IFMSA Policy Statement eHealth

Proposed by FUMSA-Uganda, BeMSA-Belgium, Seconded by Hammamet, Tunisia; March 2014

Summary IFMSA strongly supports the advancement and accessibility to the use of e-health, to deliver health and healthcare services and information over large and small distances (1)

WHO defines eHealth as the cost-effective and secure use of information and communication technologies (ICTs) for health and health-related purposes.(2) The potential impact of eHealth on both low- and high-income countries’ health care system is considered big.(2)

In the past 10 years several governments around the globe have experimented with the implementation of eHealth with very good results.(2-7) Taking these results into consideration, we strongly believe that the further implementation of eHealth may promote the implementation of Universal Health Coverage and better, more accessible and more affordable health care services for all.

We as IFMSA believe that the obstacles that currently hold back the further implementation of eHealth, can be dealt with by better collaboration between different stakeholders in the health care sector. As such we call upon governments and other stakeholders to respect and actively implement the guidelines provided by the 58th world health assembly.

Introduction eHealth is as the cost-effective and secure use of information and communication technologies (ICTs) for health and health-related purposes.2 There are seven components of eHealth, namely: leadership and governance; strategy and investment; legislation, policy and compliance; human resources; standards and interoperability; infrastructure; and solutions or applications and services (2).

Welcoming WHO’s affirmation about the potential impact that advances in information and communication technologies could have on health-care delivery, public health, research and health-related activities for the benefit of both low- and high-income countries (2).

Multiple and diverse stakeholders--including hospitals and other healthcare organizations, clinician groups, consumer and patient groups, employers and purchasers, health plans, healthcare information technology organizations, manufacturers, public health agencies, academic and research institutions, and public sector stakeholders should be engaged to define and then implement specific actions that will address the quality, safety and efficiency challenges of our healthcare system through the use of interoperable information technology. (11)

Bearing in mind the clear advantages that many other sectors both in civil society and industry take from ICT and that this is the technology development era;

Believing that this view is the direction we follow today, and that a proactive approach will be more meaningful than a reactive one;

Taking into consideration successful examples such as:

• Health ministry of Kenya developing the “Kenya National e-Health Strategy 2011-2017” (3) • Ethiopia’s effort of on health management information systems, electronic medical records,

human resources information systems (HRIS), and telemedicine (4) • Development done in Telemedince in countries such as Brazil (5) and Cape Verde (6) • And the development of eHealth in India (6) and mHealth in Bangladesh (8).

Considering that a lot of effort is yet to be done, as lack of infrastructures, ICT facilities, and phone and internet coverage do impede eHealth service implementation; and ICT access and its global development is unequal and happens according to local and regional needs and capacities;

Main text Strongly believing that eHealth Services would promote

• Achievement of Universal Health Coverage • Better and more affordable access to medical care, both in developed and developing

countries • Effectiveness of healthcare systems, as gathering patient information and making it easily

accessible will enhance both follow-up and preventive care, in a multidisciplinary based approach,

• Gathering and archiving of medical data, encouraging research and facilitating preventive medicine

Taking into account that eHealth systems

• cannot be implemented without ICT facility creation • should not replace today’s healthcare services as they are, but aid them towards a better care

delivery • require assurance of security and privacy of patient information, that cannot be used for other

purposes that non-medical reasons.

IFMSA urges all stakeholders to draw long-term strategic plans for developing and implementing eHealth services in the health sector;

We call upon governments, organizations, countries and companies: • To respect and actively implement the guidelines provided by the 58th world health assembly

(2) • To provide access to e-health trainings within undergraduate and postgraduate medical

education • To offer access to additional training in e-health to practicing physicians • To invest in the widespread of affordable phone and internet coverage as much as possible, • To raise awareness on the benefits of e-health • To invest in infrastructure to provide access to all to participate in e-health • To call for governments to take responsibility in making sure these practices reach rural and

vulnerable populations • To create a national legislation body and a long-term strategic plan to deal with the

implementation of, risks and challenges of e-health • To create a national interdisciplinary medical framework in which information can be shared

between professionals while still protecting patient interest • To create an international framework and guidelines, and to appeal for member states’

engagement and international collaborations bringing together telemedicine / eHealth users, scientists, researchers and sponsors, advisers, manufacturers and distributors and their scientific personnel; (10)

• To actively implement the e-health system using all required and existing resources and to contribute to the dissemination and exchange of knowledge, information and technologies relating to telematic applications (10)

• To monitor and improve the standards of Practice/Quality of Clinical Care in order to achieve the best clinical outcomes, as well as protecting patient confidentiality and applying relevant legislation and regulations related to patient decision-making and consent

IFMSA commits to • Raise awareness, enhance discussions and promote ideas on this issue, via our internal

meetings through capacity building and online communication platforms, and provide follow up • Advocate for the implementation and development of e-health at external meetings • Develop ethical guidelines for medical students and physicians who use eHealth to provide

health care services (1) • Protect the private health information of all patients,as the advent of the internet and social

media, combined with the increase in health care workers participating in global health experiences, has left many patients vulnerable to abuse of their private health information. (9)

References

[1] WMA Statement on Guiding Principles for the Use of Telehealth for the Provision of Health Care Adopted by the 60th WMA General Assembly, New Delhi, India, October 2009 [2] FIFTY-EIGHTH WORLD HEALTH ASSEMBLY. Resolutions and Decisions. WHA58.28. Geneva, Switzerland : http://www.who.int/healthacademy/media/WHA58-28-en.pdf, May 2005.

[3] MINISTRY OF MEDICAL SERVICES. Kenya National eHealth Strategy 2011-2017. Nairobi, Kenya, 2011. http://www.isfteh.org/files/media/kenya_national_ehealth_strategy_2011-2017.pdf.

[4] Capacity Plus. CapacityPlus Contributes to eHealth Workshop in Ethiopia. Addis Ababa, Ethiopia, July, 2011. http://www.capacityplus.org/capacityplus-contributes-ehealth-workshop-ethiopia.

[5] Ana Karina P. Barbosa, M.Sc. A Web Application to Support Telemedicine Services in Brazil. AMIA Annu Symp Proc. 2003; 2003: 56–60.

[6] International Trust Fund for Demining and Mine Victim Assistance. International Telemedicine and e-Health Training for leadership personnel from Cape Verde. May, 2013. http://www.itf-fund.si/news/international-telemedicine-and-e-health-training-for-leadership-personnel-from-cape-verde.

[7] S, Jaros Awski. In eHealth in India today, the nature of work, the challenges and the finances: an interview-based study. BMC Med Inform Decis Mak. 2014 Jan 6;14(1):1.

[8] OM, Ginsburg. An mHealth Model to Increase Clinic Attendance for Breast Symptoms in Rural Bangladesh: Can Bridging the Digital Divide Help Close the Cancer Divide? Oncologist. 2014 Jan 6.

[9] IFMSA Policy Statement Global Health Information Privacy and Protection Statement (GHIPPS) Adopted in Baltimore, United States of America - March 13th 2013

[10] International Society for Telemedicine & eHealth (ISfTeH) Statutes (rev. 15/12/2012)

[11] eHealth and the future: promise or peril? BMJ 2005; 331 doi: http://dx.doi.org/10.1136/bmj.331.7529.1391 (Published 8 December 2005) Cite this as: BMJ 2005;331:1391