Chapter One

Introduction to eHealth
 Chapter Objectives
At the completion of this chapter the students will be
able to:
Define eHealth
Identify the domains of eHealth
Describe Ethiopian ehealth policy and strategy
Explain global and local ehealth experiances
 Introduction to eHealth
ehealth is the application of internet healthcare industry
to improve the access, efficiency, effectiveness, and
quality of clinical and business processes utilized by
healthcare organizations, practitioners, patients, and
consumers to improve the health status of patients.

Information exchange between providers on secure

networks to enable providers to have timely access to
critical information at the point of care
 Introduction...Cont’d
• World Health Organization (WHO) defines eHealth as
the cost-effective and secure use of ICT in support of
health and health-related fields, including healthcare
services, health surveillance, health literature, and health
education, knowledge and research.
 Introduction...Cont’d
• According to WHO three main core areas of eHealth are:
– Delivery of health information, for health professionals and health
consumers, through the Internet and telecommunications.
– Using the power of IT and e-commerce to improve public health
services, e.g. through the education and training of health workers.
– The use of e-commerce and e-business practices in health systems
management.
 Some common terminologies related to ehealth and informatics
• Health informatics • eHealth
– Medical informatics – Health Telematics
• Bioinformatics – Telemedicine
– Chemical • EHR
– Nursing
• TeleEducation
– Dental
• • TeleSurveillance
Public health Informatics
• Organizational informatics – Telehealth
• Social informatics • eCommerce
• Clinical informatics • eTransaction
• ePrescription
 Reading Assignment one
• What is Telematics?
• what are Telematic systems?
• How Telematics works?
• Benefits of Telematics
• Telematics in the future???
• Is Telematics applied in Ethiopia?
 Introduction...Cont’d
• eHealth system is an enabler for more integration, improved
access, and better health care through better information
management and use.
• Integrating the Healthcare Enterprise (IHE)
– is an organization that enables users and developers of information
technology for healthcare to achieve interoperability of systems
through:
• the precise definition of healthcare tasks
• the specification of standards-based communication between systems required
to support those tasks and
• the testing of systems to determine that they conform to the specifications.
 Introduction...Cont’d
Some examples of ehealth Solutions
 Introduction...Cont’d
• In summary eHealth is:
– the use of internet and other technologies in the health care
industry.
– the transfer of health resources and healthcare by electronic
means (electronics, informatics and tele-communications).
– delivery of health care using modern electronic information
and communication technologies when health care providers
and patients are not directly in contact and their interaction is
mediated by electronic means.
 Introduction...Cont’d
• In summary eHealth.......
– Illustrates the technical progress to expand health care
locally, countywide, and universal by using
information and communication technology.

– encompasses all sorts of electronic health data

exchange such as Telemedicine, Tele-health, mHealth,
communications via email, research health
information and access to medical records, etc.
 Introduction...Cont’d
• In summary eHealth.......
– characterizes technological commitment towards global
health care action.
– is a cost effective method method of providing health
services to the people.
– needs a trained workforce who has a skill in using eHealth
solutions, the need for proper governance, funding etc.
 Evolution of eHealth
1960s  Electronic data processing

1970s  Medical Informatics (computing in medicine

Administration and Finance; statistics and Epidemiology;
modeling; literature services)

1980s  Health Informatics (Computer-assisted image and

voice processing)
 Evolution...Cont’d
• 1985s  Telemedicine (The practice of medical care using
audio, visual and data communication)healthcare delivery,
diagnosis, consultation, treatment, education, and transfer of
data

• 1990s  Telehealth (e-transcriptions and eCommerce)  e-

prescription
 Evolution...Cont’d
• 2000s  eHealth
– Clinical care of the individual: Telemedicine
– Home health care: Tele Home care
– Management of clinical care: e.g. EHR, eprescriptions, …
– Monitor & control Public Health: Tele Surveillance
– Human resources development: Tele Education
– Commercial transactions, eCommerce in medical
commodities
– ICT Support to Research
Evolution...Cont’d
 Evolution...Cont’d
• The next technology boost to eHealth: Sensor Technology,
Internet of Things (IoT)
– Temperature sensor
– Pressure sensor
– Texture/feel sensore
– Shape (positional variation) sensor
– Smell sensor
– humidity sensor, etc…
 Evolution...Cont’d
• In summary:
– eHealth applications generally improve the quality of patient
care and make the doctor's practice more efficient. But
thehealthcare providers must be willing to work with it
sustainabily.
– external scientific analysis of complex applications with AI and
sensor technology is needed. If these conditions are met, e-
health applications can make healthcare significantly better and
more available.
 Advantages of eHealth
• Advantages
Ease of use.
Always availability.
Speed – no need to wait for appointments.
Less demand for physical consultations.
Limited data collection.
No negative impact on ultimate treatment decisions.
Overall improvement of patient outcomes.
High satisfaction – good acceptance by patients.
More economical in use
 Advantages of eHealth...cont’d
Provides quick access to patient records and information for
efficient health care.
Reduces paper work, reduced duplication of costs etc. thus
reducing the cost of health care.
Reduces medical errors and better clinical decision making.
Communication is much easier and bridges the gap between the
patient and health service provider
Patients conditions can be easily monitored through its use and
their progress can be recorded in real time
 Advantagesof eHealth...cont’d
It is the most cost effective and time saving means to improve
the access and quality of care
Patients can make better health decision as they have the power
to manage their own health
Covers more than a few interventions, together with telehealth,
telemedicine, mobile health (mHealth), electronic medical or
health records (eMR/eHR), big data, wearable’s, and even
artificial intelligence.
Conveys the promises and excitement of bringing e-commerce
to health care.
 Advantagesof eHealth...cont’d
Can be used in the bridging the gap of inaccessibility of the
resources for the consumer to receive the service.
eHealth can also be used for distance learning.
eHealth is crucial in accomplishing supreme health priorities
such as universal health coverage and the Sustainable
Development Goals
Provides better health care by improving all aspects of patient
care, including safety, effectiveness, patient-centeredness,
communication, education, timeliness, efficiency, and equity.
 Disadvantages of ehealth
• Disadvantages
Resistance from doctors due to perceived loss of control
over care process.
Potential loss of revenue for healthcare providers.
Lack of good-quality scientific research into eHealth
impacts
Difficult to access electronic health information due to
digital divide
Ethical issue regarding privacy and security
Cost challenges in common
 Disadvantages of ehealth...Cont’d
Generating distrust and interference in the doctor- patient
relationship
Increased additional cost/financial barrier in procurement of
internet
Requirement of skilled personal for the use of advanced
technologies
Shortage of IT and clinical resources
Trouble in learning and using the software
Increased personnel costs
 Disadvantages of ehealth...Cont’d
It might be time-consuming to bring electronic health
records up-to-date
The unavailability or lack of the basic infrastructure,
such as internet connection in remote areas
The lack of applicable software
Even though it saves time, the decline list of options in
health information systems may perhaps lack
comprehensive information.
 Characteristic of eHealth (“10 E”)
• Efficiency
– e-health upturn efficiency in healthcare, reducing costs.
– achieved through avoiding duplicative or unnecessary diagnostic,
decreasing overhead cost in practice and involving patients for
improving communication.
• Enhancing the quality of care
– improve the quality of health care by allowing comparisons between
diverse providers.
– focus on quality assurance, aiming patient streams to the finest quality
suppliers.
 Characteristic...Cont’d
• Evidence-based
– its interventions must be evidence-based in the sense that their value
and competence should not be presumed but proven by laborious
scientific assessment.

• Empowerment of consumers and patients

– expanding patients knowledge and access of personal electronic
records over the internet
– it provides new opportunities for patient-centered medicine and
facilitates evidence-based patient choice.
 Characteristic...Cont’d
• Encouragement
– it enhance patients participation through more proactive care.
– it provides encouragement for a new link between the patient and
health expert, towards a true corporation, where choices are made
mutually.
• Education
– it is platform to expand knowledge through researches or health care
information for both patient and providers.
– it helps to educate physicians and consumers through online sources
(ongoing medical education and other resources)
 Characteristic...Cont’d
• Enabling
– Creation of environment for easier exchange of information and easy
communication between the consumer and the service provider
– eHealth promotes information discussion and communication between
health care institutions in a consistent way .
• Extension
– it extends opportunity of health care further than its conservative
boundaries (topography).
– E-health also facilitates consumers to effortlessly achieve health
services online from international providers.
Characteristic...Cont’d
 Characteristic...Cont’d
• Ethics
– it includes new forms of patient-physician communication,
poses new challenges, and pressures to ethical issues
• For example: online professional practice, informed consent,
privacy and equity issues.
– It is one of the pressing issue that poses threat to eHealth.
 Characteristic...Cont’d
• Equity
– Despite clear gap between the ‘haves’ and ‘have not’,
equity is one of the promises made by eHealth.
– To make health care further fair is one of the
assurances of e-health.
– E-health should be equitably accessible to all the
people, irrespective of their age, race, gender, ethnicity
etc.
 Characteristic...Cont’d
• The issue of equity is in question if poeple:
– whose economic conditions are poor
– who lack skills, and access to computers and networks
– who cannot use computers efficiently
• The digital gap presently runs between rural vs. urban
inhabitants, rich vs. poor, young vs. old, male vs. female
people, and among the neglected/rare vs. common
illnesses
 Domains of eHealth
• A clinical decision support system (CDSS)
– is intended to improve healthcare delivery by enhancing
medical decisions with targeted clinical knowledge, patient
information, and other health information
– include computerized alerts and reminders to care providers
and patients; clinical guidelines; condition-specific order
sets; focused patient data reports and summaries;
documentation templates; diagnostic support, and
contextually relevant reference information, among other
tools.
 Domains of eHealth...Cont’d
–Telemedicine
– the use of technology (computers, video, phone, messaging) by
a medical professional to diagnose and treat patients in a
remote location
– examples:
• follow up visits
• remote chronic disease management
• remote post hospitalization care
• preventive care support
• school based telehealth
• Assisted living center support
 Domains of eHealth...Cont’d
• Consumer health informatics
– is a branch of health informatics which analyzes users’
requirements; develops, tests and implements strategies to
deliver the best possible health information; and builds user
preferences into health information systems
– Three programs are
• Health Literacy:
– Presenting selected internet resources to increase patient
understanding of the nature of health problems, and their
recommended treatments.
• Consumer Education
 Domains of eHealth...Cont’d
• Consumer health informatics....
– Patient-Focused Informatics:
• Predicting various elective procedures associated with a
given treatment
• Predicting the level and type of information required to
support a given treatment
• Predicting treatment schedules, based on patient symptoms
and basic measurements
• Recommending various interventions to be made or
precautions to be delivered to prevent future ailments.
 Domains of eHealth...Cont’d
• mHealth (Mobile health)
– is a set of apps, devices, connections that allow the user to be
mobile in madical care.
– is the use of mobile phones and other wireless technology in
medical care.
– its most common application is the use of mobile devices to
educate consumers about preventive healthcare services.
– it is also used for disease surveillance, treatment support,
epidemic outbreak tracking and chronic disease
management.
 Domains of eHealth...Cont’d
• Medical research using grids

• guides, templates, lines, bars etc to ease the presentation

and description of research findings

– can be used to build designs, arrange information and

make consistent user experiences in medical research.
 Domains of eHealth...Cont’d
• Virtual health care
– is the use of technology, including telephones,
video, mobile apps, text-based messaging, and
other communication platforms for the delivery of
health services to a patient outside of a health
system.
– is the actual provision of care to remote patients
through technology.
 Domains of eHealth...Cont’d
• Virtual health care.....
– is essential to reaching and serving more people and
addressing resource and staff shortages.
– useful for providing second opinions, consultations,
chronic condition management, and remote monitoring
of certain conditions
 Domains of eHealth...Cont’d
• Laboratory information system
– is a collection of software, operating systems, and hardware
designed to serve the operational processes of the clinical
laboratory
– involved in the processes of test ordering, specimen
collection, and specimen processing.
– responsible for result transmission, report generation, and
critical value identification and documentation
 Domains of eHealth...Cont’d
• Electronic Research/data collection
– is a newer and more popular method that involves tools like
tablets, smartphones or laptops to record responses.
– is most effective generate a much higher response rate and
allow researchers to connect with a vast population
regardless of their location.
– data entry and integration is fast, information gets stacked
and processed for real time usage.
– eliminate the need for manual intervention and minimize
human error.
 Domains of eHealth...Cont’d
• Monitoring, evaluation and patient trucking system
– ongoing trucking of overall process of customers
throught electronic evidences
– using indictors (input, process, output, outcome and
impacts) to check whether activities are on the their
planned action of performance.
– searching customers outcome through established
electronic evidences
 Domains of eHealth...Cont’d
• Big data systems for digital health
– is a term used to describe massive volumes of information
created by the adoption of digital technologie
– sources for big data include hospital records, medical records
of patients, results of medical examinations, and devices that
are a part of internet of things.
– Biomedical research also generates a significant portion of
big data relevant to public healthcare.
– This data requires proper management and analysis in order
to derive meaningful information.
 Domains of eHealth...Cont’d
• Electronic health record and medical record
– EMR is an electronic record of healthcare information of an
individual that is created, gathered, managed, and consulted
by authorized clinicians and staff within one healthcare
organization.
– EHR is an electronic record of healthcare information of an
individual that conforms to recommended interoperability
standards for HIT and that are created, managed, and
consulted by authorized clinicians and staff across multiple
healthcare organizations.
 Domains of eHealth...Cont’d
• Electronic health record and medical record
– is an electronic version of a patients medical history
– is maintained by the provider over time
– include all of the key administrative and clinical data
relevant to patient care under a particular provider:
• demographics and vital signs
• present and past medical history
• diagnosis and progress notes
• medications and immunizations
• laboratory data and radiology reports
 Domains of eHealth...Cont’d
• Electronic patient record
– is information about a patient health treatment
electronically produced, stored and accessed
within a healthcare institution

– all health-related information related to a patient

in electronic form, assembled as a single entity
 Domains of eHealth...Cont’d
• Computerized Physician order entry
–is the process of a medical professional entering
physician orders such as:
• medication orders
• physician instructions
• lab orders electronically instead of using paper charts
 Domains of eHealth...Cont’d
• ePrescribing
• is a technology framework that allows physicians and
other medical practitioners to write and send
prescriptions to a participating pharmacy electronically
instead of using handwritten or faxed notes or calling in
prescriptions
• an e-prescribing system serves as an electronic
reference handbook
 Domains of eHealth...Cont’d
• A qualified e-prescribing system must be able to:
– transmit prescriptions electronically
– warn prescribers about potential allergic
reactions
– inform physicians about generic alternatives,
among other functionality
– reduces the number of prescription errors
attributed to bad handwriting or illegible faxes
 Domains of eHealth...Cont’d
• Evidence based medicine
– is the conscientious, explicit, judicious and reasonable
use of modern, best evidence in making decisions
about the care of individual patients.
– integrates clinical experience and patient values with
the best available research information.
– is a movement which aims to increase the use of high
quality clinical research in clinical decision making.
 Domains of eHealth...Cont’d
• Evidence based medicine.....
• it requires:
– new skills of the clinician, including efficient literature-searching
– the application of formal rules of evidence in evaluating the
clinical literature
• The practice of evidence-based medicine is a process of
lifelong, self-directed, problem-based learning in which
caring for one’s own patients creates the need for
clinically important information about diagnosis,
prognosis, therapy and other clinical and health care
issues.
 Domains of eHealth...Cont’d
• Sources of evidence for EBM:
– Researches (experimental) through:
• meta-analysis of several randomized controlled research
• only one randomized controlled research
• well designed controlled research
• one quasi experimental research
– Evidences from non experimental studies
• comparative research
• case study
• textbooks.
– Evidences from experts and clinical practice
 Domains of eHealth...Cont’d
• Patient reminder (appointment) system
– is a systems that automate repetitive tasks like scheduling and
following up with patients.
– it includes:
• Patient text SMS & email reminders
• Patient rescheduling reminders
• appointment reminder such as video, audio messages, home
visits, phone calls, etc. to patients
 Domains of eHealth...Cont’d
• Pharmacy information system (PIS)
– is a system that records, oversees, and stores patient related
information for tracking of patients, decision making, re-
ordering, reporting, billing, workflow management and
quality assurance utilized in inpatient and outpatient settings.
– is a system that maintain the supply and organization of
drugs.
 Domains of eHealth...Cont’d
• Pharmacy information system....
–some major advantags of using PIS are:
• reduce medication errors
• increase patient safety
• report drug usage
• track costs
• etc.
 Ethiopian ehealth Policy and Strategy
• The ultimate purpose of establishing health-related policies and
strategies is to improve the quality of life by providing
equitable, affordable, and quality health services.

• no ehealth policy and strategy until recent years

• HSTP I - 2015-2020
– Information revolution is a transformation agenda.
– lacks a road map
 Ethiopian ehealth...Cont’d
• HSTP II -2020-2025
– Information revolution continued as a transformation agenda.
– Established information revolution roadmap for digital health

• FMOH developed National Digital Health Blueprint in 2021

– to achieve sustainable development goals (SDGs) that sets
universal health coverage (UHC)
 Ethiopian ehealth...Cont’d
• Strategic directions of government of Ethiopia in
HSTP-II are:
– Enhance provision of equitable and quality
comprehensive health service
– Improve health emergency and disaster risk
management
– Ensure community engagement and ownership
– Improve access to pharmaceuticals and medical
devices and their rational and proper use
 Ethiopian ehealth...Cont’d
• Strategic directions of government of Ethiopia in
HSTP-II are:.......
– Improve regulatory systems
– Improve human resource development and
management
– Enhance informed decision-making and innovations
– Improve health financing
– Strengthen governance and leadership
 Ethiopian ehealth...Cont’d
• Strategic directions of government of Ethiopia in
HSTP-II are:......
–Improve health infrastructure
–Enhance digital health technology
–Improve traditional medicine
–Enhance health in all policies and strategies
–Enhance private engagement in the heath sector
 Ethiopian ehealth...Cont’d
• FMOH identified five transformation agendas
as a priority issues to implement HSTP-II are:
– Quality and Equity
– Information revolution
– Motivated, competent, and compassionate health
workforce
– Health financing
–Leadership
 Ethiopian ehealth...Cont’d
• FMOH identified five transformation agendas as a
priority issues to implement HSTP-II are:
– Quality and Equity
• Ensuring equity in delivery of quality health services by creating
high-performing primary health care units, ensuring active
engagement of the community in service delivery, and continually
improving clinical care outcomes.
– Information revolution
• Improving methods and practices for collecting, analyzing,
presenting, using, and disseminating information that can influence
decisions.
 Ethiopian ehealth...Cont’d
• FMOH identified five transformation agendas as a
priority issues to implement HSTP-II are:
– Motivated, competent, and compassionate health workforce
• Ensuring equitable distribution and availability of an adequate
number and skill mix of health workers who are motivated,
competent, and compassionate to provide quality health services.
– Health financing
• Reforming public financial management and health financing to
improve efficiency and accountability, while pursuing the agenda of
sustainable domestic resource mobilization for health.
 Ethiopian ehealth...Cont’d
• FMOH identified five transformation agendas as a
priority issues to implement HSTP-II are:
– Leadership
• Enhancing leadership and governance mechanisms
at all levels of the health system to drive attainment
of the national strategic objectives through activities
to ensure alignment and harmonization, thereby
creating an enabling environment for the translation
of plans into results.
 Ethiopian ehealth...Cont’d
• The overall goal of information revolution
– to improve the capability of the health system to generate
and use high-quality data for evidence-based decision-
making and advance towards better health systems
performance.
• The information revolution is not only about changing
the techniques of data and information management; it is
also about bringing fundamental cultural and attitudinal
change regarding perceived value and practical use of
information.
 Ethiopian ehealth...Cont’d
• HSTP-II, efforts on information revolution
focus on three pillars:
–transforming a culture of high-quality data use

–digitization of the health information system

–improving health information system

governance.
 Ethiopian ehealth...Cont’d

• From these strategic directions, enhancing informed decision-

making and innovation as well as enhancing digital health

technology are directily over the shoulder of informatics team

for its acheivement

 Ethiopian ehealth...Cont’d
• Enhance Informed Decision-Making and
Innovation
• focuses on:
– generation of quality evidence
– research and innovations
– building a culture of evidence-based decision-making
– developing and using technology (new and/or
improved tools)
 Ethiopian ehealth...Cont’d
• Enhance Informed Decision-Making and Innovation......
– promotes use of data from routine and non-routine data
sources, including new research supported with ICT, and
using an established HIS governance framework.
– improving evidence generation and use from numerous
sources, including census, civil registration, and vital
statistics; as well as surveys, surveillance, routine
information systems, researches, and monitoring and
evaluation systems.
 Ethiopian ehealth...Cont’d
• Enhance Informed Decision-Making and Innovation......
– It focuses on continuously improving the availability and
quality of data, building capacity in data use core
competencies, bridging the gap between data users and data
producers, strengthening organizational data demand and use
platforms, documentation and communication of data
demand and use successes, data access and sharing, security,
and data warehousing.
– It also includes institutionalizing a knowledge management
system.
 Ethiopian ehealth...Cont’d
• Enhance Informed Decision-Making and Innovation......
– addresses the process of ideation, evaluation, selection,
development, and implementation of new or improved
products, services, or programs to improve health outcomes.

– Health innovation identifies new or improved health policies,

systems, products, and technologies, and services and
delivery methods that improve people’s health and well-
being.
 Ethiopian ehealth...Cont’d
• Enhance Informed Decision-Making and Innovation......
• Major strategic initiatives
– Improve the ownership and quality of health sector woreda-based
planning
– Strengthen and expand, as needed, all health management information
system and surveillance systems
– Improve quality of data through a national movement to prevent data
falsification; implement comprehensive data quality assurance and
auditing; improve demand for quality data
 Ethiopian ehealth...Cont’d
• Enhance Informed Decision-Making and Innovation......
• Major strategic initiatives
– Strengthen culture of information use at all levels (nurturing
leadership role in championing information use, capacity
building, accountability mechanism, advanced data analytics,
data use forums/platforms)
– Create structures and forums (Research Council) that
identifies research needs, coordinates the process, and
translates evidence to policy
 Ethiopian ehealth...Cont’d
• Enhance Informed Decision-Making and Innovation......
• Major strategic initiatives
– Mainstream HIS training in all health professional training
curricula
– Establish and enhance knowledge management system at all
levels
– Strengthen biomedical research to develop and test diagnostics,
therapeutics and vaccines
– Strengthen birth and death notification for Civil Registration and
Vital Statistics system and system for documenting cause of
death
 Ethiopian ehealth...Cont’d
• Enhance Informed Decision-Making and Innovation......
• Major strategic initiatives
– Strengthen health information system governance
– Strengthen health biotechnology research and use of
biotechnology products
– Strengthen short term and long term medical research
trainings
– Establish system for technology transfer for production of
vaccine and diagnostic materials
– Design and expand innovation labs
 Ethiopian ehealth...Cont’d
• Enhance Informed Decision-Making and Innovation......
• Major strategic initiatives
– Establish and strengthen a system for technology
transfer for vaccines and diagnostics production
– Strengthen biomedical research to develop and test
diagnostics, therapeutics, and vaccines
– Establish incubation centers for health innovations
– Establish and strengthen Health Research Council
 Ethiopian ehealth...Cont’d
• Enhance Digital Health Technology

– Digital technologies provide concrete opportunities to tackle

health system challenges, and thereby offer the potential to

enhance the coverage and quality of health practices and

services.
 Ethiopian ehealth...Cont’d
• Four major components to enhance digital
health technology are:
–Digitization targeted to clients
–Digitization targeted to health workers
–Digitization targeted to health system
managers
–Digitization targeted to health data services
 Ethiopian ehealth...Cont’d
• Enhance Digital Health Technology.....
• Major strategic initiatives......
– Keep the national eHealth architecture and
interoperability framework up to date
– Develop standards and guidelines for selection,
development and use of digital health solutions
– Strengthen digitization of routine and non-routine data
collection, management, analysis and use
 Ethiopian ehealth...Cont’d
• Enhance Digital Health Technology.....
• Major strategic initiatives......
– Develop digital solutions for health worker decision
support on prioritized health services
– Develop digital solutions to provide capacity building
for health workers
– Digitize digital health interventions for clients that
improve client-provider interaction and increase health
literacy
 Ethiopian ehealth...Cont’d
• Enhance Digital Health Technology.....
• Major strategic initiatives......
– Digitize and implement individual-level data
recording system
– Strengthen ICT infrastructure at all levels of the
health system
– Establish data warehouse
 Ethiopian ehealth...Cont’d
• What is digital health blueprint?
– Blueprint:
• plan of guidance for action to be followed
• serving as a model or providing guidance
• a detailed plan or program of action
– Digital health blueprint
• is a guide for governing and mapping the prioritized
digital health interventions, pillars, and enablers for the
Ethiopian health system.
 Ethiopian ehealth...Cont’d

• Enhancing digital health technology provides concrete

opportunities to tackle health system challenges, and thereby

offer the potential to enhance the coverage and quality of health

practices and services.

 Ethiopian ehealth...Cont’d
• The applications of emerging digital technologies as of
today in health care are:........
– Mobile Health
• powered by AI to detect or prevent health issues.
– Robot-assisted surgery
• improve flexibility, control, and precision during complex surgical
procedures.
 Ethiopian ehealth...Cont’d
• The applications of emerging digital technologies as of
today in health care are:
– Predictive Analytics
• uses patient data, statistical algorithms, and machine
learning approaches to predict imminent diseases.
– AI-based check-ups and care planning
• with the aid of a patient digital ID and digital payment.
 Ethiopian ehealth...Cont’d
• The applications of emerging digital technologies as of today in
health care are:
– Analysis and prediction of infectious diseases
• using AI based surveillance systems.
– 3D printing
• impacts the health care in 3D-printed orthopaedic implants, personalized
surgery and medical and dental devices.
– Cyber security
• Securing patient data using trusted AI models over blockchain in digital
health.
 Ethiopian ehealth...Cont’d
• Digital health technologies and interventions should be linked
to the broader digital health architecture.

• All digital health systems should be developed by applying

interaction design methods to make them user-friendly.
 Ethiopian ehealth...Cont’d
eHealth Stakeholders
• Patient (citizins) • Healthcare managers
• Healthcare Providers
• Professionals in Research • Government
and Practice • Donors
• Hospitals, Academia and
Public Health (Community) • Implementing partners
• Health Related Businesses • Private Sectors
 Ethiopian ehealth...Cont’d
• Impact of eHealth on stakeholders
• Patient(citizins)- provide the necessary information in
identifying needs, follow-up of development progress, and
quality of services
– Enables personalized care, throughout the health system and
across the lifespan
– Makes health care available at home, at work or in school
– Focuses on prevention, education and self-management
– Facilitates reaching out to peers for advice and support
 Ethiopian ehealth...Cont’d
• Impact of eHealth on stakeholders.....
• Professionals in Research and Practice
– Gives access to current, specialized, accredited knowledge for clinical
care, research and public health; and to research, publications and
databases
– Enables communication between patients and providers
– Makes high-quality distance learning for basic and continuing
professional education readily available
– Allows remote consultations with patients, for second opinions, and
with professional networks
 Ethiopian ehealth...Cont’d
• Impact of eHealth on stakeholders.....
• Hospitals, Academia and Public Health
– Establishes hospitals as a virtual network of providers,
connecting all levels of the system
– Monitors quality and safety; improves care processes
and reduces the possibility of medical errors
– Assists mobility of citizens and their medical records
– Providing patient information when and where needed
 Ethiopian ehealth...Cont’d
• Impact of eHealth on stakeholders.....
• Hospitals, Academia and Public Health.....
– Opens new opportunities in basic and applied research; from
health knowledge to policy and action
– Extends collaboration and shared computing power (e.g. grid
and cloud computing)
– Delivers services despite distance and time barriers
– Standardizes ordering and delivery of drugs and supplies
 Ethiopian ehealth...Cont’d
• Impact of eHealth on stakeholders.....
• Health Related Businesses
– Provides health content as a commodity to the public and health
professionals.
– Facilitates research and development of new products and services:
electronic health records, information systems, and clinical registries.
– Enables broad and cost-effective marketing for health products and
services to businesses and governments, locally and abroad.
 Ethiopian ehealth...Cont’d
• Impact of eHealth on stakeholders.....
• Government
– Delivers more reliable, responsive and timely reporting on
public health; as health becomes increasingly central to
economy, security, foreign affairs and
internationalrelationships.
– Creates enabling environments rather than technology
limitations.
 Ethiopian ehealth...Cont’d
• Impact of eHealth on stakeholders.....
• Goverment
–Offers new roles for stakeholders, health
professionals, authorities, citizens and others.
–Identifies disease and risk factor trends; analyses
demographic, social and health data; models
diseases in populations
 Ethiopian eHealth policy...cont’d
• Main eHealth Policy themes
• Operational
– Human Resource
• human resource is a major barrier for implementation of ehealth
• lack of skilled personnel taken as a barrier for deployment of EMR
in hospitals
– Collaboration
• is a key area for successful deployment of e-health
• its implementation involves collaborative work at all levels
 Ethiopian eHealth policy...cont’d
• Main eHealth Policy themes.....
• Operational.......
– Good governance
• related to the political and institutional processes and outcomes that
are necessary to achieve stated goals.
• WHO urged governments to form national ehealth bodies:
– responsible for providing support in areas of ehealth policy and strategy
development
– Effective communication
• lack of communication could lead to extensive duplication of ehealth
effort and creation of new solutions that cannot scaled up
 Ethiopian eHealth policy...cont’d
• Main eHealth Policy themes.....
• Operational......
– Motivation
• is the force that leads people to act to achieve their objectives through internal
impulse that urge to take an action.
• Lack of clear policy in incentives is a reason for early failure of ehealth
solutions in Ethiopia
– Accountability and responsibility
• responsible person able to take duty to carry out the assigned tasks
• accountable person can own consequences and the possibility for subsequent
action.
• lack of defined authorization mechanisms affect the eHealth implementation
in Ethiopia
 Ethiopian eHealth policy...cont’d
• Main eHealth Policy themes.....
• Infrastructure
–A successful adoption of eHealth system
depends on availability, and arrangements of
Infrastructure
• insufficient ICT infrastructure that can support the
deployment of E-health solutions
– a big problem in network connectivity
 Ethiopian eHealth policy...cont’d
• Main eHealth Policy themes.....
• Interoperability
– eHealth policy needs a mechanism to ensure standards and
interoperability.
– in order to ensure interoperability there should be national
agreements on the meaning of standards, technical
interoperability and semantic interoperability
– example
• EMR and LIS in governmental hospitals are not able to
exchange information
 Ethiopian eHealth policy...cont’d
• Main eHealth Policy themes.....
• Institutionalization
– eHealth policy training
– competence, credentialing and readiness
• competence and readiness as major barrier for adoption of
eHealth
• Professional practice
– licensure
 Ethiopian eHealth policy...cont’d
• Main eHealth Policy themes.....
• Security, Privacy and Confidentiality
– a legal requirement
– the adoption of new technologies such as electronic health
records and on-line personal health services makes the task
even more difficult
– data lose due to virus, poor backup system, and software
corruption
– the policy should provide detailed information on security,
privacy and confidentiality
 Ethiopian eHealth policy...cont’d
• Main eHealth Policy themes.....
• Funding
• the sustainability and success of eHealth deployment is
largely depend on the availability and adequacy of
funds.
– funding and technical support for e-health comes from
donors and NGOs this make sustainability in question
• no or in adequate budget allocated for any eHealth
activity in hospital or completely dependent on donors.
 Ethiopian eHealth policy...cont’d
• Main eHealth Policy themes.....
• Monitoring and Evaluation
• requires detailed information regarding
monitoring as well as evaluation in the
policy document.
 Ethiopian eHealth policy...cont’d
• the strategic plan of ehealth encourages national
alignment and connectivity while providing the region
and district, individual care providers and care provider
organisations with the ability to take different
approaches to solving their specific eHealth challenges.
• eHealth initiatives in Ethiopia are characterized as small
scale, duplication of efforts isolated and unable to
effectively communicate (interoperable) with each
others
 Ethiopian eHealth policy...cont’d
• eHealth strategy consider and realize standardization and
implementations of national eHealth systems that
include:
– access to health information and knowledge-sharing planning and
decision making
– health system capacity building in terms of creating enabling
eHealth environment (Human resource, legal framework, privacy
and compliance and funding)
– Health Growth and Transformation plan (GTP) to pull together
various disparate initiatives into a shared vision with a process
oriented roadmap to move ahead.
 Ethiopian eHealth policy...cont’d
• In order to achieve and support long-term FMOH health
strategic goals, the existing e-Health initiatives need to
be much more strongly integrated, interoperable and
stick with standards(technology/program) without
compromising the objectives of each sub-system and
establishing foundations for planning, coordinating
scaling up different e-Health efforts.
 Ethiopian eHealth policy...cont’d
• Challenges in eHealth implementation
strategies:
–Healthcare Sector Challenges:
• Shortage of healthcare professionals
• Emerging of new diseases
• Seamless healthcare services all over the country
• New treatments and technology.
 Ethiopian eHealth policy...cont’d
• Challenges in eHealth implementation
strategies:......
–eHealth Systems Challenges:
• Infrastructure (electricity, hardware and
communication, application)
• Human Resource (IT, informatics, HIT, other
professions)
• Leadership and Governance
• Financing
 Ethiopian eHealth policy...cont’d
• Strategic Areas of eHealth Interventions
– Adapt e-health standards (Legal and Regulatory framework)
– Implementing the national ICT infrastructure for e-health
(Infrastructure, standards and system for eHealth)
– Establish governance and leadership for eHealth.
– Educational promotion to all stakeholders on e-health ( Financing and
Investment for eHealth as well as support and promote eHealth
service and Applications)
– Support Human resource development and capacity building for
eHealth (HIT, IT, informatics, care providers).
Building Blocks of Digital Health Blueprint (DHBp) for Ethiopia
• Four Pillars:
– ICT infrastructure
– Solutions and services
– Digital health access and service delivery
– Digital health data hubs
Digital Health Blueprint...Cont’d
 Self Assessment Questions
What is the difference between eHealth and digital health?

Identify and explain each domains of eHealth?

Describe an Ethiopian ehealth policy and strategy?

Explain global and local ehealth experiances?

 References
• Kathleen GRAY and Dawn CHOO (2015); A Health
Informatics and eHealth Curriculum for Clinical Health
Profession Degrees; Health and Biomedical Informatics Centre,
The University of Melbourne
• National E-Health Transition Authority Ltd (2013); eHealth
Clinician’s User Guide; Sydney; Australia.
• Health Metrics Network Framework and Standards for Country
Health Information Systems, World Health Organization,
January 2008
• FMOH (2017), Health Information Technology Directorate
Annual Report, MOH
 References....
• Ethiopian TVET (2012), Model Curriculum for Health
Information Technique (HIT) Level IV, MoH and MoE
• FMoH (2017); e-Health and ICT projects Status Report, FMoH
• FMOH (2015); eHealth Strategy and policy Document; FMOH