Developing eHealth Strategy for India Need of the hour

1
Developing eHealth Strategy for IndiaNeed of the
hour

• Prof. S. K. Mishra, MS, FACS
• Dept. of Endocrine Surgery
• School of Telemedicine Biomedical Informatics
• SGPGIMS, Lucknow

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Agenda

• Introduction
• Need and Justification of developing ehealth
  policy
• Global Scenario
• Indian Scenario
• Standardization of IT infrastructure of health
• National Task Force
• WHO/ITU National Strategy Toolkit

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Introduction

• eHealth an important tool having potiental in
  achieving the goal of health for all.
• eHealth reduces healthcare cost
• ehealth expanded services to un-served region
• eHealth needs to be integrated in healthcare
  system both in practical and policy sense

Source Telehealth policy Looking for global
commentaryRichart E Scott et. al. J.
Telemedicine and Telecare 2002 8 (suppl. 3)
s3.55-57
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eHealth Policy

• eHealth policy is concerned with solutions that
  support capacity building and provide services
  that improve health outcomes.
• It is a set of statements, directives,
  regulations, laws, and judicial interpretations
  that direct and manage the life cycle of eHealth
• Socio-economic, financial cultural,
  Institutional conditions, Human and material
  resources, Organizational and managerial models
  defines policy boundaries

Source Telehealth policy Looking for global
commentaryRichart E Scott et. al. J.
Telemedicine and Telecare 2002 8 (suppl. 3)
s3.55-57
5
Need and Justification of developing ehealth
policy

• Advances in ICT continue to outpace the
  development of supportive policies,
  infrastructure user acceptance of eHealth
• Successful pilot projects have not translated
  into adoption in health system
• Government expenditure and business rules are
  dictated through policies
• Industry growth is heavily dependent on
  government policy
• Barriers like Interoperability, legal, security
  ethical issues can only be addressed by a set of
  rules and standards at national level
• Need of development of National eHealth Policy in
  Global Context

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Status of eHealth around the world
Source http//www.who.int/goe/publications/goe_te
lemedicine_2010.pdf
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Policy Document

• Malaysia 1997 Telemedicine Act1
• Malaysia 2000 Telehealth policy statement
• Well defined e-health policy or clear policy
  activity Australia, Canada, China, Croatia,
  Denmark, Finland, Iran, Malaysia, Malta, New
  Zealand, Russia, Singapore, South Korea, Sweden,
  Taiwan, Tanzania, Thailand, UK, USA and Vietnam
  etc.2

1. http//unpan1.un.org/intradoc/groups/public/doc
uments/APCITY/UNPAN025631.pdf 2. Source
Telehealth policy Looking for global
commentaryRichart E Scott et. al. J.
Telemedicine and Telecare 2002 8 (suppl. 3)
s3.55-57
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Adoption of eHealth policy
Source http//www.who.int/goe/publications/goe_te
lemedicine_2010.pdf
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The Rockefeller Foundation

• The initiative would improve the quality,
  equity, and cost-effectiveness of health care in
  the "Global South"a term for developing
  countries.
• It would do this by using information and
  communication technologies (ICT) to improve and
  expand diagnostic, treatment, preventive, and
  monitoring capabilities, as well as user
  awareness and access.

Source www.ehealth-connection.org/
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PAHO Pan African Health Organisation
Argentina takes steps in establishing a national
eHealth Strategy

• Experts from the Ministry of Health of Argentina,
  Hospital Italiano and universities, among others,
  stressed the need to establish an eHealth plan
  for the country, during a meeting organized by
  the Pan American Health Organization in Buenos
  Aires.
• The discussion highlighted the need of eHealth
  experts in the nation and public policies that
  support the sustainability and viability of
  projects, such as the creation of a unique
  electronic medical records and telemedicine.

Source http//new.paho.org/index.php
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UGANDA eHealth Policy

• Widely consultative and participatory with
  involvement of all stakeholders to ensure
  ownership, shared responsibility successful
  implementation.
• Provides a framework for eHealth implementation
  by all stakeholders in collaboration with other
  Sectors
• eHealth is in line with existing policies eg
  Poverty Eradication Action Plan (PEAP), National
  health Policy, Health Sector strategic Plan I
  II and National ICT policy

http//www.who.int/workforcealliance/forum/SBW_eHE
ALTH20POLICY20AND20eLEARNING.pdf
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COCIR eHealth Toolkit for an accelerated
deployment and better use of eHealth

• European Coordination Committee of the
  Radiological, Electromedical and Healthcare IT
  Industry
• In 2007, COCIR developed 10 recommendations to
  accelerate the deployment of eHealth
• Three priorities for deployment
• Develop an innovative sustainable business model
• Foster standards and interoperability
• Enable market development

Source http//www.cocir.org
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National E-Health Strategy Australia's Policy
Source www.ahmac.gov.au
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CUBA

• National health telematics network - INFOMED
  (www.sld.cu)
• Building a National eHealth Capacity Additional
  eHealth applications already functioning include
  specialized networks in nephrology, intensive
  care, cardiology, and pharmacies, and there is a
  growing electronic publishing capacity.
• Future applications include a national health
  economy management system and a hospital-level
  management system (digital diagnostic results,
  inventories, accounting, etc.)

Source www.medicc.org/mediccreview/articles/mr_42
.pdf
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WHO/ITU eHealth Strategy Toolkit
Source www.who.int/entity/ehealth/brochure.pdf
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WHO-ITU effort to support National e-Health
Roadmaps

• The health care, telecommunication and finance
  sectors have to work together in developing
  national e-Health strategies.
• Develop resource materials building on relative
  competencies of each of the two organisations.
• Deploy approaches to support the development of
  new national eHealth strategies or the update of
  existing plans to reflect experience or emerging
  challenges in the domain of eHealth.
• Approaches will ensure country ownership of the
  process and therefore sustainability

Source http//www.itu.int/ITU-D/cyb/events/2011/T
elecom11/e-health/Presentations /tuesday1-20WHOI
TU20eHealth20National20Strategy20Toolkit.pdf
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National eHealth Strategy ToolKit

• Methodology to assess actual Health System
  Status, Needs and Action Priorities
• An integrated Action Framework covering
  Infrastructure, Applications, Funding,
• Governance, Legal and policy, Workforce,
  Standards and interoperability, etc.
• Guidance on how to set eHealth targets, benefits
  and Performance Indicators

Source http//www.itu.int/ITU-D/cyb/events/2011/T
elecom11/e-health/Presentations /tuesday1-20WHOI
TU20eHealth20National20Strategy20Toolkit.pdf
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eHealth Policy Issues

• Policy Objectives
• Coordination and Collaboration,
• Connectivity and Infra-structure,
• Human Resource Development,
• Content
• Provision of Health Information and Services
• Financing Mechanism and Sustainability
• Research
• Organizational Structures Institutional Framework
• Expected Cost and Benefits of the Policy
• Monitoring and evaluation

Source http//www.itu.int/ITU-D/cyb/events/2011/T
elecom11/e-health/Presentations /tuesday1-20WHOI
TU20eHealth20National20Strategy20Toolkit.pdf
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Global Elements

• Network
• Inter-Jurisdictional Practice
• Diffusion of ehealth addressing the digital
  divide
• Integration into existing system
• Handling innovation at different levels
• Policy Goal Setting
• Evaluation Research
• Investment
• Ethical Issues

Scope of Policy Issues for eHealth Results from
a Structured Review Shariq Khoja et. al.
Bellagio, Italy, July 13-Aug, 8, 2008 source
www.ehealth-connect.org
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Planning for eHealth Policy Success

• Global eHealth Convention
• eHealth Policy Toolkit
• eHealth Education
• National eHealth Councils
• Stake Holders

Source ww.who.int/ehealth
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eHealth Challenges -I

• Coordination is not easy due to fragmented donor
  driven projects leading to duplication, equipment
  incompatibility
• Integration of ICT into budgets of the service
  delivery programs in the health system affecting
  sustainability
• Connectivity available even in remote areas but
  very expensive.
• Hardware like computers limited.

Source http//www.who.int/workforcealliance/forum
/SBW_eHEALTH20POLICY20AND20eLEARNING.pdf
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eHealth Challenges - II

• Very few ICT professionals/Technicians to
  maintain equipment and support/ train the users.
• Inadequate band width and irregular power supply
  or lack of it.
• Regulatory framework to ensure confidentiality
  and win the trust of patients
• Embracing ICT is a process of cultural
  transformation which takes place very slowly

Source http//www.who.int/workforcealliance/forum
/SBW_eHEALTH20POLICY20AND20eLEARNING.pdf
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National Resource Center
School of Telemedicine Biomedical
Informatics, Lucknow, India

• Thank You
• Contact skmishra_1956_at_yahoo.com

www.sgpgi-telemedicine.org www.nrct.in
www.stbmi.ac.in