eHealth For Urgent Public Health Challenges

High Level eHealth Conference
Barcelona, Spain
15 - 18 March 2010

eHealth Conference, Barcelona 15-18 March, 2010 |
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eHealth For Urgent Public
Health Challenges
Najeeb Al-Shorbaji
Director, Knowledge Management and Sharing
WHO/HQ Geneva

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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?

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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).

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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.

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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.

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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

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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 32% NCDs
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

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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.

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Pandemics
Disasters
HIS
Emergencies
IHR
e-Surveillance
Obstetrics/
Research Gynaecology
Society Dermatology
Journals Prevention
Patients eHealth
eHealth
e-Learning e-Care Diagnostics
Governance
Doctors
Websites Radiology Pathology
Electronic
Training Health
NursesHealth
Course
Professionals e-Management Records

Referral Hospital
Medicines Information
Systems
procurement Systems
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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).

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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;

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 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.

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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;

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 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.

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WHO's Event Management System
 WHO internal tool for public  Risk assessment driven
health event-based information
management;  Phase II enhancements
 Secure platform; being planned

 Custom-built for decision
support;

 Being rolled-out to 3 levels of
WHO;

 IHR (2005) compliant;

 All-hazards approach.
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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.

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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).

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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.

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Thank you
Q&A

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eHealth For Urgent Public Health Challenges

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