Electronic healthcare (eHealth) systems continue to hold great promise for improving global access to healthcare services and health informatics, particularly in the developing world.
This is according to the International Telecommunications Union (ITU), which says delivering on this promise requires more universal eHealth interoperability standards, overcoming technical infrastructure barriers, and addressing privacy, security, and other legal requirements.
In order to look deeper in this issue, the ITU has released a Technology Watch Report, which presents a snapshot of the current eHealth standardisation landscape, and describes some obstacles that must be overcome.
It also identifies the emerging standardisation opportunities and activities within the ITU that will contribute to the global deployment of efficient and secure eHealth systems.
The organisation says universal standardisation, whether driven through private industry collaborations or government standards policies, is a necessary precursor for any of these eHealth advancements.
“There is no question that eHealth is in a period of rapid technical, economic, and social transition,” it says. “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.
These same technological advancements in eHealth are creating heightened public policy concerns about patient privacy, information security, and the role of electronic genomic repositories in enabling genetic discrimination, the ITU points out.
“Standardised electronic medical records promise to facilitate the digital exchange of patient data among a patient's primary care physician and other health providers,” it says. Aggregated, anonymised health data mined from these digital records hold the potential to improve the efficacy of health research, it adds.
Anonymised and aggregated public health data stored in common, digital formats can improve medical research and digitally stored genetic data can provide more customised medical care to patients, says the ITU.
“Even though the health sector is 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,” it adds.
Current barriers
It is also the ITU's view that technological obstacles that hinder the promise of eHealth systems include the lack of global interoperability standards for eHealth and technical infrastructure barriers, particularly in the developing world.
The union, however, believes that many of these challenges can be addressed through advancements in technical standards for eHealth.
“Standards create the necessary interoperability among healthcare systems; minimise the risks of new technology development; prevent single vendor lock-in; reduce costs by enabling market competition and eliminating the need for expensive and customised solutions; ensure widespread adoption; and address specific concerns about privacy, security, and patient identification,” it says.
According to the ITU, eHealth standardisation 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, it adds.
Electronically integrating these entities, it says, will be a great challenge for technical standardisation.
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, it also points out.
The World Health Organisation (WHO) defines eHealth as “the cost-effective and secure use of information and communications technologies in support of health and health-related fields, including healthcare services, health surveillance, health literature, and health education, knowledge and research.”
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