eHealth Conversations: Using Information Management, Dialogue, and Knowledge Exchange to Move Toward Universal Access to Health

"Due to the variety and timeliness of the topics addressed, this work is useful for health professionals, decision makers, political leaders, developers of health-related programs, and other players interested in the broad field of eHealth."

This book is one of the products of a Pan American Health Organization (PAHO)/World Health Organization (WHO) project involving experts on electronic health (eHealth) and other specialties. (WHO defines eHealth as the cost-effective and secure use of information and communications technologies (ICTs) to support health fields, including health care services, surveillance, scientific literature, health education, knowledge, and research. eHealth uses include treatment of patients, research, education of health workers, disease follow-up, and public health surveillance, among others). Through virtual dialogues, the experts contributed with knowledge and reflections on the present and the future of eHealth in the Americas, analysed the situation, and made recommendations for the implementation of eHealth initiatives.

eHealth Conversations, developed with the support of the Spanish Agency for International Development Cooperation (AECID), explores ways of implementing regional mechanisms with free and equitable access to information and knowledge sharing. These initiatives aim to advance the goals of more informed, equitable, competitive, and democratic societies, where access to health information is considered a basic right. This e-book is one of the instruments used by PAHO/WHO to develop the initiatives outlined in the Strategy and Plan of Action on eHealth for the Americas, approved by PAHO State Members in 2011, which coincides with the global eHealth strategy. In addition to disseminating information that aims to be useful for decision makers on applying these technologies for the health of the Americas, the report offers recommendations that are not only intended for PAHO/ WHO but also for governments and the private sector. The aim of the project is to guarantee the convergence of local, national, and regional initiatives regarding the adoption and application of ICTs for public health, as well as to strengthen individual and collective capacities of health workers and institutions - connecting them in a network of online health networks and reinforcing the PAHO/WHO eHealth programme.

Through its 12 chapters, eHealth Conversations presents the opinions of specialists, further readings, and examples of successful experiences in eHealth. It provides conclusions of the project and includes interviews with the authors of the conversations and tweets disseminated through Twitter (@ehealthpaho). The digital audio of the conversations is available on PAHO/WHO's website. Since the project was based on the components of the Strategy and Plan of Action on eHealth for the Americas, the work addresses issues such as infrastructure, information systems, telemedicine, access to information, policies, education, patient safety, electronic clinical records, standards for interoperability, legal issues, the relationship with eGovernment projects and initiatives, and eHealth management. Each topic was discussed by a group of specialists, and the publication features the conclusions and recommendations on each topic.

An excerpt from the e-book follows:

"The chapter on eGovernment recommends that the countries of the Region continue improving the integration between electronic government and eHealth so that access to resources can be more equitable and health care can be improved. When analyzing health information systems, the experts concluded that a good system can offer solutions to the problems faced by health systems in the Region, including fragmented information, lack of accessibility, disaggregation, and inequality in health care. It was also suggested that national institutions, including governments, universities, NGOs [non-governmental organisations], and the private sector should recognize that the access to health information is an essential right and a public asset, and develop strategies to promote and facilitate this access for health workers as well as the general population, to guarantee equitable health access. The chapter about on-line health policies points out that well-implemented and organized policies contribute to improve the well-being of populations and to reduce imbalances and inequities in the access to health systems. Another relevant conclusion was that adequate broadband infrastructures in eHealth, which link providers and health professionals with patients and their families, are essential to improve the health of the countries of the Americas. The chapter on standards for interoperability deals with electronic systems working together, and it recommends promoting national consensus and regional agreements for interoperable information systems at all levels, especially at the semantic level, to facilitate coding and data exchange between systems.

This publication also presents discussions regarding electronic teaching, a relevant tool for training on the eHealth strategy. This approach has major advantages for the development of health professionals, including immediate access to information and knowledge, the promotion of communication between professionals, faster updating of information, better dissemination of scientific information and knowledge, and has a direct impact on clinical practice and the quality of health care. New technologies also facilitate massive dissemination of knowledge and require the promotion of digital literacy as an eHealth strategy. Regarding the advantages of the new management tools, there is analysis on how health systems can use information and communications technologies to guide their actions toward effective and efficient management of resources. Information can also improve the quality of health care and the access to services. On the topic of electronic health records, it was concluded that they are definitely helpful when compared to traditional paper records. Some of the advantages are easy access and availability of clinical information, legibility, and the display of data in different formats, as well as integration with other components of the information system.

Experts reviewed the status of telemedicine in the Region and recommended that PAHO/WHO, through its eHealth Strategy, adopt measures to enforce national programs on good telehealth practices and the integration of advanced academic networks in national programs. They also proposed that PAHO/WHO have representation in national programs, with formal support. Regarding the topic of on-line health and its impact on patient safety, it was stated that the impact of ICTs on the safety of patient care can be very positive but requires education, training, and careful design to help reduce any adverse effects. Finally, the chapter on legal aspects addresses legal questions that emerge in the eHealth field as technological improvements are developed."

Click here for the 476-page report in PDF format (English).
Click here for the 485-page report in PDF format (Spanish - published in 2014).