eHealth For Urgent Public Health Challenges

eHealth Conference, Barcelona 15-18 March, 2010 ||

High Level eHealth Conference

Barcelona, Spain

15 - 18 March 2010


eHealth For Urgent Public

Health Challenges

Najeeb Al-Shorbaji

Director, Knowledge Management and Sharing

WHO/HQ Geneva


Three questions to address:

What represents a public health challenge?

What is WHO stand on eHealth?

How can information and communication

technology help in mapping, predicting,

preventing and managing diseases to achieve

better health outcomes?


Public health challenges: global

Web search on "health challenges"

Obesity is one of the leading public health and societal challenges in the United States today;

Population ageing-a public health challenge;

Mental health of young people: a global public-health challenge;

Foodborne Diseases: The Continuing Public Health Challenge;

Malaria Remains Daunting Public Health Challenge.

Disease outbreaks such as Flu pandemics (H1N1 and H5N1).


Public health challenges: national

Natural disasters:

– Earthquakes: Chile, Haiti, Pakistan, Iran; Kobe (Japan)

– Tsunami: Indonesia;

– Flood: Madeira (Portugal);

– Famine.

Manmade disasters

– Wars: Afghanistan, Iraq, Somalia, Sudan, etc

– Environmental Pollution (chemical, biological leakages);

– Bioterrorism.


Global health gains

Increase in life expectancy;

Reduction in infant and child mortality; and

Elimination or reduction of many communicable diseases;

Advances in health and medical research;

Health is on the political agenda (health and human security).

Information and communication technology in health systems.


Still many health challenges

Global health in a "borderless world";

The Millennium Development Goals on health include:

– eradicate extreme poverty and hunger;

– reduce child mortality;

– improve maternal health;

– combat HIV and AIDS, malaria and other diseases; and

– ensure environmental sustainability.

http://www.unmillenniumproject.org/goals/gti.htm

http://www.unmillenniumproject.org/goals/gti.htm


WHO Fact sheet: top ten causes of death

Rank Cause of death Million %

1. Coronary heart disease 7.20 12.2

2. Stroke and other cerebrovascular diseases 5.71 9.7

3. Lower respiratory infections 4.18 7.1

4. Chronic obstructive pulmonary disease 3.02 5.1

5. Diarrhoeal diseases 2.16 3.7

6. HIV/AIDS 2.04 3.5

7. Tuberculosis 1.46 2.5

8. Trachea, bronchus, lung cancers 1.32 2.3

9. Road traffic accidents 1.27 2.2

10. Prematurity and low birth weight 1.18 2.0

32% NCDs


eHealth in WHO

1960: First computer application to manage statistics;

2005: World Health Assembly Resolution on eHealth;

2006-2013: Mid Term Strategic Plan has knowledge management and eHealth built-in it.

Today: DG's report to the EB in January 2010;– This is the first pandemic (H1N1) to occur since the revolution in

communication and information technologies;

– People make their own decisions about what information to trust, and base their actions on those decisions;

– Persuading people to adopt health behaviors is one of the biggest challenges in public health.


eHealthe-Caree-Learning

Prevention

Diagnostics

Dermatology

Obstetrics/

Gynaecology

Radiology Pathology

Patients

Doctors

Nurses

Society

Websites

e-Management

Pandemics

Emergencies

Disasters

Health

Professionals

eHealth

Governance

e-Surveillance

Training

Course

Research

Journals

Medicines

procurement

Referral

Systems

Hospital

Information

Systems

Electronic

Health

Records

HIS

IHR


Health is a knowledge-based sector

KM= People + Processes + Technology• Geographic information: place and location;

• Information and Communication infrastructure: connectivity, databases;

• Technical information related to the disease;

• Public information to advice people;

• Clinical information on people affected;

• Demographic information: the size and characteristics of population affected;

• Human resources information: to manage the problem;

• Financial information: to fund the operation;

• Logistics information: what materials available (medicines, equipment, transportation).


What we have learnt

Mobilize the community through timely and transparent

information campaign. Credible communication with people

reduces the risks: use radio, Internet, mobile phones;

Collect data and information on the situation and share it with

local leaders, national authorities and international community.

Decisions based on incomplete or wrong information worsen the

situation: satellite images, digital mapping, pictures, geographic

information, epidemiological surveys, samples;

Deploy telecommunication equipment at the earliest stage to

reestablish the network: satellite phones, GSM, mobile internet,

radio;


Locate and mobilize the experts who have the experience, the language and the commitment: search expert databases and profiles;

Establish local databases to record number of affected people, number of properties damaged, scale of damage, symptoms of the disease, the logistics and the finances;

Work with the private sector to provide services and products in a partnership mode. They can deploy solutions faster than the public sector;

Advocate, promote and support countries to be better prepared to mitigate the health and social impact of disasters and to provide response and recovery;

Document and share the experience, lessons leant, best practices.


Real life examples

In 2002 the first UN activity after the defeat of Taliban, Afhnaistan was to establish a mobile communication infrastructure with the help of the private sector;

In Iraq, Darfur (Sudan), Somalia and Afghanistan satellite phones and mobile units were and are used to collect data on diseases and to communicate locally and the world;

Radio communication was the only means to exchange messages and give direction in these countries. This has saved lives and not only helped in managing the sector;

Logistics database was established and used as a first priority to coordinate assistance in many of these countries. Without it duplication, loss and waste would have occurred;


In 2008, the average number of visits/month to WHO website was

4.7 million. In 2009 the average was 8 million, with the increase

attributable to the H1N1 pandemic.

48 hours after Haiti earthquake the Supercourse "Just in Time

Lecture" was produced and made available on the Internet in 11

languages.

The first UN (International Telecommunication Union) reaction to

Haiti earthquake was delivery of 100 satellite phones;

The first reaction by the US government to Chile earthquake was

delivery of 40 satellite phones.


WHO's Event Management System

WHO internal tool for public

health event-based information

management;

Secure platform;

Custom-built for decision

support;

Being rolled-out to 3 levels of

WHO;

IHR (2005) compliant;

All-hazards approach.

Risk assessment driven

Phase II enhancements

being planned


Global Observatory for eHealth:mHealth

Measure trends and up take of eHealth at global level;

Second Survey completed in 2009. Focused on mHealth as an emerging eHealth application:

The following mHealth services were identified by 115 countries as related to public health:1. Emergency toll-free telephone services;

2. Community mobilization / health promotion campaigns;

3. Awareness raising;.

4. Emergencies;

5. Health surveys;

6. Surveillance.



eHealth to go beyond data processing in

response to urgent public health challenges

Knowledge discovery allows health researchers and then decision makers to create knowledge and evidence from data sets of different types and formats.

Disease prediction using patterns and models based on data sets related to humans, animals, materials and environment.

Using the tools of public health informatics, medical informatics, bioinformatics and medical imaging to integrate different types of data (patient/personal, public, diseases, molecular).


eHealth to go beyond data processing in

response to urgent public health challenges

Integrated approach for eHealth (web, mHealth, health records, smart cards, database management systems applying open standards for interoperability.

Networking between professionals. Social networks and communities of practices;

Recognition of local and national needs to support health information and medical terminology using computer-assisted translation and databases;

Awareness and education in a citizen-centered system through development of an integrated bidirectional multimedia health record.


Q & A

Thank you

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eHealth For Urgent Public Health Challenges

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