What is eHealth infrastructure and why should we invest in it? ADB Brown Bag Presentation June 17, 2015 Derek Ritz, P.Eng., CPHIMS-CA

Disclaimer: The views expressed in this paper/presentation are the views of the author

and do not necessarily reflect the views or policies of the Asian Development Bank

(ADB), or its Board of Governors, or the governments they represent. ADB does not

guarantee the accuracy of the data included in this paper and accepts no responsibility

for any consequence of their use. Terminology used may not necessarily be consistent

with ADB official terms.

Overview

Who is your presenter?

What is eHealth infrastructure?

How does eHealth impact upon population health?

Where are there examples of this working?

Why is eHealth infrastructure a strategic investment for the bank and why now?

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Introductions

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What is eHealth infrastructure?

Lets answer using a storytelling approach. This story is about Mosa

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VCT Clinic

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Disease-specific Program

VCT Clinic

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Disease-specific Program

VCT Clinic

This is an example of an eHealth point of service (POS) application.

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Disease-specific Program

Faith-based Initiative

VCT Clinic

CHW in the Village

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Disease-specific Program

Faith-based Initiative

VCT Clinic

CHW in the Village

This is an example of an mHealth point of service (POS) application.

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Disease-specific Program

Faith-based Initiative

Regional MOH

Initiative

VCT Clinic

CHW in the Village

District Clinic

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Disease-specific Program

Faith-based Initiative

Regional MOH

Initiative

VCT Clinic

CHW in the Village

District Clinic

Information silos.

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Disease-specific Program

Faith-based Initiative

Regional MOH

Initiative

eHealth Infrastructure

VCT Clinic

CHW in the Village

District Clinic

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Disease-specific Program

Faith-based Initiative

Regional MOH

Initiative

eHealth Infrastructure

VCT Clinic

CHW in the Village

District Clinic

Coordinated service delivery Two-way information flow Continuity of person-centred care

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Disease-specific Program

Faith-based Initiative

Regional MOH

Initiative

eHealth Infrastructure

VCT Clinic

CHW in the Village

District Clinic

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Disease-specific Program

Faith-based Initiative

Regional MOH

Initiative

eHealth Infrastructure

VCT Clinic

CHW in the Village

District Clinic

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Disease-specific Program

Faith-based Initiative

Regional MOH

Initiative

VCT Clinic

CHW in the Village

District Clinic

https://ohie.org/

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How does eHealth impact upon

population health?

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eHealth Infrastructure

Modify SOP

eHealth Transactional

Data

Financial, Management &

Population Health Indicators

Standard Operating

Procedures

SOP-based Interventions

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eHealth Infrastructure

Modify SOP

eHealth Transactional

Data

Financial, Management &

Population Health Indicators

Standard Operating

Procedures

SOP-based Interventions

Operationalize guideline-based care

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eHealth Infrastructure

Modify SOP

eHealth Transactional

Data

Financial, Management &

Population Health Indicators

Standard Operating

Procedures

SOP-based Interventions

Support Care Continuity

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eHealth Infrastructure

Modify SOP

eHealth Transactional

Data

Financial, Management &

Population Health Indicators

Standard Operating

Procedures

SOP-based Interventions

Provide Management Metrics

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eHealth Infrastructure

Modify SOP

eHealth Transactional

Data

Financial, Management &

Population Health Indicators

Standard Operating

Procedures

SOP-based Interventions

Generate Population Indicators

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eHealth Infrastructure

Modify SOP

eHealth Transactional

Data

Financial, Management &

Population Health Indicators

Standard Operating

Procedures

SOP-based Interventions

Support Continuous Improvement

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Where is eHealth infrastructure

making a difference?

Better Immunization Data (BID)

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Led by PATH and funded by the Bill & Melinda Gates Foundation, the Better Immunization Data (BID) Initiative is grounded in the belief that better data, plus better decisions, will lead to better health outcomes.

Its vision is to empower countries to enhance immunization and overall health service delivery through improved data collection, quality, and use.

Better Immunization Data (BID)

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Better Immunization Data (BID)

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Tanzanian National Immunization Registry

Better Immunization Data (BID)

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Arusha Region 1.7M population ~260 immunization clinics ~55,000 babies born annually Rollout started beginning of May!

Tanzania 57M population

~6600 immunization clinics ~2M babies born annually

Go-live 2016

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What is BIDs core workflow?

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~10% of clinics, ~50% of immunizations

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Registering new children in GIIS.

Logging childs arrival at the clinic.

Recording weights; providing counseling; managing vaccination workflow.

Administering vaccines.

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~90% of clinics, ~50% of immunizations

Monthly exchange of scan-able paper registers.

Daily execution of paper-based

workflows.

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What is the ICT architecture for

BID TZ?

44 A

PI

SMS

HTTP/S

HTTP/S HTTP/S

45 A

PI

SMS

HTTP/S

HTTP/S HTTP/S

PIX PDQm

*mACM

PIX PDQm CSD XDS.b *ADX

*ADX

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Why should ADB invest in eHealth?

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ADB Operational Plan for Health, 2015-2020

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A common, standards-based, national-scale eHealth infrastructure should support both care delivery and financial payments workflows as well as produce the analytics necessary to monitor and manage these.

http://jln1.pressbooks.com/

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UHC

National ID

CRVS

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Regional eHealth Interoperability Lab

MEDIC 2007

2010

2016

Interoperability Lab

Mitigate investment risk on national-scale m/eHealth infrastructure deployments

Support capacity-building in health ICT

Act as a catalyst for innovation by the public and private sector actors in national care delivery networks.

Provide 4Ts: Teaming, Training, Tooling, Testing

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ADBs eHealth agenda

Now is the right time for ADB to move forward with smart eHealth infrastructure investments Improve DMC ability to execute health production

function

Support key strategic objectives such as UHC and CRVS

Unlock trapped value in existing m/eHealth initiatives

Mitigate investment risk by supporting regional public good (interop lab)

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Thank You!