World Health Organization May 28, 08...Improved access Wider coverage eHealth Focus of health...

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


Outline of presentation

Six point agenda and health system framework

WHO eHealth priorities

eHealth challenges

WHO collaboration mechanisms

Conclusion


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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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


HINARI

111 partners 4,200 journals

2,500 institutions

108 countries $2.5m / subscription

$7bn value


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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


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


Countries with a critical shortage of health service providers (doctors, nurses and midwives)


Distribution of health workers by level of health expenditure and burden of disease, by WHO region


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


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Malaria Pathway


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


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


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


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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


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


The value of knowledge in health

A century of unprecedented health gains

Life Expectancy at Birth over the Centuries


© 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 .


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


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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Exponential growth in information

UC Berkley, 2003 eHealth MIE 2008 Goteborg, Sweden


The Digital Divide - where digital information is created


The Digital Divide: Information flows


Sanitation coverage


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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What are WHO Collaborating Centres? Most of these institutions are universities, research laboratories,

parts of scientific academies or MoH, and hospitals


Currently there are 930 WHOCCs in 99 Member States


Number of WHO collaborating centers by Region

This economic cost is particularly difficult for poorer countries to bear


WHO Collaborating Centers by country


Number of Collaborating Centers by Subject


Ways of working: Networks

CC

CC CC

CC C

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CC

CC

CC

CC

CC

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CC CC

CC C

C

CC

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CC

CC

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


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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


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


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


A Pierre de Fermat – like conjecture

an + bn = cn

€1 invested in eHealth = 1 DALY saved?


THANK YOU [email protected]

World Health Organization May 28, 08...Improved access Wider coverage eHealth Focus of health...

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