eHealth Standardization to meet
needs of Developing Countries
ITU e-Health history
 March 1994 –Buenos Aires, Argentina, first ITU
World Telecommunication Development
Conference approved the Question for study TELEMEDICINE in the ITU-D Study Group 2.
 30 June – 4 July 1997: First World Telemedicine
Symposium for Developing Countries was organized
by the ITU-D in Portugal.
 ITU telemedicine projects in Uganda,
Mozambique, Senegal, Malta, Georgia, Bhutan,
Myanmar, Ethiopia
 Resolution 41 of WTDC in 2002 in Istanbul, recommended to
all countries to create national eHealth Committees or Task
Forces for such cooperation and coordination. (Istanbul, 2002)
2
International Telecommunication
Union
• It is due to the ITU effort the question about
telemedicine/eHealth for developing countries
was introduced and discussed for the first
time during the First World
Telecommunication Development Conference
in Argentina in March 1994. The Conference
approved Question 6 (in 1998 it was
renumbered into Question 14) on
telemedicine which was assigned to the Study
Group 2 of the ITU Development Sector.
World Telemedicine Symposium
The first World Telemedicine Symposium for
developing countries was held in Portugal from
30 June to 4 July 1997. The Symposium was an
ITU initiative, hosted by the Portuguese
Telecommunications Administration through the
Instituto das Comunicacoes de Portugal (ICP). It
was attended by more than 57 countries and for
the first time it was the case when
telecommunication specialists were sitting
together with doctors from the same country.
eHealth
• As usual for any innovative ideas, there are
many obstacles starting with the reluctance of
medical staff in developed countries to adopt
a new way of servicing till the lack of
knowledge about eHealth among medical
professionals and administration in developing
countries.
Where are the main obstacles for the
implementation of eHealth ?”
• Lack of Government Policy related to eHealth.
• Lack of Technical Guidelines on how to start
the implementation of eHealth services.
• Lack of financial resources for promotion,
training and implementation.
• Lack of information on eHealth Economy and
successful eHealth implementations in other
countries.
eHealth standardization
• There is another main obstacle that concern
both developed and developing countries –
eHealth standardization which is extremely
complex question. In spite of huge amount of
money and manpower spent in this field, the
result is rather poor particularly for the
interest of developing countries. It is required
special attention to meet their needs taking
into account the condition of their fixed and
mobile networks.
ITU Standardization Sector
• There are many generic standards developed
by ITU-T used in eHealth applications for video
coding, security, multimedia transmission, and
languages for instance.
• International Standards for eHealth need to
be based on already existing “mature and
stable technologies” in developing countries
rather than only on future advanced
technologies.
Regional Asia-Pacific ITU meeting
on e-Health
• This meeting was held in Tokyo, Japan, 10-11
March 2011 and it was hosted by the
Japanese Ministry of Internal Affairs and
Communications (MIC).
• The meeting was attended by more than 50
participants from Japan, India, Bhutan,
Pakistan, Thailand, Korea, Malaysia,
Indonesia, Russia and Bangladesh.
Tokyo Call for Action (1)
• The meeting approved “Tokyo Call for Action Speeding up the adoption and development
of e-Health Standards to meet urgent needs
of developing countries for improving access
to healthcare services”.
• This document has highlighted that it is
important to solve the problem with technical
eHealth standardization as soon as possible.
Tokyo Call for Action (2)
• It is necessary to provide standardization of
technical telecommunication platform for
different types of eHealth services.
• ICT solutions for health and eHealth services,
including mHealth as well, have been developed
a lot, particularly in the last decade. However, the
solutions are still much too often isolated islands
of small-scale applications that are unable to
communicate with other health systems and/or
share information across geographies and
technologies.
Tokyo Call for Action (3)
• Barriers to scaling-up small systems in
developing countries prevent supporting a
larger patients and care providers base.
Decision makers are not necessarily able to
assess the actual health situation, which in
turn inhibits comprehensive planning,
response and policy formulation.
Tokyo Call for Action (4)
• Technical standards will play a critical role in
both achieving the public health benefits of
aggregated patient data and providing
solutions to requirements for security, privacy,
quality assurance and interoperability.
• How to benefit practically from Cloud
computing in developing countries?
Proposed Plan of Action
• Conduct a study to identify the challenges of adopting
e-Health Standards in the context of both developed
and developing countries in terms of cost of adoption,
technical barriers, lack of incentives, lack of compliance
mechanisms, lack of national e-Health Standards, etc.
The study will also identify the requirements for eHealth solutions to be standardized and
“Standardization holes” (which standards are missing
and emerging standardization opportunities) based on
mature and stable existing e-Health technologies
specially those that are already successfully applied in
developing countries.
ITU Plenipotentiary Conference 2010
• The ITU Plenipotentiary Conference 2010 in
Guadalajara, Mexico adopted a new Resolution 183 on
“Telecommunication/ICT applications for e-Health”
…calling ITU to give priority consideration to the
expansion of Telecommunication/ICT initiatives for eHealth and to coordinate e-health-related activities
between the Standardization, Development and Radio
communications sectors and, in particular, to promote
awareness, mainstreaming and capacity building in the
creation
of
telecommunication/ICT
eHealth
standards, reporting findings to the Council as
appropriate”.
ITU World Telecommunication
Development Conference
• The World Telecommunication Development
Conference (Hyderabad, 2010) also approved
Resolution 65 on “Improving access to healthcare
services by using information and communication
technologies”, where it was stated “…to continue
to promote the development of
telecommunication standards for eHealth
network solutions and interconnection with
medical devices in the environment of developing
countries, in conjunction with ITU-T and ITU-R in
particular”.
Thank you very much
for your attention
For more information, contact
• Leonid Androuchko1, Vladimir Androuchko2
1International University in Geneva, Rapporteur, Question 14 –
Telecommunication in Healthcare, ITU-D Study Group 2,
Telecommunication Development Bureau,
International Telecommunication Union
2Inernational University in Geneva, Dominic Foundation, Switzerland
• landrouchko@iun.ch
Introduction(1)
• The delivery of effective and affordable
healthcare is a challenge that all countries
face today, irrespective of whether they are
developed or developing nations.
• The information and telecommunication
industry has an opportunity to contribute
substantially to global healthcare.
Introduction (2)
• There is no doubt that the introduction of
eHealth services will be beneficial to all
countries and in particular for developing
countries where there are no resources to
improve their healthcare systems using
classical approach by increasing the number
of medical staff and hospitals.
ITU Standardization Sector (1)
• ITU’s Standardization Sector coordinates the technical
standardization of multimedia systems and capabilities
for eHealth applications. The Sector has just released a
new Technology Watch Report (www.itu.int/en/ITUT/techwatch/Pages/ehealth-standards.aspx) that
looks to the future of eHealth.
• The report observes that eHealth development will
require more universal e-Health interoperability
standards, and strategies to overcome technical
infrastructure barriers and address privacy, security,
and other legal requirements.
Proposed Plan of Action (2)
• Complement the study by bringing the users
who adopt the standards with those who
develop them in an “International
Conference/Workshop
on
eHealth
Standardization” to facilitate a better
understanding of “adoption challenges” and
how to address them and to confirm needed
new standards. It is also help to find a solution
by drawing attention of international
community to this important issue.