1. Tokyo, Japan, 4-5 February 2013 Opportunities and Challenges for E-health – Vietnam, a case study Nguyen Quoc CUONG, Vice Director, VNPT Hanoi, cuongnq@vnpt.vn ITU Workshop on E-health services in low-resource settings: Requirements and ITU role (Tokyo, Japan, 4-5 February 2013)

2. Tokyo, Japan, 4-5 February 2013 2 Content Developing countries & E-health Vietnams characteristics Health & ICT in Vietnam VNPT & NTT cooperation

3. Tokyo, Japan, 4-5 February 2013 3 Developing countries World Bank: GNI per capita Low income$1,005 or less. Middle income$1,005 - $12,276 Lower middle$1,005 - $3975 Vietnam$1,160 E-Health Weak health systems & infrastructure, Shortage of health workers, Incomplete legal & regulatory framework Two facets: Public health & Healthcare

4. Tokyo, Japan, 4-5 February 2013 4 Vietnam - Characteristics VNLMI Urban population29%39% Adult literacy rate93%71% Health expd./ GDP6.9%4.4% Physicians/ 10K12.27.8 Nursing personnel10.115.1 Pharma. personnel3.24.3

5. Tokyo, Japan, 4-5 February 2013 5 Vietnam - Telecom Standing out !VNLMI Fixed phone subs.18.7%6.0% Fixed BB subs.4.13%1.04% Mobile phone subs.143%77.8% Mobile BB subs.14.71%*8%** H.hold w Int. 12.5%7.5% Ind.s using Int. 27.6%^ 13.5% *2011 figure, Vietnam MIC **Low and Middle income groups ^2011 figure: 34.05%

6. Tokyo, Japan, 4-5 February 2013 6 Health & ICT in Vietnam Government Plan for ICT in 2011-2015, established specific goals at different levels WAN, LAN and website development Internet access in health service offices E-learning in medical universities Standards adoption: ICD-10-CM, HL-7, DICOM etc. E-healthcare, HIS etc. Improvement of public health databases Many data missed in WHO Statistics

7. Tokyo, Japan, 4-5 February 2013 7 Health & ICT in Vietnam Hospitals & other health institution Mainly business processes and management systems Limited use of clinical applications: EHRs, order entry systems, decision support, pharmacy systems, etc. More importantly: little integration! Inside hospitals Between hospitals and government Between hospitals and social insurance

8. Tokyo, Japan, 4-5 February 2013 8 Health & ICT in Vietnam Hospitals ICT – an example 2000 beds, 3500+ out-patients/day 35 servers, 1200 workstations, no DC 17 separated softwares, developed by 7 companies No common patient ID system No interconnection b/w diagnosis, analysis, treatment, pharmacy… No acceptance from Social Insurance Authority for electronic records

9. Tokyo, Japan, 4-5 February 2013 9 Health & ICT in Vietnam Hospitals ICT – the visible outcome

10. Tokyo, Japan, 4-5 February 2013 10 VNPT & ICT for Health VNPT Flagship operator in Vietnam Fixed, mobile, value-added… services VNPT & MoH Agreement with MoH on promoting ICT application in the health sector Discount 25-50% on all services to all subscribers in health sector Join into projects at different levels and different fields

11. Tokyo, Japan, 4-5 February 2013 11 VNPT & NTT Cooperation Implemented in Hanoi area, by VNPT Hanoi NTT East / NTT Vietnam Public Health Introduction of NTT+VNPTs expertise & capability to local Health Service Office Healthcare Joint Study for e-Healthcare Service

12. Tokyo, Japan, 4-5 February 2013 12 Join Study for e-Healthcare Field trial: 06/08 – 31/10/12 Questionnaire Survey: 31/10-16/11/12 NTT EastNTT Vietnam VNPT Hanoi VNPT Direction Field Trial Users Healthcare Advisers Hanoi Medical University, Hospital of Post and Telecoms etc Trial Users 50 sets (200 IDs for the maximum) Health Advice FTTH VNPT Network Data Management System In Japan Automatic Graphing Blood pressure monitor Body composition monitor e Healthcare Service FTTH Implementation structureImplementation Image Relay Key Receiver Internet

13. Tokyo, Japan, 4-5 February 2013 13 Join Study for e-Healthcare Purpose: To confirm the demands for e-Healthcare service Measurement items: Body weight Body fat percentage Basal metabolism Physical age Estimated bone mass Number of steps Blood pressure-Pulse rate Visceral fat level

14. Tokyo, Japan, 4-5 February 2013 14 Join Study for e-Healthcare 98% care about something of their health

15. Tokyo, Japan, 4-5 February 2013 15 Join Study for e-Healthcare 98% want to get advice from professionals

16. Tokyo, Japan, 4-5 February 2013 16 Join Study for e-Healthcare Recognition of measures 88% can tell their health condition from blood pressure. Majority not familiar with the measures such as body age, body fat percentage and muscle mass. Blood pressure Body fat percentage Muscle mass Know Dont know Can perceive Cant perceive Blood sugar level Body weight Body fat percentage Do you know what the word means? Can you perceive your health condition from the measured data? 61 65 51 37 69 68 25 Body weight 90 High recognition Low recognition Blood sugar level Body age 63 Muscle mass 29 Blood pressure 88 Body age 25

17. Tokyo, Japan, 4-5 February 2013 17 Conclusions and Recommendations The following points can be either a challenge or an opportunity Government E-health awareness Necessary legal and regulatory framework National strategies and capacity building Integration of ICT into health systems

18. Tokyo, Japan, 4-5 February 2013 18 Conclusions and Recommendations Hospitals & other health institutions Transition/Integration of existing softwares to/into E-health systems First, do no harm" (primum non nocere) Balance between current load of work & involvement of E-health

19. Tokyo, Japan, 4-5 February 2013 19 Conclusions and Recommendations User High interests in health, especially in healthy diet, improvement of blood pressure and weight reduction Avoid complexity and inappropriateness to local needs Need familiarization of unfamiliar terms and indexes Reluctance in paying

20. Tokyo, Japan, 4-5 February 2013 20 Conclusions and Recommendations Technology Optical fiber and Mobile trends Health data integration and Coordination of health systems Responsiveness to local demand: Localization and Operability of the devices and web application

21. THANK YOU ! Tokyo, Japan, 4-5 February 2013 21