3 global lessons for eHealth providers

Every two years the United Nations publishes an extensive study into the global state of e-Government. Damian Radcliffe looks at what the current survey tells us about ehealth.

e-Government activity typically supports government-to-government (G2G); government-to-business (G2B) or government-to-consumer (G2C) relationships; unlocking in the process cost saving and efficiencies, whilst also providing end users with new levels of convenience and information.

As a result of this, e-gov activity is increasingly a priority for governments across the globe, with major sectors such as education, business, and health all benefitting from these IT-led efforts.  

For the United Nations, e-Government can be a tool for sustainable development and a potential lever for generating “new employment, better health and education.” So what can digital health providers learn from their analysis? Here are three key research conclusions from their most recent study.

1. The move to mobile is only just beginning

In line with most tech-related environments, the UN notes the increasing importance of mobile as a delivery platform. This is not surprising when there are 4.55 billion mobile users and 1.75 billion smartphone users across the planet, meaning that there are more mobile devices than there are people. Given this, it’s no wonder that mobile needs to be an essential part of any ehealth strategy.

Mobile subscriptions Q4 2014, Ericsson Mobility Report, February 2015

However, the authors do argue that “there appears to be substantial underutilized potential of text based Short Message Service (SMS) across a range of government functions,” a conclusion that they also identified in their previous report back in 2012.

“SMS-based information service can bring impressive change, often meeting a need which would otherwise be impossible to satisfy,” they argue. Examples in the health arena of successful SMS programmes include “text4baby” a text messaging service for pregnant women and new mums in the US and the Mobile Technology for Community Health (MoTeCH) initiative in Ghana. The UN reports that there are now more than 25,000 people registered for the MoTeCH service - which delivers individually tailored health information to pregnant women in rural Ghana - and almost 300 community health workers can track their patients via SMS.

2. Open Data is already starting to deliver benefits

The past few years have seen an explosion in the volume of data being captured—and disseminated—by public and private sector bodies. With much of this information increasingly being made publicly available, this “open data” can play a vital role in raising awareness of issues and providing an evidence base for policy and other interventions.

In Singapore, for example, the National Environment Agency (NEA) shares environmental data (e.g. air quality, public health and weather) with government agencies and the public. Coupled with material found on Singapore’s wider government open data portal, this information can then be harnessed to create mobile apps related to health (and other) issues.

Nonetheless, despite the progress being shown in this space by govenments around the world, “its real impact will not be realized without carefully planned data governance, both within the public sector as well as with appropriate non-public stakeholders,” the report cautions.

Such governance is important to ensure that privacy issues are appropriately tackled, and to ensure that a careful balance between data protection and data openness is maintained. These elements will be important to manage if governments wish to avoid a potential backlash against their open data efforts.

“In all countries, governments should focus even more on starting, growing and sustaining open data initiatives through updating their policy, legal and institutional frameworks as well as improving leadership and raising awareness at higher decision making levels,” the UN recommends.

Alongside this, the report also recognises the impact open data can have in the event of emergencies. In such situations, given the multi-agency nature of many responses, they encourage “governments and humanitarian organizations to standardize data sets before a crisis starts”.

Interoperability applies to data just as much as anything else.

3. Integration matters across the board

Technology is not a panacea for the health problems that different countries face. The Indigo Trust  Executive, Dr Loren Treisman, recently told nuviun:

People need to think beyond the tech…integrating tech into well devised programmes with offline interventions and sufficient capacity to respond is critical.

Yet, as the UN’s study alludes, IT and health professionals do risk getting carried away with the “next big thing” before the current potential of digital healthcare has been fully tapped.

Underutlilised resources in Europe identified in the report include the fact that “81 per cent of hospitals have electronic patient records systems in place, but only 4 per cent grant patients online access to their health.”

Meanwhile, the study also finds that although “71 per cent use online eBooking systems…only 8 per cent offer patients the opportunity to book their own hospital appointment online.”

For ehealth to fully deliver on its potential, “integration of services should be seen as a means and not as an end in itself.” This integration does not just require technical and medical solutions, but also a multi-stakeholder approach to ehealth development and deployment.

“Countries which have given priority to the involvement of civil society in identifying the social needs of local communities and citizens and in the implementation of social programmes and services, including education, health and sanitation, have made important strides,” they observe.

To find out more, you can read the full UN report in English, Arabic and Chinese.

The nuviun industry network is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the author.