On Thursday February 25, Talkstandards hosted a lively open forum on ICT Standardization and eHealth.
Ajit Jaokar spoke of the possibility that eHealth will take off in emerging markets and what the implications thereof could be. As an illustration, Jaokar mentioned the M-Pesa mobile payment service which took off in Kenya, serving 6.5 million subscribers by May 2009; such a service is yet to be deployed in Western countries. Jaokar argued that emerging markets have a way of solving real life problems which is likely to mean that eHealth innovation will take place in emerging markets. Further, the lack of infrastructure might actually provide further incentives, as it did in the M-Pesa case. The implications of such a development for global standards are not clear but it is important to not only think of eHealth as a ‘Western’ concept.
Highlighting the fact that the healthcare of yesterday is changing, and a new healthcare experience is emerging, Helen Disney discussed the challenges facing us in ‘the post-bureaucratic age’. New technology can revolutionize the way in which governments and citizens interact and move towards a bottom-up approach; but this requires the development of standards to build trust in new systems. Interoperability is one of the main challenges we are facing as companies are set to compete on delivering eHealth services. More open, network systems will benefit patients but at the same time it will be less easy for governments to intervene, argued Disney. This will ultimately affect which standards are going to be widely used. Further, Disney raised the question whether some of the poorest patients, who lack internet access, face a risk of being left behind in the eHealth-age.
Keith W Boone provided valuable input on US eHealth policy. He expressed concerns over the shotgun approach taken by recent US initiatives and called for more coordination in standardization efforts. Further, Boone was critical to the fact that there is no US ‘national program’, rather conflicts within government and between SSOs are impeding developments. Governments can help by offering a consolidated voice, setting national goals and driving standardization efforts. Unified efforts across the ICT spectra is needed to look after national interests.
Denise Silber expressed her optimism over Health 2.0 services as a driver of eHealth innovation and development. She drew the attention to existing services; blogs, wikis, search engines etc, and pointed to the fact that these are available by computer or mobile phone and contributing to participatory medicine. Lack of standards is not the issue, Silber argues, web to web synchronization is already possible. Security should not be an impediment either, online banks have succeeded and so should healthcare. Rather, the obstacle lies in data not being electronically available or safely portable. Silber called on doctors and laboratories to digitize their information and leave the rest to participatory medicine.
Recognizing that seamless access to information is important in eHealth, and that standards are vital in achieving this, Jay Kesan expressed concern over the likeliness of governments’ early involvement in the standardization process, choosing winners (and losers) prematurely. The reason for this, he said, is because the governmental role in healthcare is not as challenged as that in other sectors. Kesan argued that it is the ICT private sector that are the domain specialists and that they must be allowed to work towards standardization, jointly developing standards within private SSOs. Thus, competition should be fostered among private firms developing downstream, innovative, proprietary technologies relying upon ICT standards. Learning from past behavior, Kesan also argued that US authorities are more likely to focus on spectrum management and setting power ratings to avoid interference, while letting different industry solutions and standards compete with each other, European authorities will be prone to mandate interoperability.
Also, prior to the forum Talkstandards conducted an exclusive interview with David Ingram, Founding Chairman of openEHR. Ingram spoke of the difficulties of gathering all challenges of eHealth under one common umbrella, and expressed concern over governments sometimes being excessively enthusiastic. It is vital that governments appreciate the scope of ICT standardization and development, as to handle the challenges properly. The approach to eHealth should be practical and empirical, Ingram said, and welcomed the fact that practical progress toward interoperability is actively sought. Although difficult barriers to eHealth implementation exist in Europe which might be hard to overcome, Ingram is optimistic with the direction developments are taking. Ultimately, Ingram said, implementation is the best way to achieve progress since it offers a sense of learning-by-doing.
The discussion around these topics is bound to continue. Please visit the Open Forum Event Page for further reading.
