Tokyo, Japan, 4-5 February 2013

Opportunities and Challenges for E-health – Vietnam, a case study

Nguyen Quoc CUONG,Vice Director, VNPT Hanoi,

cuongnq@vnpt.vn

ITU Workshop on “E-health services in low-resource settings:

Requirements and ITU role”

(Tokyo, Japan, 4-5 February 2013)

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Content

Developing countries & E-healthVietnam’s characteristicsHealth & ICT in VietnamVNPT & NTT cooperation

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Developing countries

World Bank: GNI per capitaLow income $1,005 or less.Middle income $1,005 - $12,276

Lower middle $1,005 - $3975Vietnam $1,160

E-HealthWeak health systems & infrastructure, Shortage of health workers, Incomplete legal & regulatory frameworkTwo facets: Public health & Healthcare

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Vietnam - Characteristics

VN LMIUrban population 29%39%Adult literacy rate 93%71%Health expd./ GDP 6.9% 4.4%Physicians/ 10K 12.27.8Nursing personnel 10.115.1Pharma. personnel 3.2 4.3

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Vietnam - Telecom

Standing out ! VN LMIFixed phone subs. 18.7% 6.0%Fixed BB subs. 4.13% 1.04%Mobile phone subs. 143% 77.8%Mobile BB subs. 14.71%*8%**H.hold w Int. 12.5% 7.5%Ind.s using Int. 27.6%^ 13.5%

* 2011 figure, Vietnam MIC** Low and Middle income groups^ 2011 figure: 34.05%

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Health & ICT in Vietnam

GovernmentPlan for ICT in 2011-2015, established specific goals at different levels

WAN, LAN and website developmentInternet access in health service officesE-learning in medical universitiesStandards adoption: ICD-10-CM, HL-7, DICOM etc.E-healthcare, HIS etc.Improvement of public health databases

Many data missed in WHO Statistics

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Health & ICT in Vietnam

Hospitals & other health institutionMainly business processes and management systemsLimited use of clinical applications: EHRs, order entry systems, decision support, pharmacy systems, etc.More importantly: little integration!

Inside hospitalsBetween hospitals and governmentBetween hospitals and social insurance

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Health & ICT in Vietnam

Hospitals ICT – an example2000 beds, 3500+ out-patients/day35 servers, 1200 workstations, no DC17 separated softwares, developed by 7 companiesNo common patient ID system No interconnection b/w diagnosis, analysis, treatment, pharmacy…No acceptance from Social Insurance Authority for electronic records

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Health & ICT in Vietnam

Hospitals ICT – the visible outcome

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VNPT & ICT for Health

VNPTFlagship operator in VietnamFixed, mobile, value-added… services

VNPT & MoHAgreement with MoH on promoting ICT application in the health sectorDiscount 25-50% on all services to all subscribers in health sector Join into projects at different levels and different fields

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VNPT & NTT Cooperation

Implemented in Hanoi area, by VNPT HanoiNTT East / NTT Vietnam

Public HealthIntroduction of NTT+VNPT’s expertise & capability to local Health Service Office

HealthcareJoint Study for e-Healthcare Service

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Join Study for e-Healthcare

Field trial: 06/08 – 31/10/12Questionnaire Survey: 31/10-16/11/12

NTT EastNTT Vietnam

VNPTHanoi

VNPT

Direction

Field Trial Users

Healthcare AdvisersHanoi Medical

University,Hospital of Post and

Telecoms etc

Trial Users50 sets

(200 IDs for the maximum)

Health Advice

FTTH

VNPT Network

Data ManagementSystemIn Japan

Automatic Graphing

Blood pressure monitor

Body composition monitor

e Healthcare Service

FTTH

Implementation structure Implementation Image

Relay Key

Receiver

Internet

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Join Study for e-Healthcare

Purpose: To confirm the demands for e-Healthcare serviceMeasurement items:

Body weightBody fat percentageBasal metabolismPhysical ageEstimated bone massNumber of stepsBlood pressure-Pulse rateVisceral fat level

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Join Study for e-Healthcare

98% care about something of their health

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Join Study for e-Healthcare

98% want to get advice from professionals

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Join Study for e-Healthcare

Recognition of measures88% can tell their health condition from “blood pressure”. Majority not familiar with the measures such as “body age”, “body fat percentage” and “muscle mass”.

Blood pressure

Body fat percentage

Muscle mass

Know

Don’t know

Can perceive

Can’t perceive

Blood sugar level

Body weight

Body fat percentage

Do you know what the word means?

Can you perceive your health condition

from the measured data?

61 ％

65 ％

51 ％

37 ％

69 ％

68 ％

25 ％

Body weight90 ％

High recognition

Low recognition

Blood sugarlevel

Body age63 ％

Muscle mass 29 ％

Blood pressure 88 ％

Body age 25 ％

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Conclusions and Recommendations

The following points can be either a challenge or an opportunityGovernment

E-health awarenessNecessary legal and regulatory framework

National strategies and capacity buildingIntegration of ICT into health systems

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Conclusions and Recommendations

Hospitals & other health institutionsTransition/Integration of existing softwares to/into E-health systems

“First, do no harm" (primum non nocere)

Balance between current load of work & involvement of E-health

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Conclusions and Recommendations

UserHigh interests in health, especially in healthy diet, improvement of blood pressure and weight reduction

Avoid complexity and inappropriateness to local needsNeed familiarization of unfamiliar terms and indexes

Reluctance in paying

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Conclusions and Recommendations

TechnologyOptical fiber and Mobile trendsHealth data integration and Coordination of health systemsResponsiveness to local demand: Localization and Operability of the devices and web application

THANK YOU !

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