world health organization may 28, 08...improved access wider coverage ehealth focus of health...
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World Health Organization May 28, 08
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eHealth MIE 2008 Goteborg, Sweden
eHealth: WHO vision and priorities
S. Yunkap Kwankam
Coordinator eHealth
World Health Organization, Geneva
eHealth MIE 2008 Goteborg, Sweden
Outline of presentation
Six point agenda and health system framework
WHO eHealth priorities
eHealth challenges
WHO collaboration mechanisms
Conclusion
eHealth MIE 2008 Goteborg, Sweden
WHO has a six point agenda for addressing gaps and improving public health
Goal
Accelerate development
Foster health security
Strengthen health systems
Harness research, info & evidence
Enhance partnerships
Improve performance
Description
Bring life-saving and health-promoting interventions to the poorest of the poor
Improve health security for all especially as it relates to emerging and epidemic-prone diseases
Focus on capacity building, financing, systems for collecting vital statistics, and access to appropriate technology including drugs
Generate authoritative health info, define standards, articulate evidence-based policy options & monitor evolving global heath situation
Build partnerships with UN agencies and other international organizations, donors, civil society and the private sector
Continually improve effectiveness of WHO initiatives and staff
Fundamental health needs
Strategic needs
Operational approaches
Overall effectiveness of effort measured by impact on women’s health and health in Africa
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eHealth MIE 2008 Goteborg, Sweden
eHealth MIE 2008 Goteborg, Sweden
Access to health information
HINARI
Norms and standards Legal and ethical issues
Global Observatory for eHealth
ICT for health promotion ICT for health workforce development ICT for service delivery
PPP for ICT R&D for health
Health Academy
Global eHealth survey 2005
SNOMED
TCP
XML
HL7 v2.51
IP
HTTP
WHR 2006 eLearning Kenya
eHealth MIE 2008 Goteborg, Sweden
HINARI
111 partners 4,200 journals
2,500 institutions
108 countries $2.5m / subscription
$7bn value
World Health Organization May 28, 08
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eHealth MIE 2008 Goteborg, Sweden
Health needs drive developments in ICT
Developments in ICT help shape health systems and service delivery
Health promotion Disease prevention Diagnosis & treatment Rehabilitative care Education & training HS performance
Bioinformatics Artificial Intelligence Mobile computing Improved access Wider coverage
eHealth MIE 2008 Goteborg, Sweden
Focus of health investment should be on improving sector productivity, cannot just increase funding
The most effective way to improve productivity is to improve health systems
Source: Nicholas C. Petris Center on Health Care Markets & Consumer Welfare (UC Berkeley), WHO, A Handbook of Cultural Economics (James Heilbrun)
Baumol's cost disease: Labor intensive services, such as health care, face productivity lag - cannot substitute capital for labor as efficiently as the general economy, so the cost of producing them goes up faster than general inflation
5 ways to improve productivity: 1) Increase capital per worker 2) Improved technology 3) Increased labor skill 4) Better management 5) Economies of scale as output rises
Healthcare is an inefficient sector, can improve productivity through technology
Level of HC spending is a function of GDP/capita regardless of external funding
Hea
lth s
pend
per
cap
ita (2
005)
GDP PPP per capita (2005)
R2 = 0.94
eHealth MIE 2008 Goteborg, Sweden
Countries with a critical shortage of health service providers (doctors, nurses and midwives)
eHealth MIE 2008 Goteborg, Sweden
Distribution of health workers by level of health expenditure and burden of disease, by WHO region
eHealth MIE 2008 Goteborg, Sweden
Decision support: preliminary results from a phased implementation planned for the Map of Medicine in Africa
Prof. S. Yunkap Kwankam1
Fatima Sanz de Leon1
Craig Rhodes2
Jon Conibear 2
Pam Nicklin2
1= World Health Organization, Geneva
2= Hearst Corp (Informa), UK eHealth MIE 2008 Goteborg, Sweden
What is the Map of Medicine?
A web-based visual representation of evidence-based patient care journeys
Covers 28 medical specialties
Contains 393 pathways
Used to support clinicians; not to replace clinical judgement
World Health Organization May 28, 08
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eHealth MIE 2008 Goteborg, Sweden
Malaria Pathway
eHealth MIE 2008 Goteborg, Sweden
Mobile Map
A trial of the Mobile Map in 2007 had already proved very popular with Kijabe Hospital Kenya
The Map of Medicine on PDA was recommended by participants in the Kenya pilot
eHealth MIE 2008 Goteborg, Sweden
Positive feedback
“The Map of Medicine is a comprehensive, concise and user friendly synthesis of best research evidence and evidence based clinical guidelines. It is a one stop clinical resource for clinical decision making and continuing professional development” Paediatrician Dr. Christy Okoromah
Very useful even in the context of a developing country set up as where I practice and teach interns and students
Has been a useful teaching aid
I can find my information very quickly
eHealth MIE 2008 Goteborg, Sweden
Where people get their health care (USA)
1000 persons
800 report symptoms
<1 is hospitalized in an AMC
Green LA, Fryer GE, Yawn BP, Lanier D, Dovey SM. NEJ M 344:26 2001
327 consider seeking medical care
8 are hospitalized
13 visit an emergency dept.
14 receive home health care
21 visit hospital OP clinic
217 visit physician’s office; 113 of them primary care
65 visit complimentary care or alternative med care
eHealth MIE 2008 Goteborg, Sweden eHealth MIE 2008 Goteborg, Sweden
Bringing together technology, health information, and education for the benefit of human development
Investing in people, especially the younger generation
World Health Organization May 28, 08
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eHealth MIE 2008 Goteborg, Sweden
Pilot Jordan 21 schools
Fighting for our lives
Safely on our way
All the way to the blood bank
Egypt 24 schools
Fighting for our lives
Safely on our way
4,152 students – 35% male, 65% female
12-17 years old
1 male mentor, 1 female mentor per school
eHealth MIE 2008 Goteborg, Sweden
Global Observatory for eHealth (GOe)
Report
• Report distributed to 192 Member States and affiliated organizations
• Paper, disc, and web versions widely available • However interviews indicate report not widely read
due to need for greater promotion (e.g. through associations)
Survey
• 112 countries responded to extensive questionnaire
• Acquired detailed national data on existing foundation and enabling policies and strategies and eHealth applications
• Have heard that process of completing survey was a catalyst for bringing stakeholders together and fostering discussion and debate 10 additional countries
included in profiles 112 countries responded
eHealth MIE 2008 Goteborg, Sweden
The value of knowledge in health
A century of unprecedented health gains
Life Expectancy at Birth over the Centuries
eHealth MIE 2008 Goteborg, Sweden
© G l o b a l P r o g r a m m e o n E v i d e n c e f o r H e a l t h P o l i c y
L e g e n d 2 9 . 5 - 3 7 . 3 3 7 . 4 - 4 3 . 2 4 3 . 3 - 4 9 . 3 4 9 . 4 - 5 4 . 3 5 4 . 4 - 5 7 . 7 5 7 . 8 - 6 0 . 3 6 0 . 4 - 6 3 . 4 6 3 . 5 - 6 7 . 8 6 7 . 9 - 7 3 . 8 N o D a t a
H e a l t h y l i f e e x p e c t a n c y a t b i r t h , b o t h s e x e s
W H O 2 0 0 1 . A l l r i g h t s r e s e r v e d T h e b o u n d a r i e s a n d n a m e s s h o w n a n d t h e d e s i g n a t i o n s u s e d o n t h i s m a p d o n o t i m p l y t h e e x p r e s s i o n o f a n y o p i n i o n w h a t s o e v e r o n t h e p a r t o f t h e W o r l d H e a l t h O r g a n i z a t i o n c o n c e r n i n g t h e l e g a l s t a t u s o f a n y c o u n t r y , t e r r i t o r y , c i t y o r a r e a o r o f i t s a u t h o r i t i e s , o r c o n c e r n i n g t h e d e l i m i t a t i o n o f i t s f r o n t i e r s o r b o u n d a r i e s . D o t t e d l i n e s o n m a p s r e p r e s e n t a p p r o x i m a t e b o r d e r l i n e s f o r w h i c h t h e r e m a y n o t y e t b e f u l l a g r e e m e n t .
eHealth MIE 2008 Goteborg, Sweden
11 million children under-5 yrs old die every year-90% of them in the developing world
2/3 of these deaths (7 m) can be prevented by available, effective and cheap interventions
The growing know-do gap
Jones et al, Lancet 2003, 362:65-71
eHealth MIE 2008 Goteborg, Sweden
Just too much of it and not always what you need
Multiple parallel demands
Information goes up and never comes down
Key consumers of information not being served:
– Policy makers – Health Managers – Service Providers – General public
Drowning in data
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eHealth MIE 2008 Goteborg, Sweden
Exponential growth in information
UC Berkley, 2003 eHealth MIE 2008 Goteborg, Sweden
eHealth MIE 2008 Goteborg, Sweden
The Digital Divide - where digital information is created
eHealth MIE 2008 Goteborg, Sweden
The Digital Divide: Information flows
eHealth MIE 2008 Goteborg, Sweden
Sanitation coverage
eHealth MIE 2008 Goteborg, Sweden
An early model of partnerships in health The Second World Health Assembly (1949) laid down the policy (followed since then) that WHO should not consider the establishment, under its own auspices, of research institutions. Instead, it was agreed that research in the field of health is best advanced by coordinating and making use of existing institutions.
Thus, the concept of WHO Collaborating Centre (WHOCC) was developed.
Definition: the WHOCCs are institutions designated by the Director-General to carry out activities in support of the Organization's programmes at the country, regional and global levels.
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eHealth MIE 2008 Goteborg, Sweden
What are WHO Collaborating Centres? Most of these institutions are universities, research laboratories,
parts of scientific academies or MoH, and hospitals
eHealth MIE 2008 Goteborg, Sweden
Currently there are 930 WHOCCs in 99 Member States
eHealth MIE 2008 Goteborg, Sweden
Number of WHO collaborating centers by Region
This economic cost is particularly difficult for poorer countries to bear
eHealth MIE 2008 Goteborg, Sweden
WHO Collaborating Centers by country
eHealth MIE 2008 Goteborg, Sweden
Number of Collaborating Centers by Subject
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Ways of working: Networks
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In January 2000 the Executive Board encouraged WHO CCs to develop working relations with other centres by setting up or joining collaborative networks with WHO’s support
World Health Organization May 28, 08
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eHealth MIE 2008 Goteborg, Sweden
The RF eHealth global initiative Develop and promote a global eHealth agenda - strategies to address common policy, organizational, technical, legal, financing and sustainability challenges identified through conference track and keynote sessions;
Promote the importance of interoperability and open, standards-based platforms to donors, countries and technology companies
Catalyze the formation of new collaborations around thematic areas and explore establishment of national platforms and a self-sustaining global eHealth coalition.
Summer Bellagio series July 14-Aug 8, 2008
eHealth MIE 2008 Goteborg, Sweden
Conclusion Promoting a global vision and local insights
Human resources are key
o People, processes and technology
Partnerships are the model
Major opportunities for collaboration
eHealth MIE 2008 Goteborg, Sweden
Global Health ICT Spend USD74B
39
USA; $28
Europe; $14
Rest of World; $31
Source:IDC2007
2008 ICT Spend (M’s) United States $27,834 Rest of World $17,195 Japan $6,641 United Kingdom $5,351 Germany $4,518 France $4,515 Australia $1,980 PR China $1,771 Canada $1,327 Korea $956 India $363 New Zealand $303 Malaysia $215 Singapore $209 Thailand $209 Indonesia $88 Philippines $69 Vietnam $46 Grand Total $73,590
eHealth MIE 2008 Goteborg, Sweden
A Pierre de Fermat – like conjecture
an + bn = cn
€1 invested in eHealth = 1 DALY saved?
eHealth MIE 2008 Goteborg, Sweden
THANK YOU [email protected]