1. eHealth in the Region of the Americas:
Breaking down barriers to implementation
David Novillo Ortiz, MLIS, MSc, PhD -
Pan American Health Organization/World Health Organization
@ehealthpaho

2. Introduction Key data Conclusions Content
Pan American Health Organization

3. Introduction Objectives of the Study
To observe and identify points of reference in advancing and implementing online health processes at the national, regional, and global levels. This survey examines digital health in terms of its role in supporting universal health coverage.
Objectives:
To measure the progress of online health at the global level; and
To compare the findings with those of previous studies, in order to understand current barriers to online health and examine potential future trends in online health.
The ultimate goal is to provide recommendations that promote universal health coverage, and to do so by removing barriers to innovation and by promoting changes in health organizations.
Pan American Health Organization

4. Introduction LIMITATIONS:
Study Methodology
The World Health Organization’s Third Global Survey on eHealth concerning online health was implemented in March 2015 and concluded in August 2015.
Primarily conducted digitally, but was also made available to members in hardcopy.
Survey instructions and questions were available in all official PAHO languages, and all Member States of the Region of the Americas were formally invited to participate. The questionnaire allowed for answers in different languages.
Responses were provided by 19 of the 38 PAHO Member States, constituting a response rate of 50%.
Open ended questions allowed for qualitative analysis. For quantitative analysis, univariate and bivariate analyses were employed.
LIMITATIONS:
The Third Global Survey on eHealth 2015 was sent to the Member States under uniform conditions, in order to ensure consistency. Nevertheless, analysis of the results received revealed, in more than one case, inconsistencies and variations in the responses offered by a single country. It should also be noted with regard to the qualitative evaluation of data that in some cases information is incomplete or nonexistent, given the lack of particular data in reports prior to the one presented here.
WHO accepts at face value the responses provided by the Member States, which inherently reflect differences in interpretation of the questions and in the answers. As the Member States were limited to one response per country, consensus was required in order to best represent the overall situation in the country, even where online health activities varied within a country or when they did not meet the survey’s criteria.
Finally, the data presented here do not include the responses of other stakeholders, such as patients, communities, suppliers, health professionals, and the digital health industry. As a consequence, the report may show a certain bias toward the supply side of health services.
Pan American Health Organization

5. Key Data 77.8% 61.1% 52.6% 52.6% 36.8% Key Data from Survey Responses
PAHO Member States have a national policy or strategy for universal health coverage
77.8%
61.1%
PAHO Member States have a national eHealth policy or strategy
PAHO Member States have a national electronic health records (EHR) system
52.6%
52.6%
PAHO Member States have policies or strategies directly related to telehealth
36.8%
Pan American Health Organization

6. Key Data 57.9% 89.5% 52.6% 63.7% 73.7% Key Data from Survey Responses
PAHO Member States have government-sponsored mHealth programs
57.9%
PAHO Member States use virtual learning in training health sciences students
89.5%
PAHO Member States have legislation protecting the privacy of health-related data on individuals that is stored electronically in EHR
52.6%
63.7%
PAHO Member States reported that individuals and communities are using social media to learn about health problems
73.7%
Pan American Health Organization

7. Key Data 100% 31.6% 52.6% 63.7% 73.7% Key Data from Survey Responses
PAHO Member States reported that healthcare organizations are using social media to promote health messages as part of health promotion campaigns
100%
PAHO Member States have a national policy or strategy regulating the use of big data in the health sector
31.6%
52.6%
63.7%
73.7%
Pan American Health Organization

8. Conclusions
Incorporating ICTs
Difficulty of providing necessary scientific evidence to demonstrate clinical and economic benefits of ICT constitutes a barrier to funding.
Funding presents challenge to LMICs.
Currently mostly from public sources.
Creation of public-private partnerships could be effective in raising funds to implement and adopt eHealth strategies.
Difficulty in determining the value of an eHealth practice.
Linguistic support remains a major challenge (especially since a significant portion of the population is indigenous).
Value: The clearly diminishing trend of marginal costs make it impossible to de ne the value (or price) of a digital health practice by the traditional mechanisms under which price equals marginal cost. Moreover, services of this type involve an experiential good. In other words, the usefulness for a patient or user cannot be determined until the service has been provided.
Pan American Health Organization

9. Conclusions
Recommendations on ICTs
eHealth should be regarded holistically and as a conduit to achieving universal health coverage. Focus should be placed on implementation.
Member States (especially LMICs) are urged to move forward in supporting (and funding) new eHealth strategies that go beyond establishing national policies and strategies. These strategies must go hand in hand with rigorous assessment mechanisms and economic and financing (legislative) reports that analyze the cost-effectiveness of eHealth practices.
Greater emphasis must be placed on educating health personnel on the organizational dimension and on the role of patients (in the new empowered-patient or e-patient role).
Holistically: eHealth should be regarded as a system made up of a broad set of dimensions (a holistic model) going beyond traditional temporal sequencing.
Pan American Health Organization

10. 2005 2011 2013 eHealth PAHO/WHO Program|
Web:
eHealth PAHO/WHO Program