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ICTs for a Sustainable World #ICT4SDG
Joint ITU-WHO Workshop on e-Health Standards and Interoperability
Geneva, 26-27 April 2012 Contact:




Dominic K. Atweam (Ghana Health Service, Ghana): Ghana e-health framework
The health sector in Ghana has been characterized by a large number of different management units working and generating large amount of information which are held separate silos. This was creating difficulties in sharing information and has been a key factor in the inability of the sector to effectively demonstrate its performance.
The several management components need to a common platform for sharing information and the only way that can be achieved is through electronic means.
The Ghana Health Service recognizing the increasing use of information technology in health, has developed the Ghana Health Service Enterprise Architecture that seeks to define the structure and organization that will govern the deployment of IT solutions in Health.
The implementation and enforcement of the arrangements outlined in the document have not progressed at the same pace as the quest of the various health players to deploy IT solutions for health.
This presentation in two parts high lights  the path that we have gone through to develop the Ghana Health Service Enterprise Architecture from which we are currently revising our e-health strategy , the various m health initiatives.  Part 2 focus on how we are addressing our interoperability issues looking at how we  integrates all the e-health initiative in Ghana on to one platform.
Adrian Pacheco (CENETEC, Ministry of Health, Mexico): Mexico, Country Perspectives

​Mexican health system is facing several challenges, the integration of all the institutions is one of the solutions. This integration is not only administrative, the telecommunication and information technology plays a very important role, they will be the platform of the inter exchange of health information. With the correct use of standards, appropriate training, communication systems we will have the interoperability that the health system needs. This presentation shows the e health national plans,   goals, challenges and short and long term vision.
Chuck Parker (Executive Director, Continua): Continua Health AllianceBeyond Four Walls of Traditional Healthcare

​This presentation will highlight the Continua Health Alliance, its activities and projects, and future plans.  Continua is a not-for-profit Alliance with more than 240 members worldwide focused on creating a system of interoperable personal healthcare devices. The Alliance works to set Guidelines for the industry that is then utilized for a formal interoperability certification program. Continua works to also assist governments, standards bodies, and providers with the appropriate adoption of this common platform.
​Steve Mills (Chair, IEEE-SA Standards Board)
Challenges with consistency, interoperability and nomenclature and code—and associated gaps in standards—continue to reveal themselves as e-Health technologies evolve. The IEEE Standards Association is addressing these gaps, informed by its collaboration with other global healthcare-focused organizations.
IEEE Standards Association President Steve Mills will provide an overview of the IEEE’s efforts in developing globally deployed e-Health related standards and discuss the challenges and opportunities ahead for the standards community in collaborating to deliver integrated, globally relevant standards for the benefit of the healthcare industry and society.
Catherine Chronaki (HL7 International Board of Directors): HL7 CDA and its broad adoption

​This presentation will focus the HL7 Clinical Document Architecture  (CDA) and the characteristics that lead to its broad adoption around the globe. Key developments regarding the CDA implementation guide consolidation project, green CDA, and the free availability of the Trifolia database will be also covered.
Baljit Singh Bedi (Centre for Development for Advanced Computing; Telemedicine Society of India, India): eHealth Standardisation in India: Initiatives and Implementation Issues

​To provide effective healthcare delivery to its above one billion population has been always a challenge in India. With strong base in information and communication technologies (ICT), especially in form of quality human resource availability, policy makers have been contemplating if this can improve and augment the process of healthcare delivery with only incremental augmentation of existing infrastructure. Last two decades have seen many improvised usage of ICT technologies in healthcare sector through e-Health, hospital and health management information services being experimented and used. In this scenario, need for a standard health information system across the country that meets the requirements of diverse groups drew attention. The first policy initiatives in this regard emanated from the Department of Information Technology (DIT) in the year 2002 in form of defining the framework for an Information Technology Infrastructure for Healthcare (ITIH) in India. As its pioneering effort for defining ITIH, the major stakeholders in the industry were consulted to define the standards for health information in the country with a primary aim to define an acceptable Electronic Health Record (EHR).  Simultaneously, under a high level Committee and a Technical Working Group, a set of Standards and Guidelines were suggested for the practice of Telemedicine in India. In continuation with this effort a Subgroup for Telemedicine Standards was constituted under the aegis of Task Force for Telemedicine in India, by the Union Ministry of Health and Family Welfare (MoH&FW). The Subgroup has submitted this document on suitable standards and guidelines for telemedicine practice in India for taking further steps to make these mandatory. The above initiatives benefited and drew considerably from international efforts and experience in this sector.  MoH&FW is taking further steps by setting up a National Expert Committee for EMR Standardisation recently. The objective of the above policy initiatives is ultimately is to provide a framework for interoperability and scalability across e-Health and hospital management services to increase access and decrease healthcare delivery cost to population and simultaneously to bring down the opportunity costs to the various stakeholders. However the mechanisms of making stake holders comply to proposed standards is one of the biggest challenge faced by almost all countries which have embarked on this exercise including India. The paper deliberates on the leadership and other issues being faced in making standards mandatory and promotional efforts undertaken for creating awareness for adoption among the users and wider compliance among vendors for recommended eHealth standards.
Shigeru Tomita (NTT DATA, Japan): Remote Healthcare ICT and Mobile Healthcare ICT - Model Project in Japan by Ministry of Internal Affairs and Communications
In Japan, the need for Remote Healthcare ICT and Mobile Healthcare ICT has been recognized again due to the increasing healthcare expenditure, super aging society and the increasing number of patients of life style related diseases Adding to that , after the earthquake hit Japan in 2011, it has been discussed that it is effective from the view point of providing healthcare services rapidly in the event of a disaster.
I introduce three cases of remote healthcare ICT and mobile healthcare ICT in my presentation.
The first one is a model project, which is conducted by Ministry of Internal Affairs and Communications, to support home care patients after discharging hospitals. The second is to support people’s health promotion to prevent life style related diseases. The third is a medical information sharing service to support providing medical service with people who stayed at shelters after the earthquake and tsunami, when medical teams visited shelters.
At last I would like to share issues gained through these cases and challenges towards the future.​
Jonathan Payne (mHealth Alliance): Mobilizing standards

​The prevalence of mobile devices worldwide has led to the use of mobile devices, such as phones, tablets, or monitoring devices, to facilitate health care delivery. In low and middle income countries, where there is a shortage of health care workers, there is an enormous opportunity to use mHealth to shift tasks away from hospitals and clinics and into communities. To date, few mHealth projects have moved beyond the pilot phase and there are significant obstacles to effective integration into national health systems, including the lack of systematically applied technological standards and interoperability between systems. The development of open standards for mHealth will help shrink the standardization gap, facilitate the shift of care towards communities, support remote diagnostics, and enable scale and integration of mHealth into enterprise architectures. The mHealth Alliance is launching a global Standards and Interoperability Working Group to improve alignment on and adoption of open standards. This working group will leverage HealthUnBound, or HUB, the Alliance's online for supporting communities of practices, where implementers and decision makers can come to learn and share best practices. The Alliance and the Working Group are supporting a number of multi-national, standards-based projects to advance open standards for mHealth, including the Facility Registry Expansion Development project, the Rwanda Health Enterprise Architecture initiative, and the Maternal Concept Lab's core dataset work with Innovation Working Group grantees.
Miroslav Burša (Faculty of Electrical Engineering, Czech Technical University, Czech Republic):  State of Interoperability in the Czech Republic - Towards Personal Health Record: Current situation, obstacles and trends in implementation of Electronic Healthcare Records

​Problematic of electronic health record (EHR) and electronic prescription (EP) are highly discussed topics in the Czech Republic. Health records are nowadays usually kept in the paper form. Doctors are still used to use it and consider it a good practice (as they are versatile and complete). There is no usable standard for fully compliant EHR, although the health information is often saved in some form of a HIS (usually mutually incompatible). There is no standard for signal data (ECG, EEG, ...) and the data are often stored in proprietary formats. There is no widespread usage of HL7 standard. The only fully adopted standard in the Czech medical facilities is DICOM/PACS standard. There is a standard for statistical evidence (Data standard of the Ministry of Health) and mutually incompatible standards defined by the medical insurance companies used in reporting.
Basile Spyropoulos (Technological Education Institute of Athens, Greece): Combining Medical-Managerial Information and Communications Technology Standards to promote Interoperability in Health-Care: A Status Report

Background: Contemporary Health-Care in most countries is characterized by isolated and small-scale applications that cannot promote effectively enough, communication and information-sharing among Health-Care Providers, Medical Institutions and Health Insurance Organizations. Therefore, interoperability of Health-Care Information Systems has become one of the most crucial and challenging aspects in National Health Systems and other Health-care Providers.

Objectives: The aim of the presentation is to report on Research and Development activities during the last 15 years, attempting the harmonization of Medical-Managerial and Information-Communications Technology (ICT) Standards, and promoting Interoperability in contemporary Health-Care.

Guy Dumont and Beth Payne (University of British Columbia, Canada): PIERS on the Move – Phone Oximetry for Pre-Eclampsia

Our talk will present the Pre-eclampsia Integrated Estimate of RiSk (PIERS) model and the related projects to develop and validate simple outcome prediction tools for use in women with pre-eclampsia. Prediction modelling allows creation of complex decision support tools that have the potential to improve care of women and babies. The PIERS on the Move project aims at developing phone-based tools for both augmenting and simplifying the PIERS model for use in low-resource settings. A number of potential technologies will be presented.
Masahiro Kuroda (NICT, Japan): Healthcare ICT in disaster-stricken area and hints to e-Health standards

​The 2011 earthquake off the Pacific coast of Tohoku occurred on March 11th. This earthquake was the largest ever recorded in Japan and huge tsunami caused slow recovery of communities. Body area networks (BANs) are useful for victims to provide preventive healthcare solutions when temporary housing communities are established. We introduce interoperable BAN services for the communities using a short-range wireless standard and propose a healthcare ICT standard for aging society.
David Manset (MAAT, France): Innovation Trends in Delivering eHealth Services

​This short presentation aims to give a snapshot overview of innovative new translational research applications being developed for sanitary surveillance networks, clinical decision support and online diagnostic.
​Robert Istepanian (Kingston University, London): 4G Health- The Long Term evolution of m-health
The major advances in communications and network technologies in recent years are revolutionising the delivery of global and flexible access to information, leading to major benefits to society. These advances will also soon reflect on the delivery and access in healthcare and in particular with rapid advances in m-health. The concept of m-Health was first introduced and defined as “mobile computing, medical sensor, and communications technologies for health care.” [1]. Since then this revolutionary concept became one a major discipline in the areas of healthcare delivery and industry bringing together major academic research and industry disciplines worldwide.
‘4G health[2] is a new paradigm that represent the long term m-health evolution and embody next generation of m-health systems and encompass most of the enhanced features of the 4G communication and network technologies with transformative and yet unmet healthcare outcomes and clinical services.
One of the key applications presented, is in the area of mobile chronic disease management and diabetes in particular.  It is now well established that a policy of intensive management to lower blood sugar reduces the incidence of diabetes complications. However, translation of these research findings into routine practice remains a challenge for the healthcare community. Furthermore, recent clinical studies and evidence trials on mobile diabetes management systems show that these systems can provide good control of glucose levels, empower diabetic patients and provide effective means for minimising diabetes complication and better compliance.  The wider use of mobile phone technologies especially in the developing world makes the larger deployment of these m-health technologies very timely and urgent.
[1] Istepanian R. S. H., Jovanov E., Zhang Y.T., „Guest Editorial, “Introduction to the Special Section on M-Health: Beyond Seamless Mobility and Global Wireless Health-Care Connectivity”, IEEE Trans. Info Tech Bio., Vol. 8, No. 4, 2004, pp405-414.
[2] Istepanian, R. S. H. and Y.T. Zhang’, 4G health: The Long Term evolution of m-health-  Guest Editorial to the special section : 4G health, IEEE Trans. Information Technology in Biomedicine Special issue on 4G health, 16, 1, pp.1-5, 2012