Building Foundations for eHealth: Progress of Member States
World Health Assembly in May 2005 called on WHO to integrate eHealth
in all health systems globally. This resulted in the birth of the
Global Observatory for eHealth. This was set up to provide high
quality information to Member States, increase awareness and
commitment of governments, establish indicators for monitoring,
promote best services, assess impact of eHealth on health systems and
disseminate research findings. One of the first projects of the Global
Observatory for eHealth was to embark on a fact-finding study to
determine the present status of eHealth globally.
86-page compendium is based on inputs from 700 eHealth experts
worldwide from 112 countries (60% of the 192 WHO Member States,
representing 80% of the world's population). Response to
questionnaires between mid 2005 to mid 2006 led to this report, the
first of its kind. This survey provides an important foundation on
which future studies and actions are based, focusing on processes and
outcomes. Considerable coordination, technical inputs and design of
survey instruments at regional and national levels have gone into
compiling this report. The methodology adopted to ensure the
reliability of the information obtained, from each Member State, is
described in detail including quality assurance steps. The copy of
publication is indeed a pleasure to possess. Excellent quality of
paper, eminently readable formats, a superb layout, good
illustrations, adequate tables and graphs, appropriate eye catching
photographs to break the seriousness of the material published, all
contribute to the end product - an outstanding publication. The CD-ROM
provided with the publication describes the eHealth country profiles
of the various regions - Africa, Americas, South East Asia, Europe,
Eastern Mediterranean and Western Pacific .
report clearly demonstrates that the eHealth landscape is rapidly
changing universally. The digital divide is rapidly reducing.
Developing countries no longer have to follow the advanced countries.
eHealth eventually will be integrated into the mainstream of health
care delivery worldwide. This report will be useful for governments,
policy makers and international organizations to identify eHealth
trends, opportunities and emerging challenges. However one should
remember that global trends mask the huge variation between countries
and across regions.
of the key findings are as follows:
eHealth standards have been gaining recognition since
2000. Industrialized countries have advanced much farther than
Strong growth has occurred in eHealth since 2000 and
this is likely to continue
Developed countries are more advanced in eHealth
in developing countries are likely to be in place by 2008 but will
require more guidance and support
Implementation of enabling actions e.g., standardization
and interoperability need support
Online health information for general public showed
highest rate of adoption
e Learning in health sciences is expected to expand
National long term strategic plans for e Health, need to
be drawn up by Member States, assisted by tools, guidelines, best
practices including public private partnerships, one Health policy
provided by WHO
eHealth legal and ethics committee of WHO is likely to
Translation and cultural adaptation of existing health
materials to suit individual countries requirements is in the offing.
Computers capable of multilingual use have been
developed and promoted in India by Center
for Development of Advanced Computing. Information is being
provided in local languages for health workers in various disease
eHealth standards are more prevalent in advanced
countries. By 2008, 80 per cent of countries will have such standards.
The Baltic Health Network consisting of Norway, Denmark and Sweden
will be joined by Estonia and Lithuania. This may eventually become a
universal European model for the next generation health network.
ICT training for health science students and continuing
education in ICT is likely to be available in 80 per cent of Member
States of the WHO.
Use of ICT in support of human resources for health is
one of the key areas of WHO.
Electronic eHealth information for the general public is
steadily increasing worldwide and 90 percent of countries surveyed
will have this by 2008.
Web presence is not widespread in developing countries.
In developed countries “access” is giving way to “quality”.
Professional training in health informatics is necessary
to break the fear of technology and the resistance to change.
eHealth applications include public services, knowledge
services and providing services.
Most WHO regions have provision for international
electronic journals, national electronic journals and national open
archives. By the end of 2008,70 to 100 per cent of the surveyed
countries are likely to have international electronic journals
including those in the low income group.
eHealth governance and technology roadmaps to assist
with the planning process have already started in most countries.
It is stressed that a multi stakeholder, national level
eHealth authority, to provide leadership and direction, the adoption
of a e Health policy to define the vision and action are
required, the development of a funding framework and mechanisms to
develop ICT infrastructure for provision of eHealth services is
Governance policies in eHealth, as a measurement of
potential success were available only in 50 per cent of the countries
surveyed and mainly in the higher income countries.
Public funding remains the primary means of support for
eHealth activities though there is an increase in public private
Equitable access to eHealth is low, particularly in
Securing public and professional confidence in
information governance arrangements, and privacy and confidentiality
measures in holding and processing sensitive health information
electronically, is a major issue.
50 per cent of 112 countries surveyed do not legally
protect the confidential medical data nor do citizens have legal
recourse. Should their privacy be compromised while using eHealth services? WHA
eHealth resolution calls on Member States to advance the
principles of confidentiality of information and privacy in the
Creation of culturally sensitive electronic health
content in the local language is not high in the agenda of most
Ministry of Finance, Government of India, had mandated
that 3 per cent of the budget of all government spending will go to
§ The concept of eHealth for all by 2015 may well be an addendum to the Millennium Development Goals (MDG).