1. 2012 Annual Meeting “Towards Public Health Sector Transformation and Section Unity” Public Health in Health IT Standardization and Strategic Partnerships Walter Suarez, MD, MPH Executive Director, Health IT Strategy and Policy Kaiser Permanente Hyattsville, MD - November 14-15, 2012

2. www.phdsc.org Ten Global eHealth Trends (1)  Electronic Health Records – increase in the adoption of EHRs with more mature, robust applications, including Clinical Decision Support  Health Information Exchanges – expansion of information exchange technologies, tools, applications to support clinical care, administrative processes, public health and research  Big Data – significant increase in the volume, velocity, and variety (the 3 ‘V’s) of health information  Virtualization of Health Information – advances in use of virtualized hardware, software and networks

3. www.phdsc.org Ten Global eHealth Trends (2)  Mobile Health – explosion of advanced mobile devices that creates an opportunity to true anywhere, anytime, real-time health interactions  Telehealth – significant growth in the use of ICTs to support remote health encounters, including telediagnostics, teleradiology, teleconsultation, telemonitoring, etc  Genomics – revolution in the ability to map, analyze and use personal genetic information to assist in disease prevention, diagnosis and treatment

4. www.phdsc.org Ten Global eHealth Trends (3)  Learning Health Systems – maturity in technology, science and medicine are allowing the development of true ‘learning health systems’ in which progress in science, informatics and care culture align to generate new knowledge as an ongoing, iterative process, and to seamlessly refine and deliver best practices for continuous improvement in health  Personalized medicine – assessing each person’s unique genetic, clinical, history, and environmental information and applying that data, information and knowledge to tailor the care and services to an individual

5. www.phdsc.org Ten Global eHealth Trends (4)  Health Social Media – Social media has transformed the way we communicate and interact locally, regionally and globally; and it is transforming the way we understand health and interact with health care ----------  Privacy and Security – as more granular information is being collected about an individual, and more information is being exchanged and maintained in larger number of big databases and systems, there are increased global concerns about privacy and security of health information

6. www.phdsc.org World Health Organization’s Global Initiative on Health Data Standardization and Interoperability  The Landscape:  Unprecedented level of activity across the world towards eHealth, EHRs, HIEs, other  Many countries have passed laws, regulations and executive orders to direct industry towards standardization and interoperability  These efforts vary significant from country to county in terms of focus, scope, timeline, resources  ‘Digital divide’ effect more pronounced in eHealth, between and across wealthier and poorer countries

7. www.phdsc.org World Health Organization’s Global Initiative on Health Data Standardization and Interoperability  The Challenges:  Advancing the global (country-specific) adoption and use of international standards for eHealth  Access to eHealth standards by low and middle income countries (LMICs)  Participation in the standards development process  Availability of infrastructure and trained resources to support eHealth at country and local level  Level of commitments by governments, industry, SDOs, and others  Importance of engaging public health globally

8. www.phdsc.org World Health Organization’s Global Initiative on Health Data Standardization and Interoperability  Policy Barriers:  Inconsistent understanding of need for HIT standardization and interoperability  Lack of understanding of the essential health data standards need for health system performance  Lack of national policies for eHealth  Lack of overarching legal framework  Standards Development Barriers:  Insufficient involvement of stakeholders  Lack of informational and educational resources

9. www.phdsc.org World Health Organization’s Global Initiative on Health Data Standardization and Interoperability  Standards Adoption Barriers:  Limitations in access to international standards  Use of proprietary country-specific standards  Lack of interoperable information systems  Incomplete or inconsistent adoption of existing standards  Lack of adoption of standards-based EHRs  Lack of adoption of standards-bases systems in government; requirements by government to use ‘their’ standard

10. www.phdsc.org World Health Organization’s Global Initiative on Health Data Standardization and Interoperability  Workforce Barriers:  Need for a trained, informatics-savvy workforce in health care and government  Availability and access to education/training resources, tools and programs  Funding-related Barriers:  Absences of sustainable national and international approaches to funding eHealth and the adoption and implementation of standards  Competing priorities in countries and lack of a clear ‘business case’ for the value of eHealth

11. www.phdsc.org World Health Organization’s Global Initiative on Health Data Standardization and Interoperability  The Opportunity – Building a Global Health Data Standardization Initiative  A Global WHO Coordinated Initiative to ensure countries identify, adopt and implement health information standards  Support through multi-lateral WHO Coordinating Centers to assist countries with models, approaches and technical resources in implementing health information standards  A Global SDO Coordinating Initiative to support education, outreach and provide subject-matter expertise and technical resources to countries  Need to charter a global vision for eHealth and Health IT Standardization and interoperability

12. www.phdsc.org World Health Organization’s Global Initiative on Health Data Standardization and Interoperability  Who needs to participate:  National health system leadership and decision makers  National ICT leadership and decision makers  International and national HIT standards organizations  International and national health professional associations  Academia and researchers  Consumers  Private sector  Foundations and donor organizations  Coordinating entities:  WHO, SDOs (through Joint Initiative Council)  PHDSC exploring partnership with WHO to assist with initiative

13. www.phdsc.org World Health Organization’s Global Initiative on Health Data Standardization and Interoperability  Next Steps:  WHO Global Forum on Health Data Standardization and Interoperability  WHO Headquarters, Geneva, Switzerland, Dec 3-4, 2012  Attended by health ministers, country delegates, SDO representatives  PHDSC assisting with developing background paper

14. www.phdsc.org World Health Organization’s Global Initiative on Health Data Standardization and Interoperability  Global Forum to focus on:  Essentials on Health Data Standards for Care  Access to Standards  Adoption and Implementation of Standards  Innovative Funding Models to Support Improved Access, Adoption and Use  Human Capacity Building  In-Country Policy and Governance Mechanisms  Definition of next steps and 2013-2014 strategy

15. www.phdsc.org World Health Organization’s Global Initiative on Health Data Standardization and Interoperability  A number of resources available…  WHO  Health Metrics Network  Country Health Information Systems  WHO eHealth Atlas  WHO-ITU Health Strategy Toolkit  ITU  ICT Indicators Database  ITU- T Technology Watch Reports (eHealth Standards and Interoperability)  ITU ICT Report – Implementing eHealth in Developing Countries

16. www.phdsc.org World Health Organization’s Global Initiative on Health Data Standardization and Interoperability  A number of resources available… (cont.)  Health Informatics Standards Knowledge Resource WIKI  Joint Initiatives Council (ISO, HL7, GS1, CEN, CDISC, others)  ISO  Country delegations  ISO TR 14639-1 and 14639-2 (Capacity-based eHealth Architecture Roadmap and Maturity Model)  Public Health Task Force  HL7  Country Affiliates  International mentoring committee

17. www.phdsc.org World Health Organization’s Global Initiative on Health Data Standardization and Interoperability  A number of resources available… (cont.)  IHE  Collaborative Research for Effective Diagnostics (CRED – Canada)  International Medical Informatics Association  Others ------------------------- PHDSC expected to play a key role in this global initiative!