geneva, switzerland, 26-27 april 2012 barriers & opportunities to adoption: perspectives from...
TRANSCRIPT
Geneva, Switzerland, 26-27 April 2012
Barriers & opportunitiesto adoption:
perspectives from Bangladesh
Dr Sultan Shamiul Bashar,Medical Officer
Management Information SystemDGHS, MOHFW, Bangladesh
e-mail: [email protected]
Joint ITU-WHO Workshop on e-Health Standards and Interoperability
(Geneva, Switzerland, 26-27 April 2012)
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Introduction
In our view,
adoption of standards & interoperability framework in eHealth
needs consideration from 2 perspectives:
1.National
2.Global
Before explaining these perspectives,
please allow me to give a brief overview of:
health care infrastructures &
eHealth
in Bangladesh
Health Care Infrastructures
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Geographic unit
No.Average
PopulationHealth Facility
Bangladesh - 150 mill Super-sp. Hospitals
Division 7 23 millTertiary Hospital/
Medical College Hospital
District 64 2.5 millDistrict Hospital/ Medical
College Hospital
Sub-district 483 0.3 mill Sub-district hospital
Union 4,501 35,500 Union Health Center
Ward 13,503 12,000Community clinic – one
for 6,000 population
~600 hospitals~24,000 day-care
facilities~150,000 health
workforce
ehealth found phenomenal changein 3 years from 2009
Digital Bangladesh 2021
5-yr HPNSDP 2011-2016 with ambitious ehealth plan
National Health Policy 2011 with ehealth as a major component
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ehealth vision 2016
Internet ConnectivityCurrently 1,000 places, national to sub-districtTo scale to 20,000 places (USCs to CCs) by 2 yrs
DHIS v2.7Currently collecting data for >5,000 health facilities
(national to union level)To be scaled soon to >20,000 health facilities
Tele-medicine8 centers with quality videoWeb camera in all district
& sub-district hospitalsSoon to be scaled to CCs
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ehealth found phenomenal change…
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DatabasesHRM, PDS, Field Staff InfoSupply Chain ManagementHealth Facility DatabaseOthers
mhealthPregnancy care advice by
SMSComplaint-suggestion boxHealth Statistics Distribution
SystemBulk SMS for health staffs
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ehealth found phenomenal change…
Hospital automationwith OpenMRS1 yr3 hospitals (all
modules)All district & sub-
district hospitals (2 modules)5 yrsAll hospitals (all
modules)
Recognition
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United Nations Digital Health for Digital Development Award 2011
One of top 11 Global Innovations in 2011
The Manthan Award South Asia
National Digital Innovation Awards 2010 & 2011
Barriers & Opportunities:National Perspective
ProblemDatabases flourishing
both within & outside health sectorThey lack uniform
coding system for locations, common fields & optionsOpportunity of
interoperability is being missedHardware & network
choice also often lack standardization
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BarriersLack of knowledge among
database developers about standardization &interoperability
Lack of knowledgeable & skill staffs in public sectorPolicy makers want quick
solutionsInadequate communications
& TAs from DPsInadequacy of freely
available standards
ehealth in preliminary stages - Still have timeThe Highest level Policy Support – Digital Bangladesh 2021The country started initiative to develop Common National Coding System & Standards
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Barriers & Opportunities:National Perspective
MoH initiative to form multi-sectoral & GO-NGO-DP National HIS Steering Committee for interoperability & standardization issue
A HL7 committee exists
We prefer OpenSource SW (compatible with IMR, SDMX-HD, ICD-10, HL7 (e.g., DHIS, OpenMRS)
Hardware choice follows ministry-wide approach
Opportunities
Conclusions & Recommendations
1. Improve availability knowledge & practice of ehealth standards & inter-operability in developing countries
2. Ensure free & easy accessibility of ehealth standards
3. Improve DP coordination for ehealth
4. Increase ehealth TA for developing countries
4. Increase TA to developing countries with advancing situation of ehealth for generating global ehealth knowledge for replication
5. Consider geo-locations & common demographics to include for standards development
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Thank you!
Woman receiving prescription from from Union Information & Service Center given by doctor at our office