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Technology for Health, or for Healthcare ? by Yunkap Kwankam

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Yunkap Kwankam, Executive Director,
ISfTeH, Switzerland

Published in: Healthcare
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Technology for Health, or for Healthcare ? by Yunkap Kwankam

  1. 1. Going Digital and to Scale: Prof. S. Yunkap Kwankam, PhD Executive Director, International Society for Telemedicine and eHealth (ISfTeH) CEO, Global eHealth Consultants, Switzerland Addressing the Digital Health Grand Challenges
  2. 2. Outline Digital health priority action areas – not much change in a decade Benefits of digital health well understood – but benefits limited by critical factors: review of Digital Health Grand Challenges Examples of scale limitations - application areas and enabling actions Scale effects: application areas and enabling actions Suggestions for a way forward Conclusions
  3. 3. WHO eHealth priority actin areas (2006) ! " # $ % & ' ( )* " + , - )& ' ( $ , ' * $ . " % & / / " ' * , - )& ' ( . & , * / , 0 $ 1 & + $ 2 " 3" / " * )% )' " ! " # $ !% &' ( ) &!* + ' , &$ - % $ !. ' / / ' + 0 !1 ' 2 !3+ + ' 4 ) " 3' + 0 !3+ ! # $ ) &" # 5!6 !7 89 : 6 8!; < = 9 >?@9 ; A!6 B C!DB 9 E 8< C 7 < !>F 6 ; ?B 7 != 86 G 9 ; H ! rity mHealth application areas (W H O ’06)   • eLearning • MOOCs • BCC • Rapid SMS • EHR/PHR • HIS • Telemedicine modalities • DSS Service delivery Access to info Workforce Dev. Health promotion Priority mH ealth enabling actions (W H O •SDOs •Interoperability •IHE; C.A. •MAMA, ZMD •ZMD •Who? •What? •Where? •Lessons •Legal issues •Ethical considerations •Policies •Strategies Policy & Regulatory Environment Business Inteligence Norms & Stds; Interop. PPPs, ICT R&D for Health Application areas Enabling actions
  4. 4. The Digital Health Landscape ICT – the third pillar of the health care industry http://medcitynews.com/2014/08/often-consumers-use-digital-health-tools-graph-will- show/
  5. 5. Creating knowledge commons for Digital Health Going to scale with Digital Health interventions – commensurate with the scale of problems Creating integrated eHealth systems Transforming all health workers into ePractitioners ICT to support health production ICT for the health system of the future Digital Health Grand Challenges
  6. 6. Going to scale with digital health What to scale – the need for evidence How to scale – the need for information and knowledge sharing (The Global Knowledge Commons)
  7. 7. Examples of scale limitations Most glaring hurdles are in information intensive digital health applications – HIS; EMR/EHR – adoption by some but not others Health facilities Health districts Build resistance to digital health adoption – the equivalent of MDR-or XDR-TB
  8. 8. Framework 1: ADA white paper
  9. 9. Framework 2: PMNCH workbook Purpose inter-alia to: Identify obstacles to scale-up Guide exchange of ideas 12 specific mHealth applications and 9 themes structured to guide the dialog
  10. 10. Framework 3: ITU process Purpose: Propose a six-step process for scaling eHealth interventions in step with advances in ICT developments. Scalinge-Health Servicesin step with ICTTransformation Mappingclient platform and connectivity requirementsof ane-Health system Method: This study has adopted the methodology suggested in (17) and customized it as illustrated in flowchart of figure (1). Initially, several real-life scenarios in preventive, curative and palliative care delivery was surveyed covering 26 major e-health initiatives from a mix of private, government and NGO organizations addressing over 200000 patients across India. These e-health networks aggregated the skills and facilities of primary, secondary and tertiary care from rural villages and urban cities, from several thousands of entities (hospitals, clinics, diagnostic labs, insurance claims administrators, medical colleges, call centres, pharmacies, etc.,) across India. India was chosen for its wide spectrum of technological, economic, social, linguistic and cultural diversity and number of pioneering initiatives already underway (18). From their publications, site visits and in some cases interviews with the staff, various usage models and infrastructure at the point-of-care were studied to identify adoption pattern of connectivity and end-user platform technologies in their activities (for details refer (19)). FIGURE1: Stepsused in thisstudy Survey Health care initiatives and identify care activities Identify possible transactions within such activities Categorize nature of information exchange events within transactions Map user platform & communication requirements for information events Group information events with similar requirements in various transactions Remap and group information events as a function of infrastructure
  11. 11. Regulatory interoperability Issues of mutual recognition and fee waiver for cross-jurisdictional practice in states within a country Legal instruments for cross-border activities among countries, such as in the European single market All WHO member countries – 194 18,721 separate bilateral agreements, or 1,198,144 tri-lateral agreements, or 1 all-party accord Examples: IHR-2005; Framework convention on Tobacco
  12. 12. Dimensions of the GKC Who is doing what, where; how well is it working; what can we learn and what can we use from it?
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
  14. 14. First decade-and-a-half of the 21st century has seen major advances in digital health At policy level In national programs Technological advances – with industry rediscovering health as a market Local capacity for digital health in countries Conclusions - 1
  15. 15. Conclusions - 2 To further consolidate gains and plan for the future, we must 1. Focus on the big picture Emphasis on overall economic development. Paradigm shift. ICT4H  ICT4D 2. Strategic and Tactical Creation of pull structures for sustainability Emphasis on health and wellbeing Address the Digital Health Grand Challenges, especially the GKC for Digital Health innovation ! "#$%&'&( )"*+,&-+. -"/"%0)&%1++ + 2 $30+#3%+4"+5&%"+0&+. -"/"%0+. "&. '"+*6,,"-)%( +,-&7 +#$-&%)#+#&%5)0)&%*+,-& 5"/"'&. )%( +'&%( 80"-7 +#&7 . ')#30)&%*9+ + 2 $30+#3%+4"+5&%"+0&+. -"/"%0+0$&*"+. "&. '"+,-&7 +5"/"'&. )%( +#$-&%)#+ #&%5)0)&%*+)%+0$"+,)-*0+. '3#"9+ + : )*#6**1+ • 0"#$%&'&( )"*+4"$)%5+. -"/"%030)/"+#3-" o ; -)7 3-<+. -"/"%0)&% o ="#&%53-<+. -"/"%0)&% o !"-0)3-<+. -"/"%0)&% • 4"*0+. -3#0)#"*+>+*<*0"7 *+0$30+#3. 06-"+. $"%&0<. "+5303 o -"0)%&( -3. $<?+. 3-0)#6'3-'<+,&-+5)34"0)#* o 2 "3-34'"+"'"#0-&%)#*+3%5+@&5<+A-"3+B"0C &-D*+E@AB*F ! eHealth Corps eHealth Steering Committee eHealth Center/Network of Excellence - Resource Ctr National eHealth Council ! ! ! ! National eHealth Society ! ! ! The GeHCs-ISfTeH Framework
  16. 16. Thank You 16 ykwankam@gehcs.com ykwankam@isfteh.net

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