: Towards Concrete Deliverables and Impact Comprehensive report on m-health with two tracks E-Repository of m-health case studies Regulatory and policy assessment kit Twinning programme for transfer of knowledge Direct assistance to countries European Member States and other Stakeholders

Thank you very much for your attention! EURregion@itu.int Europe Coordination Unit, BDT (EUR) International Telecommunication Union www.itu.int/itu-d/eur ehealth@itu.int ICT Applications Division, BDT International Telecommunication Union www.itu.int/itu-d/cyb

Additional Resources ITU statistical database of ICT indicators per country and region (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) Training opportunities (www.itu.int/ITU-D/hrd/tc/index.asp) Policy and regulatory reports and symposia (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) eHealth could make a huge contribution to maternal and child health and even immunization; but the message has not been accepted so far. 22

Thank You! For more information on ITU’s ICT Applications Activities visit the website at: www.itu.int/ITU-D/cyb/app/index.html or contact cybmail@itu.int 23