By Neil Versel, contributing editor
November 18, 2008 | Health-IT and other electronic communications tools can improve health quality, efficiency, and access to care at least as much in the developing world as in industrialized countries, but there must be coordinated and aligned local and global efforts to ensure interoperability, sustainability, and replicability.
Such is the message of a global “call to action” on e-health issued Tuesday.
“To achieve substantial progress on improving health quality, access, affordability, and efficiency, nations must share and work toward a global eHealth vision,” reads the action statement, which is the product of Making the eHealth Connection: Global Partnerships, Local Solutions, a series of Rockefeller Foundation conferences held last summer in Bellagio, Italy. South African Nobel Peace Prize Laureate Desmond Tutu introduced the document Tuesday at the Global Ministerial Forum on Research and Health in Bamako, Mali.
Signatories, which include more than 100 representatives of health care organizations, health-IT vendors, national governments, universities, industry groups, and charitable foundations, call for technologies that are “person-centered, need-driven, promote health and disease prevention, and are interoperable, standards-based, collaborative, sustainable, scalable, reusable, and owned by in-country organizations.” International donors should be aligned, the document says, to help prevent the kind of fragmentation that has hampered health systems in the West.
Brooke Partridge, a facilitator of the Rockefeller Foundation’s week-long mobile health conference in July, calls the document “a fantastic representation of best practices.” Partridge, president and chief executive of Vital Wave Consulting (Palo Alto, Calif.), says interoperability so far has failed in the U.S. because multitudes of competing interests have not fully embraced such principles. “The developing world can learn a lot from [the mistakes of] the developed world,” Partridge says.
Signatories also ask for interoperability based on open standards, though the final document backed off a reliance solely on open source software contained in an earlier draft.
“I think it was important to us to make a clear distinction between open source and open standards,” says Rockefeller Foundation associate director Karl Brown, reached by phone from Bamako today. Open source refers to software code, while open standards are industrywide agreements that promote interoperability. “I think we recrafted the language in a way that is acceptable to all,” Brown says.
Brown believes it might be easier to achieve interoperability in developing countries than in the U.S. or Europe. “You don’t have all the legacy systems in place,” he says.
This notion of “leapfrogging” old technologies in areas with limited existing technology infrastructure came up often at the Bellagio conferences. “There’s an advantage to starting late,” Brown says.
A prime example of the “leapfrog” strategy is with mobile phones, which have gained wide acceptance among people in regions that never had much in the way of landlines, and a key component of the call to action is mobile technology.
“The potential of m-health as a part of e-health is enormous,” says Partridge. She noted that there are more than 3.5 billion mobile phones in use, suggesting that more than half of the world’s population has one. (See “Mobile Medicine for the Developing World.”)
Partridge says a collaboration between the United Nations Foundation and the UK-based Vodafone Foundation will launch an m-health alliance early next year to put some of these plans into action. Also in the works is an International Medical Informatics Association health-IT workforce training program (see “AMIA Announces Plans to Take Training Program Global”) and a technical working group to develop a strategy for a technology framework that could work in multiple countries, sources tell Digital HealthCare & Productivity.