Download - eHealth Tools Services WHO
-
8/6/2019 eHealth Tools Services WHO
1/36
Report of the WHO Global Observatory for eHealth
Needs of the Member States
TOOLS&SERVICESeHealth
-
8/6/2019 eHealth Tools Services WHO
2/36
World Health Organization 2006
All rights reserved. Publications o the World Health Organization can be obtained rom WHO Press, WHealth Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 3264; ax: +41 22 791 4857; e
[email protected]). Requests or permission to reproduce or translate WHO publications whether or sale
noncommercial distribution should be addressed to WHO Press, at the above address (ax: +41 22 791 4806; e
The designations employed and the presentation o the material in this publication do not imply the expressany opinion whatsoever on the part o the World Health Organization concerning the legal status o any co
territory, city or area or o its authorities, or concerning the delimitation o its rontiers or boundaries. Dotted
on maps represent approximate border lines or which there may not yet be ull agreement.
The mention o specic companies or o certain manuacturers products does not imply that they are endors
recommended by the World Health Organization in preerence to others o a similar nature that are not menti
Errors and omissions excepted, the names o proprietary products are distinguished by initial capital letters.
All reasonable precautions have been taken by the World Health Organization to veriy the inormation cont
in this publication. However, the published material is being distributed without warranty o any kind, either exor implied. The responsibility or the interpretation and use o the material lies with the reader. In no event sh
World Health Organization be liable or damages ar ising rom its use.
All photographs are copyright o WHO.
Printed in Switzerland
-
8/6/2019 eHealth Tools Services WHO
3/36
Report of the WHO Global Observatory for eHealth
Needs of the Member States
TOOLS&SERVICESeHealth
WHO/EHL/06
-
8/6/2019 eHealth Tools Services WHO
4/36
AcknowledgementsSincere thanks are due to the hundreds o eHealth experts in over 90 countries world-wide
have helped shape this report by sharing their knowledge through completing the rst gl
survey on eHealth.
Special thanks or their guidance and vision are due to:
Yunkap Kwankam
Ariel Pablos-Mendes
The undertaking o the survey required considerable
coordination at the regional and national levels.
WHO regional coordinators played a vital role in
this process as well as in contributing their regional
perspective to help develop the survey instrument.
Thanks are due to:
Yok-Ching Chong
Angela Dunbar
Francois Fortier
P.T. Jayawickramarajah
Emmanuel Nkakoumoussou
Ezekiel Nukuro
Soe Nyunt-U
Abel Packer
Oana Roman
Reijo Salmelar
Grard Schmets
Najeeb Al ShorbajiSangay Thinley
Richard Van West-Charles
Tejbir Walia
This report was prepared by the WHO Global
Observatory or eHealth by:
Misha Kay
Maryo Olesen-Gratama van Andel
Kaarina Klint (consultant)
Clive Tristram (consultant)
Sta at WHO headquarters provided support idesign o the survey instrument as well as tech
input in their areas o expertise. Thanks are due
Barbara Aronson
Christopher Black
Philippe Boucher
Pascale Broisin
Can Celik
Somnath Chatterji
Chrissie Chitsulo
Robert Constandse
Raphal Crettaz
Joan Dzenowagis
Steeve Ebener
Jean-Claude Healy
Chandika Indikadahena
Iciar Jauregui Larizgoitia
Nirmala Naidoo
Alena Petrakova
Thomson Prentice
Ftima Sanz de Len
Tevfk Bedirhan Ustun
Special thanks to:
Fabrice Girardot, Eric Maroni and Franck Vasserot o
Mondoragilis Network or the design and layout and t
Lashley or technical editing.
-
8/6/2019 eHealth Tools Services WHO
5/36
Contents
Executive summary 2
Key fndings 3
Proposed action 3
First global survey on eHealth 4
Introduction 4
Global Observatory or eHealth 5
Survey process 6
Data analysis 8
Results 10
Responses 10
Data summary 11
eHealth tools 13
eHealth services 21
Recommendations 27
Key fndings 27
Conclusion 28
Proposed action 29
Annex 30
List o Member States by WHO regional distribution 30
p
p
p
p
p
p
p
p
p
p
p
p
p
p
-
8/6/2019 eHealth Tools Services WHO
6/36
Executive summaryThe Global Observatory or eHealth (GOe) was established by the World Health Organiza
(WHO) in 2005. As its initial task it carried out the rst global survey on eHealth. The su
covered seven key themes in the eHealth domain and one o these is the subject o this re
The ull survey results will be published in the Annual Report o the Global Observator
eHealth in May 2006.
This report summarizes the needs or eHealth tools and services o the WHO Member St
and their expectations rom the WHO Secretariat as expressed in the survey. It is targete
policy makers, eHealth practitioners, researchers and academics.
1
WHO emergency response
team member collecting
surveillance data and
transmitting it to
headquarters ater thedevastating earthquake in
Pakistan in October 2005.
-
8/6/2019 eHealth Tools Services WHO
7/36
Key findings
The survey ound that:
active involvement o WHO in the development o generic eHealth tools, and guidance
in creating and implementing eHealth services would be welcomed by Member States;
the need or guidance in a broad range o eHealth areas was expressed in particular by
countries that do not belong to the Organisation or Economic Co-operation and Devel-opment (OECD);
OECD countries did not express consistent views o their needs in eHealth areas; and
there is a need to raise awareness as to what eHealth tools and services already exist at
global and national levels.
Proposed action
It is thereore recommended that WHO, in collaboration with public and private sector partners,
should take action in the ollowing key areas:
Provision of generic tools
WHO should acilitate the development o those generic eHealth tools most sought ater byits Member States including:
tools or monitoring and evaluation o eHealth services;
drug registries;
institutional patient centred inormation systems that could be extended to include
electronic health record systems; and
directories o health care proessionals and institutions.
Access to existing tools
As a parallel and complementary action, electronic directories o existing eHealth tools and
services should be created with an emphasis on open source solutions.
Facilitating knowledge exchange
An international knowledge exchange network to share practical experiences on the
application and impact o eHealth initiatives should be built. This would be Internet based
and could be complemented by international eHealth conerences to acilitate networking.
Providing eHealth information
WHO should create a digital resource o eHealth inormation to support the needs o Member
States in key areas such as eHealth policy, strategy, security and legal issues.
Education
The use o eLearning programmes or proessional education should be promoted in the
health sciences as well as in ongoing proessional development. Collaborations should be
developed to generate databases o existing eLearning courses. WHO should advocate or the
inclusion o eHealth courses within university curricula.
1 For statistical reasons, responding countries were grouped by OECD/non-OECD membership.http://www.oecd.org
p
p
p
p
p
p
p
p
p
p
-
8/6/2019 eHealth Tools Services WHO
8/36
First global survey on eHealt
Introduction
At its Fity-eighth Session in May 2005, the World Health Assembly (WHA) adopted resolu
WHA58.28 establishing an eHealth Strategy or the World Health Organization. The resoluurged Member States to plan or appropriate eHealth services in their countries. It
recognized that a WHO eHealth strategy would serve as a basis or WHOs activities in eHe
and requested the Director-General to submit to the 117th Session o the Executive Bo
(EB) an action plan, including budgetary implications, aimed at the use o eHealth tools
services or implementation by Member States.
eHealth, the use o inormation and communication technologies (ICT) or health, is on
the most rapidly growing areas in health today. However, limited systematic research
been carried out to inorm eHealth policy and practice. It is or this reason that WHO, thro
its newly created Global Observatory or eHealth (GOe), undertook a world-wide surve
eHealth. The ndings provide an important rst measure o eHealth capacity in Member Stas well as their current and most important needs. With this global picture, these data w
used or comparison with those o urther studies. They will also help WHO tailor its sup
and guidance to match the immediate needs o its Member States in the area o eHealth
p
-
8/6/2019 eHealth Tools Services WHO
9/36
All WHO Member States were strongly encouraged to participate in the survey. At the time
o printing, 93 countries had responded, which represents a response rate o 48%. The GOe
secretariat was encouraged by the response rate, especially given it was the rst survey o its
kind, and the short time rame in which it was conducted. It is anticipated that the response
rate to uture surveys will increase signicantly over the next three years as the GOe raises its
international prole and urther develops its collaboration with Member States.
Global Observatory for eHealth
Established in early 2005, the GOe is a signicant new WHO initiative; it reects the Organizations
recognition o the emerging importance o the use o ICT or health systems and services.
The Observatorys mission is to improve health by providing Member States with strategic
inormation and guidance on eective practices, policies and standards in eHealth. Its
objectives are to:
provide timely and high-quality evidence and inormation to help national governments
and international bodies improve policy, practice and management o eHealth services;
raise awareness and commitment o governments and the private sector to invest in,and advance, eHealth;
collect, analyse and distil eHealth-related knowledge, which will signicantly contribute
to the improvement o health using ICT; and
disseminate research ndings through publication o the GOe Annual Report on key
eHealth research topics as a reerence or governments and policy-makers as well as
theme-based reports on special topics.
The GOe operates within the eHealth unit o the Department o Knowledge Management and
Sharing (KMS) at WHO in Geneva. As a networked, decentralized operation, membership o the
secretariat includes at least one coordinator rom all six WHO regions and three sta members
rom headquarters. Fiteen experts at headquarters have been invited to contribute to various
tasks o the GOe through working groups. Project planning and implementation occurs mainly
through regular teleconerences to ensure active involvement o all WHO regions.
Operations and collaborations began expanding in mid-2005 to include research centres,
national and regional eHealth observatories and other operationally signicant partners
across the globe. A Strategic Advisory Group o Experts (SAGE) was created and consists o
international eHealth experts in industry, research elds, academia and practice. This group
will provide ongoing high-level strategic guidance to the Observatory.
2 The Annual Report o the GOe will contain all country responses including those received ater the publicationo this report.
p
p
p
p
p
-
8/6/2019 eHealth Tools Services WHO
10/36
Survey process
As this was the rst survey o the Global Observatory or eHealth, and indeed the rst W
global survey on eHealth, it ocused on issues relating to processes and outcomes in
eHealth action lines previously identied by the World Summit on the Inormation Soc
(WSIS) and supported by the WHO.
The survey instrument was developed in collaboration with eHealth proessionals rom
WHO regional ofces and headquarters, Geneva. It was piloted in Jordan and the Democ
Republic o the Congo, beore being circulated globally.
It aimed to:
describe and analyse eHealth proles in countries, regions and internationally;
identiy and evaluate measures taken in key action areas to support the developmen
eHealth in countries; and
establish the useulness o WHO providing generic eHealth tools and services or Me
ber States.
The survey covered the ollowing seven themes:
Theme Action
Enabling environment Create an enabling environment or the development o eHealththrough policy.
Inrastructure Develop inrastructure in a health context.
Content Provide access or health proessionals and the community to dighealth content.
Cultural and linguistic diversity Produce and disseminate multicultural digital health content.
Capacity Build ICT knowledge and skills in the health sector.
National centres or eHealth Expand the eHealth international network.eHealth systems and services Query and respond to Member States requirements or eHealth t
and services.
Table 1. Survey th
The survey was carried out in six stages, which are described in Table 2. Surveys w
completed at country level by teams o three to ve key inormants, although some coun
selected up to ten experts to contribute. Survey meetings were held so that the quest
could be discussed and answered by all inormants. Where there were dierences o opi
the survey acilitator would request that the group reach a consensus. Meetings lasted o
eight hours.
The survey instrument, guidelines and glossary o survey and eHealth terms were provide
the six ofcial United Nations (UN) languages.
3 http://www.itu.int/wsis/
p
p
p
p
-
8/6/2019 eHealth Tools Services WHO
11/36
Stage Activity Comments
GOe headquartersdistributed surveysand brieed regionalcoordinators.
Regional coordinators provided with translated survey instruments,procedures and timelines.
Country coordinators
brieed.
WHO regional coordinators worked directly with country coordinators
and liaison ocers to advise them o the process; survey materialsprovided.
Country coordinatorsselected keyinormants and sentsurvey materials.
Country coordinators given guidelines to assist with the selection okey inormants.(In some countries it did not prove dicult to fnd appropriate experts.In others, particularly where eHealth is not yet advanced, it was morechallenging.)
Inormants conductedresearch prior to takingthe survey.
Inormants given two weeks to conduct the background researchrequired to complete the survey.
Survey meetings held. Key inormants met in countries; meetings lasted between our hoursand one day.
Sessions acilitated by administrator.Endorsement by WHO representative or designated ocer requiredbeore survey returned to WHO or quality control and to ensure thatspecifed survey guidelines were met.
Completed surveysreturned to WHO.
responses were received by the time o publication.
Table 2. GOe survey process
Scientist studying
malaria mosquito an
transmitting data to othe
laboratories in Tunisia
5
-
8/6/2019 eHealth Tools Services WHO
12/36
Data analysis
The inormation contained in this report is based on the country responses to the ollow
questions on eHealth tools and services:
Please rate the ollowing list oeHealth tools on the basis o how useul they would b
WHO could oer generic prototypes or adaptation by your country.
Electronic Health Records (eHR)
Patient Inormation Systems (PIS)
Hospital inormation Systems (HIS)
General Practitioner Inormation Systems (GPIS)
National electronic registries
National drug registries
Directories o healthcare proessionals and institutions
Decision Support Systems (DSS)
Telehealth
Geographical Inormation Systems (GIS)
Other, please speciy
p
p
p
p
p
p
p
p
p
p
p
Which o the ollowing eHealth services does your country require rom WHO and plea
grade their useulness.
Advice on national needs assessment or eHealth
Advice on eHealth policy and strategy
Advice on methods or monitoring and evaluation o eHealth services
Inormation on eective/best eHealth practices
Advice on eHealth norms and standards
Inormation on trends and developments in eHealthAdvice on eLearning programmes
Advice on human resources development or eHealth
Other, please speciy
p
p
p
p
p
p
p
p
p
Data rom the completed surveys were processed on a question-by-question and countr
country basis. Additional secondary data were obtained rom sources such as WHO He
Systems Financing, World Bank, United Nations Conerence on Trade and Developm
(UNCTAD) and OECD to investigate correlations based on internationally recogn
parameters. In order to establish a basis or analysis, correlations were made between
responses and various country characteristics. These included GDP per capita, the UNCICT Diusion Index, and membership in OECD. It was decided to group countries accordin
OECD/non-OECD membership as this provided the clearest separation to the responses
allowed or meaningul statistical analysis.
p
-
8/6/2019 eHealth Tools Services WHO
13/36
The analysis below ollows the structure and sequence o the questionnaire. For each survey
question there is a denition o the tool or service, a description o the most important ndings
and the mean, median and mode score.
The useulness indicator or each eHealth tool or service is taken as being the mode point. It is
represented by bars in each table (Figure 1).
Extremely useul
Very useul
Moderately useul
Slightly useul
Not useul
Figure 1. Useulness levels and indicators
4 Mean: average value; median: value in the middle range; mode: most requently occurring value.
-
8/6/2019 eHealth Tools Services WHO
14/36
Results
Responses
At the time o publication 93 countries had responded, which represents a response rat
48% and covers 65% o WHO Member States population (see Annex or list o countries).
Figure 2. Responding count
A number o actors may have aected the response rate: some countries ound the deaor completion too tight to meet; the timing o the survey coincided with summer in
northern hemisphere making it difcult to plan national meetings; and in some coun
eHealth is still in the early stages o development. Since 84% o the responding countries w
non-OECD members, this introduces a certain level o bias in the sample.
p
-
8/6/2019 eHealth Tools Services WHO
15/36
Data summary
The number o responses received and the calculated mode or each survey question is shown
below. Responding countries were grouped by membership in the OECD (Table 3). Table 4
shows the responses by WHO region.
Non-OECD OECD
eHealth tools Responses Mode Responses Mode
Electronic Health Records (eHR)
Patient Inormation Systems (PIS)
Hospital inormation Systems (HIS)
General Practitioner Inormation Systems(GPIS)
National electronic registries
National drug registries
Directories o health care proessionals andinstitutions
Decision Support Systems (DSS)
Telehealth
Geographical Inormation Systems (GIS)
eHealth services
Advice on national needs assessment oreHealth
Advice on eHealth policy and strategy
Advice on methods or monitoring andevaluation o eHealth services
Inormation on eective/best eHealth
practices
Advice on eHealth norms and standards
Inormation on trends and developments ineHealth
Advice on eLearning programmes
Advice on human resources development oreHealth
Table 3. Analysis o the country responses to the GOe survey, grouped by membership in the OECD
5 See Annex or list o WHO regions.
p
-
8/6/2019 eHealth Tools Services WHO
16/36
AricanRegion
(33*)
Regiono the
Americas
(9*)
South-EastAsia Region
(9*)
EuropeanRegion
(1*)
EasternMediterra-
nean Region
(1*)
WestPacRegi
(11
eHealth tools Responses
Mode
Responses
Mode
Responses
Mode
Responses
Mode
Responses
Mode
Responses
Electronic Health Records (eHR)
Patient Inormation Systems(PIS)
Hospital inormation Systems(HIS)
General PractitionerInormation Systems (GPIS)
National electronic registries
National drug registries
Directories o healthcareproessionals and institutions
Decision Support Systems (DSS)
Telehealth
Geographical InormationSystems (GIS)
eHealth services
Advice on national needsassessment or eHealth
Advice on eHealth policy andstrategy
Advice on methods ormonitoring and evaluation oeHealth services
Inormation on eective/besteHealth practices
Advice on eHealth norms andstandards
Inormation on trends anddevelopments in eHealth
Advice on eLearningprogrammes
Advice on human resourcesdevelopment or eHealth
Table 4. Summary o responses to the GOe survey, by WHO r* Total number o responding countries per WHO r
-
8/6/2019 eHealth Tools Services WHO
17/36
eHealth tools
Figures 3 and 4 illustrate the responses o the non-OECD and OECD countries. The x-axis
represents eHealth tools options. The y-axis indicates the percentage response and the level
o useulness as identied by responding countries.
Over 70% o non-OECD countries rated all eHealth tools as either very usefulor extremely useful
(Figure 3).
eHealth tools non-OECD countries
%
0
10
20
30
40
50
Geograp
hica
l
In
formation
Systems
(GIS)
Te
lehea
lth
Dec
ision
Support
Systems
(DSS)
Directorieso
f
hea
lthcare
pro
fess
iona
lsan
d
institutions
Nationa
ldrug
reg
istr
ies
Nationa
le
lectron
ic
reg
istr
ies
G
enera
lPractitioner
In
formation
Systems
(GPIS)
Hosp
ita
lInformation
Systems
(HIS)
P
atient
Information
Systems
(PIS)
Electron
icHea
lth
Records
(eHR)
Score questions
Not useul Slightly useul Moderatly useul Very useul Extremely useul
Figure 3. eHealth tools non-OECD countries
p
Technicians erectin
VSAT dishes in Islamabad
Pakistan, to provid
the vital satellite health
communications link
required between WHO
headquarters and the feld
5
-
8/6/2019 eHealth Tools Services WHO
18/36
All eHealth tools with the exception o GPIS and GIS were rated by at least 50% o O
countries as either very useful or extremely useful. GPIS and GIS were rated by 46% and
respectively as very usefulor extremely useful(Figure 4).
eHealth tools OECD countries
%
0
10
20
30
40
50
Geograp
hica
l
In
formation
S y s t e m s
( G I S )
Te
lehea
lth
Dec
ision
Support
Systems
(DSS)
Directorieso
f
hea
lthcare
pro
fessiona
lsan
d
institutions
Nationa
ldrug
reg
istr
ies
Nationa
le
lectron
ic
reg
istr
ies
Genera
lPractitioner
In
formation
Systems
(GPIS)
Hosp
ita
lInformation
Systems
(HIS)
Patient
Information
Systems
(PIS)
Electron
icHea
lth
Records
(eHR)
Score questions
Not useul Slightly useul Moderatly useul Very useul Extremely useul
Figure 4. eHealth tools OECD count
WHO Operations CentreIslamabad, Pakistan.
5
-
8/6/2019 eHealth Tools Services WHO
19/36
Results are presented in the ollowing ormat:
a denition or description o the eHealth tool;
an analysis o the response; and
a table o aggregated data indicating the mean, median and mode values.
Electronic Health Records
Also called Electronic Medical Records (eMR), Electronic Health Records (eHR) o a patientsclinical history are used to support clinical actions by health proessionals. They include
inormation such as test results, medication and general clinical history. They can be made
rapidly available through ICT to authorized personnel providing patient care.
Table 5 indicates that eHR would be very usefulor non-OECD countries and extremely usefulor
OECD countries. It should be noted, however, that there is a signicant disparity between the
numbers or OECD countries.
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD . .
Table 5. Electronic Health Records
Patient Information Systems
Patient Inormation Systems (PIS) contain inormation about a hospitalized patient and are
used to support both the administrative and clinical activities in a hospital. They are usually
hospital-wide, but may be restricted to single or multiple departments. They do not usually
contain multimedia data distinguishing them rom an electronic health record system. They
contain numeric and textual data about the patient in addition to the basic administrative
data, which distinguishes them rom hospital inormation systems.
Non-OECD countries indicated that they would nd a generic tool or Patient Inormation
Systems very useful. OECD countries were less consistent in their answers but overall scored PIS
as extremely useful(Table 6).
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD . .
Table 6. Patient Inormation Systems
p
p
p
-
8/6/2019 eHealth Tools Services WHO
20/36
Hospital Information Systems
Computer-based inormation systems that support inormation processing within a hos
in areas such as administration, appointments, billing, planning, budgeting and personn
Table 7 shows that non-OECD countries would nd it very useful to have a generic Hos
Inormation System (HIS) provided by WHO. OECD countries were less consistent and gene
inclined to nd it slightly useful. This may be explained by the act that the majority o hospin these countries already have some orm o HIS installed.
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD .
Table 7. Hospital Inormation Sy
General Practitioner Information Systems
ICT-based systems that support the work o a general practitioner (GP)/primary health practitioner are called General Practitioner Inormation Systems (GPIS). The variation in he
care models makes unctions required by countries quite dierent. Where the GP is pa
a primary health care team the system may also be known as a Primary Care Inorma
System. Their prime unctions are to manage and share data about patients. They oten
to other health care systems such as billing, GP reimbursement or laboratory results repor
systems.
There was strong indication that non-OECD countries would nd it very usefulto have ge
GPIS provided by WHO. OECD countries were less consistent and generally inclined to
slightly useful(Table 8). This may be because many o these countries already have program
or equipping their GPs with computerized inormation systems.
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD .
Table 8. General Practitioner Inormation Sy
-
8/6/2019 eHealth Tools Services WHO
21/36
National electronic registries
Electronic databases o related records on specic medical subjects. They contain data on
births, mortality, cancer, diabetes or other subjects o medical or epidemiological interest.
Registries can be accessed by authorized users through the use o ICT.
Creation o generic national registries or diseases were reported as very usefulby all non-OECD
countries and moderately usefulby OECD countries (Table 9).
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD .
Table 9. National electronic registries
National drug registries
Electronic databases containing national pharmaceutical inormation. The content varies
depending on the purpose o the registry. Examples include databases o risks o exposure todrugs during pregnancy and potential drug interactions.
Table 10 shows that creation o a generic national drug registry was considered very usefulby all
responding countries. Access to these data can have a signicant impact on burdened health
care budgets.
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD
Table 10. National drug registries
Laboratory worker in
Indonesia using ICT t
record sample inormatio
and transmit results to
the central hospita
5
-
8/6/2019 eHealth Tools Services WHO
22/36
Directories of healthcareprofessionals and institutions
Electronic databases o individuals and institutions providing health care. These are usu
searchable by location, specialization, proessional association or credentials. They are o
associated with registration and accreditation status.
Creation o generic directories o health care proessionals and institutions was considvery usefulby the majority o non-OECD countries, with most OECD countries reporting t
would be extremely useful(Table 11).
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD .
Table 11. Directories o healthcare proessionals and instit
Decision Support Systems
Automated or semi-automated systems that support decision-making in a clinical environm
Both country groupings reported that the provision o generic decision support tools w
be very usefulor the majority o respondents (Table 12).
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD .
Table 12. Decision Support Sy
Telehealth
The use o ICT to either support the provision o health care or as an alternative to d
proessional care. It encompasses telemedicine and the use o remote medical expertise.
Table 13 shows that generic telehealth developments were seen by non-OECD countrie
extremely useful. This may reect a desire to supplement health care resources in less develo
areas. The OECD countries ound it moderately to very useful, possibly reecting the act
they have already established telehealth acilities.
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD . .
Table 13. Teleh
-
8/6/2019 eHealth Tools Services WHO
23/36
Geographical Information Systems
Computer-based applications or capturing, integrating, analysing and displaying data
related to geographic coordinates.
Generic geographical inormation systems were regarded by non-OECD countries as extremely
useful, however the response rom OECD countries was less clear (Table 14).
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD .
Table 14. Geographical Inormation Systems
WHO Strategic Health
Operation Centre using IC
to share health inormation
and coordinate WHO
emergency respons
ater the Tsunami in
December 2004
5
-
8/6/2019 eHealth Tools Services WHO
24/36
Other requests
This question allowed countries to express any urther needs not already included in the su
The comments made were mainly rom non-OECD countries. Some o the requirem
have been covered in other sections o this report, but their inclusion here reiterates
importance to the countries requesting these generic systems.
Tools for professionals
eLearning tools especially those which provide interaction between the learner an
instructer. There was also a specic request or eLearning on the topic o public heal
a digital library (also called virtual library); and
databases to support the use o evidence-based medicine.
Tools to support health care provision
telehomecare/telehealth support;
remote diagnosis;
radiology inormation system; and
laboratory inormation system.
Health care and financial administration
nancial inormation system;
patient reerral system; and
access to unding or eHealth tools.
Policy and population health care tools
disease surveillance;
health inormation system (this may be similar to a disease surveillance and reporting
system);
public health advisory inormation system;
an integrated public health monitoring and advisory system;
vaccination status reporting;
national eHealth portal; and
a global health inormation system (wider than national).
Technical requirements
basic generic systems on open source sotware;
generic inrastructure tools;
interoperability tools;
standard methods in eHealth;
meta-data models; and
data mining tools.
Tools for citizens
personal health care inormation systems.
p
p
p
p
p
p
p
p
p
p
p
p
p
p
p
p
p
p
p
p
p
p
p
p
-
8/6/2019 eHealth Tools Services WHO
25/36
eHealth services
Figures 5 and 6 illustrate the responses o the non-OECD and OECD countries. The x-axis
represents eHealth services options. The y-axis indicates the percentage response and the
level o useulness as identied by responding countries.
Over 65% o non-OECD countries rated eHealth services as either very usefulor extremely useful
(Figure 5).
eHealth services non-OECD countries
%
0
10
20
30
40
50
60
70
80
Adviceonhuman
resources
development
foreHealth
Adviceon
eLearning
programmes
Informationon
trendsand
developments
ineHealth
Adviceon
eHealthnorms
andstandards
Informationon
eective/best
eHealthpractices
Adviceonmethods
formonitoring
andevaluationof
eHealthservices
AdviceoneHealth
policyandstrategy
Adviceonnational
needsassessments
foreHealth
Score questions
Not useul Slightly useul Moderatly useul Very useul Extremely useul
Figure 5. eHealth services non-OECD countries
p
-
8/6/2019 eHealth Tools Services WHO
26/36
All eHealth services were rated by over 60% o OECD countries as either moderately, ve
extremely useful(Figure 6).
eHealth services OECD countries
%
0
10
20
30
40
50
60
70
80
Adviceonhuman
resources
development
f o r e H e a l t h
Adviceon
eLearning
programmes
Informationon
trendsand
developments
ineHealth
Adviceon
eHealthnorms
andstandards
Informationon
eective/best
eHealthpractices
Adviceonmethods
formonitoring
andevaluationof
eHealthservices
AdviceoneHealth
policyandstrategy
Adviceonnational
needsassessments
foreHealth
Score questions
Not useul Slightly useul Moderatly useul Very useul Extremely useul
Figure 6. eHealth services OECD count
With regard to eHealth services, there is a degree o consistency between the OECD and OECD country groups: both would consider it very usefuli WHO would provide:
advice on methods or monitoring and evaluating eHealth services;
inormation on eective/best eHealth practices;
inormation on trends and developments in eHealth; and
advice on eLearning programmes.
Results are presented along the ollowing ormat:
denition or description o the eHealth service;
an analysis o the response; and
a table o aggregated data indicating the mean, median and mode values.
p
p
p
p
p
p
p
-
8/6/2019 eHealth Tools Services WHO
27/36
Advice on national needs assessments for eHealth
Services to assess the needs and benets o eHealth. These would be provided at a national
level and on a country-by-country basis.
Table 15 shows that the non-OECD countries would nd advice o this kind very useful. The
OECD countries, however, ound it only moderately useful. The dierences are likely to be
explained by the more advanced development o eHealth in the OECD countries.
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD .
Table 15. Advice on national needs assessments or eHealth
Advice on eHealth policy and strategy
The eective development o eHealth and its integration into mainstream health care is best
achieved through the creation o an eHealth strategy with the support o appropriate policies.Advice can improve the quality o both i provided in a timely manner.
Table 16 illustrates that non-OECD countries would nd this very usefulwhile the OECD countries
ound it moderately useful; many o the latter already have policies and strategies in place and
this would explain their response.
This policy theme will be covered in greater detail in the Global Observatory or eHealth
Annual Report.
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD .
Table 16. Advice on eHealth policy and strategy
-
8/6/2019 eHealth Tools Services WHO
28/36
Advice on methods for monitoring andevaluation of eHealth services
It is the responsibility o governments to ensure that money allocated to health care is s
eectively. The creation o monitoring and evaluation tools are expensive and time consum
so any advice provided which shortens the development process or improves its efcacy w
be useul. In the case o eHealth it is important to ensure that it is delivering the expec
promised benets.
Most countries would nd WHO guidance on methods or monitoring and evaluatio
eHealth services very useful(Table 17).
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD .
Table 17. Advice on methods or monitoring and evaluation o eHealth se
Information on effective/best eHealth practices
There is an increasing acceptance that evidence-based medicine can contribute signica
to the eectiveness o medical practice. This principle also applies to eHealth.
Table 18 shows that most countries would nd this inormation veryto extremely useful.
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD . .
Table 18. Inormation on eective/best eHealth pra
Advice on eHealth norms and standards
eHealth is a combination o ICT and healthcare technologies and practices. Standards
critical to ensure lowest cost implementations and interoperability between systems.
Most countries would nd this service very useful(Table 19). There was some variation am
the OECD countries as to the useulness o such advice. For example, some countries alre
have organizations applying technical standards in this domain.
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD .
Table 19. Advice on eHealth norms and stan
-
8/6/2019 eHealth Tools Services WHO
29/36
Information on trends and developments in eHealth
Providing such inormation allows or the benchmarking o progress. Others can learn rom
these experiences and apply them to their own situation.
Most countries would nd this service very useful(Table 20).
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD .
Table 20. Inormation on trends and developments in eHealth
Advice on eLearning programmes
eLearning uses ICT to develop and deliver courses in most disciplines, and can be an eective
tool in teaching health sciences. Advice on the availability o existing courses as well as training
on how to develop new courses can help countries benet rom this mode o learning.
The non-OECD countries would nd this service very useful, while OECD countries ound itmoderately useful(Table 21).
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD .
Table 21. Advice on eLearning programmes
Advice on human resources development for eHealth
This includes the provision o advice on all aspects o human resource development romtraining in the use o eHealth techniques to the organizational structures required to best
ensure the sae and eective use o eHealth.
Both OECD and non-OECD countries would nd this service moderately to very useful
(Table 22).
RESPONSES MEAN MEDIAN MODE
Non-OECD .
OECD . .
Table 22. Advice on human resources development or eHealth
-
8/6/2019 eHealth Tools Services WHO
30/36
Other requests
This question allowed countries to express any urther needs not already included in
survey. Some o the requirements have been covered in other sections o this report, but
inclusion here reiterates their importance to the countries requesting these services.
Legal, policy and standards
legislation or eHealth implementation and use;
eHealth security issues; and
guidelines on what organizational structures are needed to integrate eHealth into th
existing health care system and how to achieve this.
Self-help and benchmarking
inormation on eective practice and an analysis o those eHealth initiatives that aile
a network to exchange inormation on eHealth;
study tours to learn rom other country experiences; and
guidelines on ICT equipment required to benet rom eHealth.
Use of eHealth services by health care professionals
training o eHealth proessionals and providing advice on the development o eHealt
services; and
equipping eHealth training centres.
Direct action by WHO
advocating the inclusion o ICT in government-sponsored health-related curricula;
organizing international conerences on eHealth;
encouraging the development o transnational collaborative programmes using eHe
technologies; and
creating and providing access to a network o suitably qualied eHealth consultants.
Finance and funding
allocation o unds and other resources to support the introduction o eHealth and
eHealth support.
Technical
encourage the use o open source sotware in the development o eHealth systems.
p
p
p
p
p
p
p
p
p
p
p
p
p
p
p
-
8/6/2019 eHealth Tools Services WHO
31/36
Recommendations
Key findings
Several issues emerged ater analysis o the country responses to the survey.
First, it is clear that most Member States would welcome the active involvement o WHO
in the development o generic eHealth tools and the provision o guidance in creating and
implementing eHealth strategies and services.
Second, there is an overall lack o awareness as to what eHealth tools and services already exist
world-wide.
Third, the data were somewhat conounded because OECD countries did not express
consistent views o their needs in eHealth areas. This can be explained by the more advanced
and varying degrees o eHealth implementation in these countries. Non-OECD countries did,
however, consistently express their need or guidance in a broad range o eHealth areas.
p
1
Database manager i
the Democratic Republi
o Congo receivin
epidemiological dat
rom the feld via HF radi
and recording result
on a central databas
-
8/6/2019 eHealth Tools Services WHO
32/36
Conclusion
Based on the results o this survey, the Global Observatory or eHealth now has valuable
with which to tailor uture initiatives.
Healthcare
There was signicant demand or the provision o generic tools to support the clinical
administrative unctions o health care services. This included systems o varying deg
o complexity in both primary and secondary care such as electronic health records, pa
administration, hospital inormation systems and general practitioner inormation system
Policy and strategy
Countries indicated a strong desire or:
guidance with policy and strategy development or eHealth;
advice on needs assessment and evaluation o eHealth services;
inormation on best practice and trends;
advice on eHealth norms and standards; and
consultancy services to assist in all aspects o eHealth.
Education
All respondents expressed a need or education and training in eHealth. There is a
signicant demand or the use o eLearning methods in health sciences.
Some additional requests included:
access to digital libraries and inormation about evidence-based research within the
eHealth domain; and
establishment o a network to share experiences internationally.
Information
Directories o health care proessionals and institutions can assist governments in real
quickly and eectively, the required administrative and legal basis or many aspects o eHe
delivery.
Pharmaceutical or drug registries are undamental i control o the efcacy and cos
medicines is to be exercised at regional or national levels. This is especially true in situat
where health care consumes an increasing proportion o national budgets. Generic ICT-b
tools are seen as a undamental way o creating these both cost-eectively and rapidly.
Providing generic tools to enable registration o groups o patients suering rom sim
conditions creates a valuable basis or maintaining the health o these groups and identi
priorities or health care expenditure.
The importance and value o these inormation systems was clearly recognized by counresponding to the survey. Not surprisingly, the highest demand came rom countries w
are still waiting to implement these solutions.
p
p
p
p
p
p
p
p
-
8/6/2019 eHealth Tools Services WHO
33/36
Proposed action
The resolution passed at the Fity-eighth World Health Assembly raised expectations that
WHO will become actively involved in the provision o generic eHealth tools and services. The
survey responses received have clearly demonstrated that this move is welcomed by many
WHO Member States. In this vein the report by the WHO Secretariat on eHealth tools and
services prepared or the 117th Session o the Executive Board proposes specic initiatives thatthe Secretariat plans to develop to support eHealth in Member States.
The ollowing recommendations complement the projects proposed to EB 117, ocusing on the
needs o Member States as expressed in the GOe survey.
It is recommended that WHO in collaboration with appropriate partners should:
Facilitate the development of those generic eHealth tools most sought after by
its Member States. These would include generic forms of tools for the monitoring
and evaluation of eHealth services, drug registries, institutional patient centred
information systems and directories of health care professionals and institutions.
Raise awareness of existing eHealth tools and services through the creation of
electronic directories and that there should be a special focus on open source
eHealth solutions.
Develop an international knowledge exchange network to share practical
experiences on the application and impact of eHealth initiatives. This would be
Internet based and could be supplemented by international eHealth conferences
to facilitate networking.
Create an eHealth information resource to support the needs of Member States in
key areas such as eHealth policy, strategy, security and legal issues.
Promote the use of eLearning programmes for professional and ongoing educationin the health sciences. Collaborations should be developed to generate databases
of existing eLearning courses. Further, WHO should advocate for the inclusion of
eHealth courses within university curricula.
p
1.
2.
3.
4.
5.
-
8/6/2019 eHealth Tools Services WHO
34/36
Annex
List of Member States byWHO regional distribution
(indicating survey respondents and OECD members)WHO Arican RegionAlgeriaAngolaBeninBotswanaBurkina FasoBurundiCameroonCape VerdeCentral Arican RepublicChadComorosCongoCte dIvoireDemocratic Republic
o the CongoEquatorial Guinea
EritreaEthiopiaGabonGambiaGhanaGuineaGuinea-BissauKenyaLesothoLiberiaMadagascarMalawiMaliMauritaniaMauritiusMozambiqueNamibiaNigerNigeria
RwandaSao Tome and PrincipeSenegalSeychellesSierra LeoneSouth AricaSwazilandTogoUgandaUnited Republic o TanzaniaZambiaZimbabwe
WHO Region o the AmericasAntigua and BarbudaArgentinaBahamasBarbadosBelizeBoliviaBrazilCanada**
ChileColombiaCosta RicaCubaDominicaDominican RepublicEcuadorEl Salvador
GrenadaGuatemalaGuyanaHaitiHondurasJamaicaMexico**
NicaraguaPanamaParaguayPeruPuerto Rico*
Saint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSurinameTrinidad and TobagoUnited States o America**
Uruguay
Venezuela (Bolivarian Republic o)
WHO South-East Asia RegionBangladeshBhutanDemocratic Peoples
Republic o KoreaIndiaIndonesiaMaldivesMyanmarNepalSri LankaThailandTimor Leste
WHO European RegionAlbaniaAndorraArmeniaAustria**
AzerbaijanBelarusBelgium**
Bosnia and HerzegovinaBulgariaCroatiaCyprusCzech Republic**
Denmark**
EstoniaFinland**
France**
GeorgiaGermany**
Greece**
Hungary**
Iceland**
Ireland**
IsraelItaly**
KazakhstanKyrgyzstanLatviaLithuaniaLuxembourg**
MaltaMonacoNetherlands **
Norway**
Poland**
Portugal**
Republic o MoldovaRomaniaRussian FederationSan MarinoSerbia and MontenegroSlovakia **
SloveniaSpain**
Sweden**
Switzerland**
TajikistanThe ormer Yugoslav Republic o
MacedoniaTurkey**
TurkmenistanUkraineUnited Kingdom o
Great Britain and
Northern Ireland**
Uzbekistan
WHO Eastern MediterraRegion
AghanistanBahrainDjiboutiEgyptIran (Islamic Republic o)Iraq
JordanKuwaitLebanonLibyan Arab JamahiriyaMoroccoOmanPakistanQatarSaudi Arabia
SomaliaSudanSyrian Arab RepublicTunisiaUnited Arab EmiratesYemen
WHO Western Pacifc ReAustralia**
Brunei DarussalamCambodiaChina
China, Hong Kong SpecAdministrative RegionChina, Macao SpecialAdministrative Region
Cook IslandsFijiJapan**
KiribatiLao Peoples Democratic RepMalaysiaMarshall IslandsMicronesia (Federated StatesMongoliaNauruNew Zealand**
NiuePalauPapua New GuineaPhilippinesRepublic o Korea**
SamoaSingaporeSolomon IslandsTokelau*
TongaTuvaluVanuatuViet Nam
Bold indicates survey respondents. * WHO associate members. ** OECD member countries.
p
-
8/6/2019 eHealth Tools Services WHO
35/36
-
8/6/2019 eHealth Tools Services WHO
36/36
N
e
e
d
s
o
f
t
h
e
M
e
m
b
e
r
S
t
a
Reportof
theWHOG
lobalObservatoryf
oreH