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Redefining ‘health’ and prioritizing health care needs

14 October 2011 - According to the World Health Organization, rising and, in many places, ageing populations will make it difficult to sustain adequate levels of medical care without a big expansion in available services. Information and communication technologies (ICTs) will play an essential role in delivering those services and improving access to care for everyone in a world of 7 billion people. They hold particular promise for citizens in developing countries and remote areas where health resources are scarce.

ICTs are already helping to improve healthcare in three main ways: through better information collection, transmission and distribution; through better delivery of services, especially in remote or rural areas; and through reducing operational and administrative costs. Benefits include:

• Access to health advice: people can access information on the internet, either directly or through health centres. Mobile phone applications can convey information in local languages or in pictures to reach illiterate patients.
• Training for healthcare workers, especially in remote areas: ICTs can deliver distance education, up-to-date information and help upgrade skills.
• Patient monitoring: patients with heart monitors can send regular data to their doctors and elderly people can be supported while they continue to live at home.
• Patient information: patients can be sent reminders via mobile phone messages to take their medicines, or bring their child to the local clinic for vaccination.
• Telemedicine/remote consultation: patients far from hospitals or clinics can receive remote diagnosis or specialist advice through video conferencing, avoiding delays and the need for travel or to take time off work.
• Disease surveillance: information systems linked to mapping capabilities can improve disease surveillance, epidemic tracking and responses.
• Data collection: health workers can use ‘smart’ hand-held devices and mobile phones to send data through to processing centres or add to health records, improving speed and reliability of data collection and processing. A pilot project in Senegal reported that data that took two weeks to collect on paper were collected in one hour.
• Access to emergency services such as ambulances and paramedics can be facilitated through better communications systems.
• Management of patient records: ICTs enable patients to carry their own records on mobile phones or allow health workers to access online patient records, speeding information exchange and improving the quality of treatment.
• Transparency and accountability: health data and information can be made more accessible to the public as well as policymakers, researchers, healthcare providers and professionals. Social networking offers further opportunities for strengthening accountability.

Telemedicine is likely to become more widespread in the future, as video conferencing and ‘telepresence’ systems improve and more households and community health facilities have access to fast Internet networks. Hospitals and clinics are also expected to increase their use of visualization technology. This will enable consultants and surgeons to see, and even experiment on, virtual 3D images of a patient’s heart, before operating in reality, or see exactly where a brain is malfunctioning, without the need to open up the skull. There will also be a massive proliferation in machine-to-machine communications, with personal and home-based sensor devices playing an increasingly prominent role.

ITU is active in several areas related to e-health, which is defined by the World Health Organization as “the cost-effective and secure use of information and communications technologies in support of health and health-related fields, including health-care services, health surveillance, health literature, and health education, knowledge and research”. ITU advises members on e-health strategies and policies, develops guidelines, disseminates best practices on e-health applications, and assists in implementing technical cooperation projects.

ITU also participates in a number of international e-health initiatives. ITU Secretary-General, Dr Hamadoun Touré, is co-chair of the Digital He@lth Initiative, a unique multi-stakeholder collaboration between the ICT and healthcare sectors to implement the Millennium Development Goals. Dr Touré was also co-vice chair of the UN-backed Commission on Information and Accountability for Women’s and Children’s Health, which recommended in May 2011 that by 2015 all countries should be using ICTs in their national health information systems and health infrastructure. This was one of a set of recommendations in its report, Keeping Promises, Measuring Results, aimed at ensuring effective, transparent and inclusive accountability mechanisms for all stakeholders.

E-health requires appropriate regulatory, legal and policy frameworks in both the telecommunications and the health sectors. Data security and privacy are key issues in this area, so ITU recommends that wherever possible e-health networks and applications share expensive communication infrastructures with, for example, e-government or e-commerce systems that also require secure and interoperable systems.

Interoperability is also needed to ensure different national and international systems can exchange information and to reduce the cost of devices through economies of scale. Through its standardization work involving all the major players, ITU coordinates the development of a set of open global standards for e-health applications.

In helping countries make better use of ICTs for e-health, ITU is working to improve access to health services for all.