Thursday, January 27, 2011

The International Telecommunications Union Issues A Status Report on E-Health Standards.

An interesting summary report from the ITU appeared a little while ago. The report is titled:

Standards and eHealth

ITU‐T Technology Watch Report January 2011

The full report can be downloaded from here:

V. Conclusion: Standards and eHealth

eHealth standardization is inherently a complicated area. eHealth systems have to connect many stakeholders ‐ hospitals, pharmacies, primary care physicians, patients in their homes, and administrative entities such as insurance companies or government agencies. Each of these entities has an enormous installed base of technologies, information systems, and medical devices, often based upon proprietary specifications. Electronically integrating these entities will be a great challenge for technical standardization. A second requirement complicating the standards landscape for eHealth is the inherently sensitive nature of the information, requiring a high degree of privacy protections, quality assurance, and security. The health sector is also heavily regulated by national authorities. New technologies can present a risk of not meeting those regulations. Furthermore, health practitioners can be inherently risk adverse and reluctant to adopt new technologies.

As described above, many eHealth standards initiatives exist but many questions remain about whether some of these initiatives are in competition or conflict; whether standards will be adequately implemented by health care providers; and whether there will be interoperability among various efforts. There are also different approaches to eHealth standardization in different countries and regions, a condition which will may impinge upon the efficacy of eHealth standards efforts and complicate standards adoption policies of device and systems manufacturers that sell globally.

There is no question that eHealth is in a period of rapid technical, economic, and social transition. In the foreseeable future, common digital formats and structures have the potential to allow for the exchange of integrated patient information among all of the patient’s medical providers. Multimedia and messaging standards can continue to improve remote clinical care, remote patient monitoring, and remote diagnostics. Beyond remote access, it can also facilitate exchange of information and collaboration among various health practitioners, as well as portability of results to be shared, for example, at a later date by the patient with another practitioner. Anonymized and aggregated public health data stored in common, digital formats can improve medical research and digitally stored genetic data can provide more customized medical care to patients. Universal standardization, whether driven through private industry collaborations or through government standards policies, is a necessary precursor for any of these eHealth advancements. There are three reasons for this:

Technical Interoperability: eHealth applications such as remote diagnostic systems and electronic medical records will only be successful if there is a high degree of interoperability among the institutional systems exchanging this information, and a high degree of compatibility among medical devices and digital systems, regardless of manufacturer;

Economic Efficiency: Medical providers and public entities will invest in costly eHealth solutions only if assured that the systems will have some longevity into the future rather than becoming quickly deprecatedbecause of the introduction of yet more eHealth standards options. Globally (or at least regionally/ nationally) agreed‐upon standards can provide the necessary stability to economically incentivize new investments and, if openly available rather than proprietary, can help foster economic competition among compatible eHealth systems and equipment made by different manufacturers or systems developers.

Public Accountability: To an even greater extent than most types of technical standards, the design decisions underlying eHealth standards will have public interest effects in areas such as individual privacy, nondiscriminatory access to healthcare, and the overall public good. These decisions should be made with some type of global public accountability, whether developed in a multistakeholder fashion or at least openly available to the public for oversight.

----- End Conclusions

The report is worth a read as it does explain a good number of the issues and makes clear the complexity that is faced by all involved.


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