世界卫生组织eHealth趋势和使用的标准和指导方针

1、china health informatics society annual conference | december 8-9, 20101 |ehealth trends and the use of standards and guidelines mr mark landryhealth information technical officerworld health organization, regional office of the western pacificchina health informatics society annual conference | dec

2、ember 8-9, 20102 |outline l introductionl trends in ehealthl next steps: identifying and implementing standardsl future possibilities and potential impactsehealth:using information communication technology (ict) such as computers, mobile devices, and satellite communications for health services and

3、informationchina health informatics society annual conference | december 8-9, 20103 |health and ehealthl health and ehealth are inseparable due to the fact that health is an information intensive sector.l health is a global concern that is trans-border by definition and affects the world population.

4、l information technology and telecommunications (ict) is a global issue especially with the emergence of the knowledge economy and the information society.l this has required who to adopt global approaches to ehealth. china health informatics society annual conference | december 8-9, 20104 |why ehea

5、lth?l health systems unable to deliver high-quality, affordable services with universal accessl increasing time and effort needed for acquiring information and data as well as for administration and documentationl critical health information buried in thick medical files and unsystematic data storag

6、e and retrieval systeml specialisation & sub-specialisationl new diseasesl increasing support to ehealththe next breakthrough in health systems improvement china health informatics society annual conference | december 8-9, 20105 |global cellular subscriptionschina health informatics society annu

7、al conference | december 8-9, 20106 |mhealth apps: 9,000phone apps: 400,000 +tablets: 12 million +smartphones: 90 millionfeature phones: 4.4 billionmobile subscriptions: 5.3 billionhospitals: 270,000midwives: 1.9 million +hospital beds: 20.9 millionhealth workers: 40 million+ households: 1.7 billion

8、 population: 6.7 billion2010 key global statisticssource: mhealth alliancechina health informatics society annual conference | december 8-9, 20107 |scope of ehealth services and applicationse-e-learninglearningtraining coursee-surveillancee-surveillance ehealthehealth governancegovernancepatientsnur

9、sessocietywebsitesemergenciesdisastershealth professionalsresearchjournalshisihrchina health informatics society annual conference | december 8-9, 20108 |whos responsel adoption of the world health assembly resolution on ehealth (wha58.21) in 2005 by who member statesl the ehealth resolution gave le

10、gitimacy to the concept itself but also defined: the scope of ehealth the potential stakeholders the role of governments and the private sector the need for legal, ethical and regulatory frameworks for its implementationl catalyzed recognition of the role of ehealth in: strengthening health systems

11、improving health services reaching out to remote communities enhancing the capacity of health workforce health promotionchina health informatics society annual conference | december 8-9, 20109 |ehealth global uptakel who global observatory of ehealth and the ehealth intelligence report: http:/www.wh

12、/goe/ehir/en/ l first global ehealth survey, 2005: benchmarking comparison between countries hard data and evidence on progress made.l second global ehealth survey, 2009: more in-depth analysis included eight thematic areas: mhealth, telemedicine, management of patient information, legal and et

13、hical frameworks for ehealth, ehealth policies, ehealth foundation actions, elearning and country profiles.china health informatics society annual conference | december 8-9, 201010 |most commonly reported mhealth initiatives in goel 50% in emergency/disaster situationsl 50% in health call centre or

14、healthcare telephone helplinel 45% for surveillance programsl 40% for voice/text messages to achieve treatment compliancel a number of countries highlighted using mhealth for hiv/aids and maternal health serviceschina health informatics society annual conference | december 8-9, 201011 |ehealth value

15、 stacktime/maturity of servicesbenefits to participants/providersinformationinteractiontransactionintegrationtransformationcommunication systemshealth and wellness content; messaginginformation systemsbi-directional communicationmanagement systemsidentity, security, audit; payments; health systems m

16、anagementdecision support systemsenhanced health, clinical and administrative decision-makingexpert systemsintelligent cross-platform solutionssource: mhealth alliancechina health informatics society annual conference | december 8-9, 201012 |the grand challenges to ehealthlorganizational and governa

17、nce challengesltechnical challengeslfinancial challengesllegal and ethical challengesllocal challenges based on differences in healthcare systems, culture, economy, regulations, policies, ict infrastructure, and human resourceschina health informatics society annual conference | december 8-9, 201013

18、 |global and national governance of ehealthl code of ethicsl multi-sectoral coordinationl human resources development l standardizationl interoperabilityl charters and frameworksl collaboration and partnershipschina health informatics society annual conference | december 8-9, 201014 |awareness and a

19、ccessamong ehealth end userslvalue of ict in health not fully recognizedlehealth typically not high on national health prioritieslevaluation of ehealth has concentrated mainly on pilot projectslthere is often a communications gap between health and ict professionals lchina is a unique exceptionwith

20、strong political will and excellent leadership to continue maximizing health outcomes with increasing use of ehealth solutionslchinas world-class ehealth solutions and outstanding experience should be shared with the rest of the worldchina health informatics society annual conference | december 8-9,

21、 201015 |technical competenciesof health professionals lhealthcare professionals usually do not receive ict training. their understanding of it comes late in their career. lict professionals are mainly hardware and software engineers with little orientation on biomedical applications. lthere is a ne

22、ed for in-service training and continuous education are missing in the area of health informatics. lthis is challenged by having very few specialized health informatics programmes.lpromote peer-to-peer learning and sharing within and between countries:china health informatics society (chis)internati

23、onal medical informatics association (imia): china health informatics society annual conference | december 8-9, 201016 |standardization and systems interoperability challengeslfragmented efforts to develop ehealth applications in the absence of adequate governance, standard

24、s and national plans resulted in development of ehealth systems that cannot exchange data.lthese systems are mainly standalone and disintegrated, lacking unified coding schemes, following different or no standards which resulted in total lack of interoperability between them.china health informatics

25、 society annual conference | december 8-9, 201017 |who ehealth standardization coordination group (ehscg)l platform to promote stronger coordination amongst the key players in all technical areas of ehealth standardization.l place for exchange of information on standards: identify areas where furthe

26、r standardization is required provide guidance for implementations and case studies consider the requirements for appropriate development paths for health profiles of existing standards support activities to increase user awareness of the existing standards, and case studiesl ehealth standards list:

27、 /ehscg/resources/en/ehscg_standards_list.pdf china health informatics society annual conference | december 8-9, 201018 |two examples:hl7 and sdmx-hdl health level 7 (hl7) data exchange/messaging standard primarily for patient-based transactional systems within a health system emr,

28、laboratory, rx, billing, immunization, maternal health, othersl statistical data and metadata exchange health domain (sdmx-hd) intended to be part of national his and m&e infrastructure strengthening strategy, facilitating seamless flow of information from facility to district, national, and int

29、ernational levels contains a data structure definition (dsd), which defines concepts, dimensions, attributes, code-lists and other artefacts necessary to describe the structure of data defines attributes of a data items, which reduces the negotiation required to exchange data between information sys

30、temschina health informatics society annual conference | december 8-9, 201019 |china health informatics society annual conference | december 8-9, 201020 |public health informatics innovationsl communication among geographically dispersed health workers and consumersl strengthening and streamlining d

31、ata collectionl implementing standards and promoting interoperabilityl disease prevention via electronic health records and improved lab systemsl data collection for research and evaluationchina health informatics society annual conference | december 8-9, 201021 |who collaborating centre for health

32、informaticsl work planning and application submission/review process underway now to establish the chinese centre for health statistics and information (chsi) as a new who collaborating centrel areas of focus may include: improving vital statistics and monitoring & evaluation systems building ca

33、pacity in health informatics developing and implementing standards evaluating ehealth solutions and demonstrating success sharing and learning from experience in chinal the rest of the world is eager to learn more from chinachina health informatics society annual conference | december 8-9, 201022 |c

34、an ehealth save livesand improve health?yesl could be directly, could be indirectly, to the individual and to the society. citizens, patients healthcare professionals healthcare providers governmentsl benefits are clear: to improve the quality and efficiency of healthcare; to expand access and contribute to equity/universal access; and to contribute to reduction of cost of health services.chin