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!
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