Hexagon April to June 2014 issue

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Volume I Issue 3 | April to June 2014

The official publication of the Asia eHealth Information Network

IT Governance Training: A Leap Towards National eHealth Capacity T

his May 7-9, the Asia eHealth Information Network supported 11 countries for an IT governance training using COBIT 5 in Manila, Philippines to prepare individuals and institutions towards national eHealth capacity for an eHealth Governance framework. This enables them to build a stable authority on policy, oversight, procedures, and controls to ensure eHealth success that will result to better delivery of healthcare in the country. Mr. Reginald Nery, COBIT 5 trainer from Diaz Murillo Dalupan and Company, delivered this 3-day course to 33 participants from Bangladesh, Cambodia, India, Indonesia, Malaysia, Mongolia, Pakistan, Philippines, Sri Lanka,Thailand and Viet Nam. COBIT 5 is a business framework that benefits enterprises through strategic plans with the help of IT governance and management. The course tackled how COBIT 5 will assist in creating stakeholder value: the worth of a stakeholder’s interest to an enterprise’s product. It also covered the key principles for governance and management of enterprise IT which allow an enterprise to build an effective governance and management framework. It also discussed the seven categories of enablers. These are the factors needed to influence the achievement of success. The enablers optimise IT investments and uses for the benefit of the stakeholders. Continued on page 4

33 participants from Bangladesh, Cambodia, India, Indonesia, Malaysia, Mongolia, Pakistan, Philippines, Sri Lanka, Thailand and Viet Nam who underwent the COBIT 5 Training last May. Undersecretary Ted Herbosa (PHL) leads the participants.

First Thai AeHIN Hour Conducted Bangkok, Thailand - Seeing the benefits of AeHIN Hours, Thailand conducted the first Thai AeHIN Hour on 18 June 2014. The first Thai AeHIN Hour session focused on health information standards and the standards exchange across hospital and pharmacy. The topics included overview of Hospital Information System, Pharmaceutical Management Information System, Health Information Standards, Health Information Exchange, Thai Medicines Terminology and its application in quality assurance, and Decision Support Systems: A Perspective from Hospital Executive Administrator. The speakers were Dr. Boonchai Kijsanayotin, Dr. Anuchai Theeraroungchaisri, Dr. Daorirk Sinthuvanich, and Dr. Narongrit Masayaanon. In general, Thai AeHIN Hour aims to determine gaps in health IT and to provide better understanding of health IT through sharing of knowledge by involved parties in Thailand. The online knowledge sharing session was open to all Thai health IT professionals from hospitals, government and nongovernment organizations, universities, and other interested parties. Continued on page 4

Ministry of Interior, positive on CRVS next steps in Cambodia May 22, Phnom Penh, Cambodia – With the completed national civil registration and vital statistics assessment (CRVS), the country is ready for next steps in developing an implementation plan for rolling out CRVS improvements in Cambodia. This plan includes a CRVS web based database, use of International Classification of Diseases 10 (ICD10) and cause of death in health facility and integration of ICD10 and cause of death training in academic curriculum. “It is envisaged that the government will drive the development and adoption of the strategic plan from a central mandate, and implementing it through large-scale national programs and projects,” Mr. Heng Sophat from the Camdbodia Ministry of Interor said. Continued on page 4

Workshop on Comprehensive Civil Registration and Vital Statistics System in Cambodia

MoH Mongolia Levels Up with Enterprise Architecture and Modelling Last November 2013, the Ministry of Health Mongolia underwent an enterprise architecture training with the support of the World Health Organization (WHO) and the Asia eHealth Information Network AeHIN). The training was held upon request of the MOH plan as they commence the implementation of a Medical Safety Management System (MSMS), a complex multi-stakeholder project that crosses several Ministries and requires various stakeholders in the health sectors to work together. Enterprise Architecture (EA) is a holistic approach in implementing core business information technology. Continued on page 4

The Hexagon in AeHIN symbolizes “interoperability of systems” and when viewed in the context of the organization, it means “working together”. Though the hexagons are differently colored and sometimes overlapping, they still fit together. In AeHIN, like The Hexagons, there are many components to arrive at solutions in many eHealth problems in various countries in Asia. When AeHIN members work together, in every way, problems are solved and capacities are enriched. 1


AeHIN Welcomes Satellite Secretariat in Thailand A

eHIN members at the Thai Health Information Standards Development Center (THIS) in Nonthaburi, Thailand recently commit to share the work in AeHIN as its satellite secretariat this April. This came up with the increased interest, activities, and involvement of AeHIN in support to knowledge sharing and exchange in the network in webinars and eLearnings like the AeHIN Hour and the AeHIN Academy. “AeHIN encourages members to share their experience, explore innovative technique and tools within countries and in the region,” says Win Min Thit who works as research assistant at THIS. Together with Jitsupa Peelay, also from THIS, they form the AeHIN satellite secretariat leaded by Dr. Boonchai Kijsanayotin, AeHIN’s Co-chair. “We hope to assist members gather feedback that would help improve AeHIN’s activities”, adds Win. Win Min Thit and Jitsupa Peelay, AeHIN Satellite Secretariat at THIS. Win has just graduated with a degree of Masters of Science in Biomedical Health Informatics from the Faculty of Tropical Medicine, Mahidol University in Thailand while Jitsupa earned her Masters of Science in Nursing Informatics at Univeristy of Utah, USA.

According to THIS, the diverse background of its staff contributes to the strength of the newlyformed AeHIN satellite secretariat. THIS role in coordinating within ministries, universities, and other development partners, providing peer-topeer support on eHealth, Health Information Systems (HIS), and Civil Registration and Vital Statistics (CRVS) in Thailand also helps to the work that has to be done in the region. “We expect more stakeholder involvement and joint research among members to increase collaboration between countries,” says Win. At the moment, THIS works in close collaboration with the AeHIN secretariat based at the University of the Philippines Manila, National Telehealth Center. With THIS focus on developing the standards and terminologies for health information system to improve the quality of Thai eHealth, it is deemed that the secretariat’s role in consolidating efforts of individuals, groups, and partners towards regional eHealth development will be strengthened.

7 Countries Plan for a Regional Enterprise Architecture Advisory Council Eighteen AeHIN members from Bangladesh, Indonesia, Malaysia, Pakistan, Philippines, Sri Lanka, and Thailand underwent a certification training on enterprise architecture at Kuala Lumpur last March 25-28. In a side meeting, the participants discussed the potential of creating a regional enterprise architecture advisory council that can provide support to national eHealth strategies. In collaboration with the World Health Organization, the Asia eHealth Information Network facilitated official training on TOGAF or “The Open Group Architecture Framework” to help ministries of health formalize their national ehealth strategy using an international, industry-accepted framework. This training follows a series of steps starting with the WHO-International Telecommunication Union National eHealth Strategy Toolkit and IT Governance using COBIT5. These trainings are as suggested by the AeHIN National eHealth Capacity Roadmap The proposed regional architecture advisory council is seen as a mechanism for the network to share knowledge and experience and support each other achieve their national eHealth strategy objectives. The forum was facilitated by Dr Fazilah Allaudin, Deputy Director, Telehealth Division of the the Malaysian MoH, and a member of the AeHIN Working Council.

AeHIN members from Bangladesh, Lao, Malaysia, Nepal, Philippines, and Sri Lanka who were sponsored to participate in the District Health Information System Academy (DHIS 2 Academy Asia 2014 this February in Vung Tau Viet Nam. 2

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he Asia eHealth Information Network (AeHIN) supported the recent mPossible Conference in Dhaka, Bangladesh. AeHIN Co-Chairs, Dr. Alvin Marcelo and Dr. Boonchai Kijsanayotin, presented the “Role of Enterprise Architecture from the perspective of AeHIN,” and the “Adoption of Health Standards in Thailand” respectively. Along with them are AeHIN Bangladeshi members with Professor Dr. Abul Kalam Azad as their gracious host. The 1st Regional Conference on Health Informatics highlighted how tradition meets innovation in the grassroots level of Bangladesh. Community Health Workers (CHWs) work with mobile phones to complete their daily activities of household visits and interviews. The mobile phone is more convenient to use and sends the gathered data immediately to the main office. “It made it easy for CHWs to collect and submit data,” Dr. Marcelo said when asked how mHealth solutions helped in the interaction of CHWs with the families they work with. “It also empowered them to deliver more complex information to the patients via the multimedia [content] on the tablet,” he added. Similarly, Community Health Care Providers (CHCPs) use digital systems to facilitate their work. According to the Management and Information System, Directorate of General Health Services (MIS - DGHS), “CHCPs enter their patients’ data into the online District Health Information System (DHIS 2) software hosted into the ministry’s national health cloud data center.” With the DHIS 2 software, each patient’s health condition can be monitored in real time to determine if health interventions need to be conducted.

(first row) Dr. Jakir Hossain Bhuiyan Masud, Fatema Uddin, Dr. Alvin Marcelo, Hannan Khan, Prof. Abul Kalam Azad, Dr. Boonchai Kijsnayotin, Dr. Paul Biondich, (second row) Dr. Alain B. Labrique, Mr. Mirza Rakibul, Dr. Sultan Shamiul Bashar, Dr. Abu Md. Akteruzzaman, Dr. Maruf Haque, Mr. Muhammad Ullah, Dr.Garrett Mehl, Dr. Ali Rashidee

AeHIN members who attended the conference also learned on their country’s experiences, successes and failures in the implementation of a “Digital Bangladesh”. According to Dr. Marcelo the transition for a Digital Bangladesh has been so far successful because “the national government has a vision itself shared by the ministry” where “resources were made available to make the vision a reality”. The 1st Regional Conference on Health Informatics held in Dhaka, Bangladesh, emphasized the reproductive, maternal,

neonatal, and child health innovations. This 2-day conference from June 23 to June 24 “promoted the need for continuous efforts to develop the country’s health information system.” “I learned [from the Conference] how much the Bangladesh Ministry of Health (MOH) has progressed from the last time Prof. Azad presented his plans in Hoi and Manila back in 2011. The lesson was that it takes time for eHealth to be developed but that it can happen for as long as there is clear leadership and governance,” Dr. Marcelo shared.

AeHIN Visit Gates Foundation and MoTECH in New Delhi

11 Countries Complete AeHIN Academy to Support National eHealth Strategies 24 individuals from 11 countries completed the first AeHN authored eLearning course to support national eHealth Strategies this May. The course was put together as there are no existing trainings outside the arena of eHealth that support developing competencies to support for a national eHealth strategy. Dubbed as “eHealth 101: Capacity-Building to Support the Development and Delivery of National eHealth Strategies” this is the first offering of the AeHIN Academy , the network’s online learning program . The course also supports the release of the WHO-ITU National eHealth Strategy Toolkit, the AeHIN National eHealth Capacity Roadmap, and the innovation and eHealth recommendations of the UN Commission on Information and Accountability for Women’s and Children’s Health. It has assisted participants on understanding how eHealth strategy, planning, an architectural approach, and standards and

AeHIN Members Participate in mPossible Conference in BD

quality, frame the requirements for capacity development. It also helped them identify skills and trainings needed to deliver to the requirements for a national eHealth strategy. After the course, graduates have identified that standards and interoperability, institutional readiness, and leadership that delivers an eHealth action plan were top three of topics which addressed their most immediate personal needs for skills development. Meanwhile, topics which they think need to be addressed with most urgency to support national eHealth strategy development in their country were Health Information Exchange, said Standards and Interoperability, Institutional readiness. As of writing, several improvements in the program are being made so it could be reshared with the broader AeHIN community. It is also being planned to engage the graduates of the program to help monitor progress of their national eHealth strategies.

The WHO Regional offices for South-East Asia (SEARO) and Western Pacific Region (WPRO) of the World Health Organization in collaboration with Bill & Melinda Gates Foundation (BMGF) organized a meeting on the Mobile Technology for Community Health (MOTECH) platform in New Delhi, India on 31 March to 1 April 2014. Dr. Prakin Suchaxaya, Acting Director, Health Systems Development and Ms. Jyotsna Chikersal, Regional Adviser, Health Situation and Trend Assessment both from World Health Organization (WHO) South East Asian Regional Office (SEARO), Mr. Mark Landry, Team Leader Health Information, Evidence & Research from World Health Organization (WHO) Western Pacific Regional Office (WPRO), Mr. Rahul Mullick, Senior Program Officer, ICT from Bill & Melinda Gates Foundation, India Country Office, New Delhi, Mr. Jonathan Jackson, Founder and Chief Executive Officer, Dimagi and Ms. Sara Chamberlain, Head of Information Communications Technology, India at BBC World Service Trust, Dr. Alvin Marcelo, Chair, Dr. Boonchai Kijsanayotin, Co-Chair and Mr. Jai Ganesh, Working Council Member (India) from AeHIN participated in this meeting. Mark Landry presented the WPRO Intensive HIS/eHealth Country Support with Lao PDR as an example. Jyotsna Chikersal presented the SEARO Regional eHealth Strategy while Dr. Boonchai Kijsayanotin and Dr. Alvin Marcelo gave an overview of AeHIN on day one of the travel.

Bill and Melinda Gates Foundation (BMGF) vision for Mobile Technology for Community Health (MOTECH) was discussed by Mr. Rahul Mullick and Mr. Jonathan Jackson explained deployment architecture. On day 2 of the meeting held at Gates Foundation office, Ms. Sara Chamberlain presented the Ananya programme from BBC Media Action which aimed at reducing child mortality, improve maternal health and reduce infectious diseases in the State of Bihar, India. The participants of the meeting were briefed about Mobile Academy to expand and refresh community health workers (CHWs) with knowledge of 10 life- saving health behaviours, Mobile Kunji which is a multimedia service to enhance the immediate impact of CHWs’ counselling of families, and another mobile service called Kilkari. This was followed by a detailed presentation and discussion MOTECH Suite with questions from participants on implementation aspects dealt by both Mr. Rahul Mullick and Mr. Jonathan Jackson. The meeting concluded with next remarks from participants in terms of exploring possibilities for collaboration and partnership in future. Dr. Alvin Marcelo invited Mr. Rahul Mullick to share about MOTECH with AeHIN membership.

The AeHIN Team at SEARO

Jyotsna Chikersal @ SEARO

Day 2 Meeting at Gates Foundation

For further information about MOTECH, we suggest looking-up: The MOTECH Suite http://motechsuite.org/ http://www.grameenfoundation.org/sites/grameenfoundation.org/files/MOTECH_Suite_Overview_Nov2012.pdf Empowering community health workers in Bihar: Mobile Academy and Mobile Kunji http://www.bbc.co.uk/mediaaction/where_we_work/asia/india/india_sdp_empowering_chw_ma_mk.html

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AeHIN Lends Online Learning Platform Center For Free Asia eHealth Information Network (AeHIN) members can now easily collaborate with each other, across the world and in real time, through its newly acquired online meeting platform. Beginning June 2014, AeHIN is lending its own Cisco WebEx Event Center to all its members for free. WebEx is an online platform that lets people meet over the internet. “Online meetings save a large amount of time and travelling costs by allowing attendees to learn from other participants who live on the other side of the world,” Win Min Thit and Jitsupa Peelay of the newly-installed AeHIN Satellite Secretariat in Thailand commented. With this, members from various countries can frequently meet and exchange experiences on their eHealth implementations in real time communication. Countries can also use the platform for their own meetings which they want to extend to a larger audience either within or outside their country. This is foreseen to build stronger relationships within the network that will lead to solving health IT problems in countries. “Cisco WebEx is a platform for eLearning, and resources and information exchange,” Win Min

Thit said when asked on benefit on using Cisco WebEx Event Center for AeHIN members. Cisco WebEx can assist AeHIN members in planning, organizing, and conducting an event with a seating capacity of 500 participants. Cisco Webex Event Center has various features to ensure that online meetings are managed effortlessly. It has “automated email management for sending out invitations, confirmations, reminders, and follow-ups about upcoming events automatically. AeHIN members can share a lot of multimedia content like presentations, applications, white boards and video files with the audience. Feedback on the event can be easily obtained with flexible audio, threaded Q&A, chat, poll, and attention monitor. Other features encourage the audience to actively participate in the event like responding with ‘applause,’ “‘raising hands,’ and asking questions which reinforce the sessions with such hands-on activities,” said Thit and Peelay. Dr. Sambath, AeHIN Working Council

Ministry of Interior...

IT Governance Training...

Continued from page 1

Continued from page 1

Assessment equates ownership “The CRVS Assessment is very important to show that country-ownership is the backbone of any successful programmatic CRVS intervention,” Sophat added. Existing efforts of stating improvements in the CRVS system have been reported meaningful in the Asian region. Information and communications technology assist on this as “a phased country-wise transition from paper-based to computerized web-based civil registration system.”

As of writing, earlier integrations on COBIT 5 to country implementations are being recorded. For an instance, AeHIN scholars from the Philippines have been added to the National eHealth Technical Working group with the Undersecretary of Health mandating a rapid self-assessment on using COBIT 5. Post-conference, this topic was also discussed at the OpenMRS Implementers meeting in Kenya with the participation of DHIS2 core personnel.

AeHIN’s WebEx for eLearning

CRVS Assessment to strengthen implementation After the assessment, implementations are already being made such as creating a system for identifying and analysing expected versus actual registrations of births and deaths and modifying the legal framework so it is mandatory for all health facilities to notify the civil registration office about births, deaths and cause of deaths for all cases that occur inside health facilities. It also established a regular monitoring and evaluation mechanisms, with feedback loops to complete timely data. Additional improvements include adoption of the International Medical Certificates of Cause of Death by all health facilities for private and public sectors and Orientation and training of all doctors and medical officers of cause of death certification practises to ascertain the underlying cause of death in line with ICD 10 rules. The assessment, which was leaded by the Department of General Administration of the Ministry of Interior, was done with the joint efforts of the country’s Ministry of Planning and Ministry of Health and was supported by the World Health Organization and various partners. 4

“This is a significant clinical and public health informatics problems which has been plaguing researchers. AeHIN members will be willing participants in efforts to find cost-effective, standards-based solutions to the problem,” says Dr Marcelo. In a separate workshop also in IMIA, the issue of eHealth capacity-building within ministries of health was a major finding. The workshop led by Drs Tony Luberti and Janise Richards (and participated by AeHIN) raised the possibility that many ministries in developing countries may not have a full grasp of the required capacities for national eHealth development. Thus they may benefit from guidance on what capabilities need to be built locally to support the national eHealth strategy.

First Thai AeHIN Hour... Continued from page 1

It was a joint effort among Thai Health Information Standards Development Center (THIS), The Faculty of Pharmaceutical Sciences of Chulalongkorn University, the Thai Medical Informatics Association’s Biomedical, Health Informatics Education Special Interest Group (TMI BHI-ED-SIG) and Asia eHealth Information Network (AeHIN).

Preparation for Thai AeHIN Hour at Faculty of Pharmaceuticals Sciences, Chulalongkorn University. member from Cambodia said that “country members can use Cisco Webex for meeting or training at country level.“ Apart from participating in AeHIN Hour, members can [also] organize their local AeHIN Hour which allows you to create eLearning programs like AeHIN Academy by using Cisco WebEx with no extra costs for both organizers and participants. With the availability of Cisco WebEx Event Center, members can look forward to participating in AeHIN training events on eHealth-related topics and help create knowledge among members and non-members within or outside of AeHIN,” elaborated Thit and Peelay.

WebEx Features real-time screens “The feature we like most in Cisco WebEx Event Center is assigning the presenter,” Win Min Thit and Jitsupa Peelay discuss. This feature allow sharing of desktop screens and make participants feel they’re meeting with each other face-to-face. They also mentioned the “easy process for requesting the access, registration and participation in the webinars” by clicking the link from their invitation emails and joining the meeting room. Cisco WebEx Event Center also allows AeHIN members’ easy interaction on participant’s presentation with the “use of a chat box, microphone, discussion board and computer camera.”

MoH Mongolia Levels Up... Continued from page 1 Mongolia MOH opted for The Open Group Architecture Framework or TOGAF since it provides certification training for EA. In addition, TOGAF is the same framework being used by the larger government-wide IT Council. This year, MOH Mongolia proceeded with Archimate 2.0, a modelling language for EA to augment their capacity. Dr. S. Tugsdelger Director Department of Monitoring, Evaluation and Internal Auditing Ministry of Health, is the first AeHIN TOGAF certified professional under the network’s roster of capacity building programs. Eighteen other Mongolians were trained thereafter in Archimate. A key action after the trainings held was when Khurelbaatar.Kh, Policy Planning and Coordination for Information Technology Developments in the Health Sector, MOH , presented the MSMS and Dr. S. Tugsdelger commit to use TOGAF and Archimate.


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