Last week I returned from an Asian eHealth conference in Myanmar. The trip was extraordinary for a number of reasons: exploring places, people and cultures quite different to the African environment I call home, learning about our Asian colleagues' approach to eHealth leadership, and learning first-hand how ubiquitous the open source DHIS2 platform has become.
As our African countries health systems move towards eHealth goals, looking at other global regions provides valuable insights.
Set up in 2011, the Asian eHealth Information Network (AeHIN) provides an overview of eHealth in that part of the world. When it started, it identified a shared problem of, at best, minimal Interoperability (IOp) “Even within Ministries of Health.”
AeHIN has a clear trajectory for its 25 country members. The Asia eHealth Information Network: Strategic Roadmap 2016-2020 sets out a wide array of initiatives to support national eHealth development in Asia. There are four strategic goals:
- Build eHealth capacity for Health Information Systems (HIS) and Civil Registration and Vital Statistics (CRVS)
- Effective networking to increase peer assistance and knowledge exchange and sharing
- Promote IOp in and between countries
- Enhance leadership, sustainable governance and M&E.
eHealth governance framework for enterprise ICT is based on COBIT5, from the Information Systems Audit and Control Association (ISACA). It’s an internationally recognised framework for ICT governance. Its three overarching themes are evaluate, direct and monitor. There are four main parts in AeHIN’s model:
- Align, plan and organise
- Build, acquire and implement
- Deliver, service and support
- M&E and assess.
AeHIN has eHealth blueprints for enterprise architecture. Its four components are business, data, application and technology. It also has a Regional Enterprise Architecture Council for Health (REACH). Its eHealth capacity framework has seven modules:
- eHealth service agreements
- Management, plans, policies and procedures
- IOp profiles and terminology services
- Health Information Exchange (HIE)
- National Standards and IOp framework
- eHealth governance framework
- National eHealth action plans.
Supporting these initiatives are special interest groups. They include:
- Geographic Information Systems (GIS) lab
- Routine HISs
- District Health information Systems (DHIS) 2, implemented in twelve countries
- Research, with ten PhDs to work on AeHIN topics
- Community of IOp labs.
The African Centre for eHealth Excellence (Acfee) has much in common with AeHIN and its aspirations. A working relationship has been initiated between Acfee and AeHIN to begin sharing African and Asia lessons for mutual benefit.
This structured approach offers a template for Africa’s eHealth. Modest, steady, sustained investment can start to achieve it.