1. The process of building a national eHealth strategy for Ukraine “ How do we get to where we want to be?” Clayton Hamilton Unit leader, eHealth and Innovation, WHO Regional Office for Europe eHealth development in Ukraine workshop 27 April, 2016

2. Key steps to creating a national eHealth strategy for Ukraine To move forward, we need to work together to: Start with a mutual understanding of “where we are now” Map a clear and pragmatic path from the current state of eHealth  the future state of eHealth by: 1.Agreeing on the eHealth vision expressed by the Ministry of Health 2.Developing an action plan (activities, resources, costs, responsibilities) 3.Monitoring and evaluating progress regularly 4.Proactively communicating what is being done

3. WHO-ITU National eHealth Strategy Toolkit A resource for developing or renewing a country’s eHealth strategy From countries just setting out to those that have already invested in eHealth A framework and method for the development of a vision, action plan and monitoring framework Available in several languages (free download): http://apps.who.int/iris/handle/10665/75211http://apps.who.int/iris/handle/10665/75211 (English, Russian, Arabic, Portuguese language versions) https://www.itu.int/pub/D-STR-E_HEALTH.05-2012 (English, Arabic, Chinese, French language versions) https://www.itu.int/pub/D-STR-E_HEALTH.05-2012

4. WHO-ITU National eHealth Strategy Toolkit – High level structure

5. Overview of the vision development process Understanding the contribution eHealth can have in the national context What elements of action/change are required and where

6. Establishing the strategic context for eHealth

7. Constructing an initial vision – linked to health goals Linking the eHealth outcome to the health goal (or challenge)

8. eHealth strategy components

9. Linking a service and application component (initiative) to an eHealth outcome Linking between components and desired outcomes

10. Expressing outcomes in terms of benefits for stakeholders

11. Applying an understanding of the existing environment & components

12. Steps for redefining the eHealth vision

13. The national action plan is based on groups of activities, or action lines, that provide a high- level view of the major areas of work The quality, cost and availability of resources (local or international) will affect the scope, timing and delivery of activities Phases and targets shape the feasibility of the plan and should be understood by stakeholders Framework for an action plan

14. Methodology for developing the action plan The process involves translating the vision and strategic recommendations developed in part 1 into concrete action lines (activities) within a well-structured and integrated plan, mapping out high-level resource requirements and applying funding constraints. From this, a plan - broken down into several implementation phases - will emerge.

15. Action LineExample characteristics Governance Develops coordination, visibility, structures and mechanisms to ensure accountability and effective leadership in place. Foundations eHealth components that secure national information exchange and/or are too risky or complex if done more locally, and cost-effective if done once at a national level. Solutions Deliver eHealth components that access, interact with and use national foundations and infrastructure to access and share information. Change and adoption Motivate and support the health system, establish incentives, and needed changes in work practices. Define main action lines

16. Methodology for developing the M&E Framework Involves the development of a number of indicators, their respective baselines and targets and a supporting governance process. Costs and resource allocation for monitoring and evaluation are proposed to be included as a part of the planning and costing of the national eHealth programme.

17. Define the process for national monitoring and evaluation

18. Many countries are using/have used it to greater or lesser extents. First (and lasting) impression of the toolkit is that it is an excellent source of knowledge but can be somewhat of an overwhelming quantity of information to digest. Is best leveraged through multi-stakeholder workshops and online communities of practice. Triggers national discussion and approaches that otherwise may not have happened in the development. Serves as a “best-practice checklist”. Use of the toolkit methodology is not a guarantee for success but can increase the credibility, quality and legitimacy of the process. The political, funding, institutional, process and change management issues still need to be appropriately addressed. Countries use and opinion of the WHO-ITU NeHS Toolkit

19. Some practical considerations and points of emphasis Linkage to National Health Goals and priorities is strongly recommended and provides credibility to the proposed strategic recommendation. Choice of language, length and technical complexity should be carefully considered. Often the strategy is used as an advocacy and communication tool - in addition to providing strategic direction. Intersectoral engagement (health, ICT, Social care, education, private sector, representative groups etc.) throughout the development process is really key and is often underestimated in importance. Patient engagement is a crucial factor for success (and arguably the most important). Strategic (re)alignment needs to be supported by a clear change management process (and people dedicated to managing the change).

20. A completed eHealth strategy is the point of departure, not the final destination. Implementing a strategy involves a great deal of change, some of which will be well- received, some of which will not. Most of all, this change needs to be well managed and well communicated. 20 Some final thoughts on the strategy development process

21. Thank you for your attention! http://www.euro.who.int http://www.who.int hamiltonc@who.int Twitter: @ClaytonHamilton #eHealthUkraine #е-здоров’я