ADBs Digital Health Flagship Program

Disclaimer: The views expressed in this paper/presentation are the views of the
author and do not necessarily reflect the views or policies of the Asian
Development Bank (ADB), or its Board of Governors, or the governments they
represent. ADB does not guarantee the accuracy of the data included in this paper
and accepts no responsibility for any consequence of their use. Terminology used
may not necessarily be consistent with ADB official terms.

27 June, 2016

Outline
ADBs digital health sector flagship program.
ADB supports the regional digital health network.
ADB supports digital health innovation.
ADB advances digital health investments.

Outline
ADBs digital health sector flagship program.
ADB supports the regional digital health network.
ADB supports digital health innovation.
ADB advances digital health investments.

Definition of Digital Health=ehealth

E-health is the transfer of health resources and health
care by electronic means. It encompasses three main
areas:
The delivery of health information, for health professionals and
health consumers, through the internet and telecommunications.
Using the power of IT and e-commerce to improve public health
services, e.g. through the education and training of health
workers.
The use of e-commerce and e-business practices in health
systems management.
mhealth (mobile health) is part of digital health and means that
mobile devices are used.

ADB supports leveraging ICT in health

Increase efficiency, improve management,
speed and transparency

Rapid case detection and communications applications

Health issues monitoring dashboards

Shared electronic health records

Telemedicine
Mobile health applications, health promotion
Mobile phone-based reminder systems, CDR applications
Integrated patient ID registries

Hospital and insurance digital payments

Financial management information systems
ICT-based supply chain logistics
Human resources for health information system
Use of GIS for targeting services

Why digital health?

Health Information reduces waste
Examples from Australia

$1.5bn
Cost of non-collaboration
on Chronic Disease
Management

$2bn

17%

of

Pathology tests are

duplicates ($306m)

18%

Cost

of

Errors due to wrong

medical Info

of adverse events

$380m
Cost of preventable
medication errors

25%
of Physicians time
spent on getting
medical info

* Peter Fleming, CEO NeHTA | Canberra, 12 April 2010

The value of digital health

Positive socio-economic value after 7-9 years2)

Source1)

1) DesRoches CM et al. N Engl J Med 2008;359:50-60

2) The Socio-economic impact of interoperable EHR and e-prescribing systems in Europe and Beyond, Oct 2009

High

Countries are at different ICT maturity levels

Canada

Health IT Spending Levels (Momentum)

Spain

Germany

Australia Hong Kong

Singapore
France
India

Malaysia

China
Low

Silos

Legal and Org. Maturity

Standards Adoption
Architecture & Technology Complexity

USA

Philippines

Legacy Systems

ERP

PAS

LIS

RIS

EMR

EHR

Health Information Maturity Levels / Adoption Level

Source: Presenters analysis
PAS: Patient Administration Systems | LIS: Laboratory Information Systems | RIS: Radiology IS | EMR: Electronic Medical Records (Across Hospital Depts),
EHR: Electronic Health Records (Across Multiple Hospitals)

Time

Integrated

Digital health is a Flagship Programs

- ADB responds to DMC needs

Asia Pacific,
Greater Mekong Subregion

Asia Pacific,
Greater Mekong Subregion,
Samoa

South Asia

ICT is mainstreamed in all program

Peoples
Republic of
China

Outline
ADBs digital health sector flagship program.
ADB supports the regional digital health network.
ADB supports digital health innovation.
ADB advances digital health investments.

ADB supports the

Asia ehealth Information Network
Technical
ITU, UNICEF,
UN
ESCAP,WHO
universities,
other

Private Sector
Interoperability
lab
Private Sector
Private Sector dialogue
TA
Loans

Peer to peer
learning

Development

Communities

DFAT, GIZ,
GF, Norad,
PEPFAR,
USAID, WB

Ehealth
experts,
users, HingX,
OpenHIE

Development partner coordination

Developing
Member
Countries

ADB supported the formulation of priority next

steps for DMCs to use ICT

Source: http://www.adb.org/publications/universal-health-coverage-by-design
https://prezi.com/qcs5bbswhhws/copy-of-icten/

ADB promotes new models for public private

collaboration
ESRI GIS software company
Asia ehealth Information
Network interoperability lab

Thought Works
Software solution provider

AIT (Advanced Information Technology)

Digital Health software development

Health ICT start-ups

ADB provides advisory services

Outline
ADBs digital health sector flagship program.
ADB supports the regional digital health network.
ADB supports digital health innovation.
ADB advances digital health investments.

ADB supports the establishment of the

Regional Digital Health Interoperability Lab

MEDIC

2007
2016/2017

2010

16

Testing center for interoperability

CR

HW

HF

Registry

Registry

Registry

HRHIS

GIS

HRHIS
HIV

TB

MALARIA

Courtesy of

Collaborative Learning for Digital Health in

the Interoperability Lab

Teaming

Testing

Tooling

Funded with $0.5 M from ADB

Located in the Philippines
Technically supported by WHO
and UNICEF

Training

Co-financing
from private
sector

Geo-enabled AeHIN interoperability lab

Geo-enabled health information for better

planning

Data Silos leading to inefficient

and low quality care

Digital Health for Patient-Centered Care

Care Record

Care Guideline

Digital Health
Infrastructure
Digital health
infrastructure connects
and coordinates care
workflows to improve
system efficiency and
patient health outcomes.

ICT supports Information loops

Operationalize guideline-based care
Standard
Operating
Procedures
(SOP)

SOP-based
Interventions

Support Care
Continuity

ICT Infrastructure

e-Health
Transactional
Data

Provide Management Metrics

Modify
SOP
Financial, Management &
Population Health
Indicators

Digital health interoperability is key for

improving health insurance
UHC

Re-usable digital
assets support
financial
National
ID
transaction
processing, system
management, and
inter-connections
CRVS
to other
eGovernment
systems.

http://jln1.pressbooks.com/

The Ideal ID Situation

CRVS System

Population identification System

Citizen
ID

Passport
Integrated
population register

Info Disclosure System

Residential
Records

NETWORK
Nationality

Voting

Public Sector

Private Sector

Health ID

Example from Cambodia

Medical treatments over 10 years

Health protection over 10 years

2001

2000

2002

2005

2007

2007

2011

2011
(C) M. Stahl, 2015

Local IDs cross-referenced to a master ID

ICT for the Elderly Care Ecosystem

Community care

Home based care

ICT to share information

and optimize care

Geriatric Hospital

Residential care

ADB published a series on digital health

Video on interoperability
https://vimeo.com/140234698

To be finalized in 2016
The business case of digital health
HMIS strengthening for malaria
elimination and CD control

Outline
ADBs digital health sector flagship programs.
ADB supports the regional digital health network.
ADB supports digital health innovation.
ADB advances digital health investments.

Digital health business development

Regional Networks

Project Development

Projects

Asia ehealth Information Network

Health projects with ICT features

2017 PRC Elderly Care Dev Project
2017 UZB Digital Health project
2018 Tonga ehealth project
2017-2020 components of ADF HSG
2015 Samoa Submarine Cable project
2016 components of GMS Health Security,

ICT provides evidence for decision making

ADB supports UHC M&E through Digital Health

ICT provides evidence for decision making

ADB supports UHC M&E through Digital Health

The Regional Malaria and other

Communicable Diseases Threats Trust Fund
supports digital health
RMTF duration: end 2013 to 2017

Donors: Australia, UK, Canada

Total amount: USD 28.7M
Regional coverage: Asia Pacific
Total project allocations to date (5
TAs & CDC2 additional financing)
USD 27.57M

http://reliefweb.int/sites/reliefweb.int/files/resources/malaria-elimination.pdf
37

Trust fund supports health systems including

health management information systems

38

Support for
strengthened regional
knowledge capacity
sharing platform
(AeHin)

Lack of
disaggregated
data
Country support
for eHealth
initiatives

Lack of
investment in
data collection

Fragmentation
fuelled by
development
partner funding of
single initiatives

Weak ID
management

Assessment of
malaria
surveillance
tools

Externalities
ADB Action

Private sector
engagement
(e.g., ESRI)

Policy dialogue
with MoH on
business case
for ICT

Limited recognition
of need for unique
health IDs

Convening
HMIS of
disease
programs

OUTPUT 4
Better use of ICT

Engaging in policy
dialogue on ID
management

Growing need for

data to support
UHC and social
health insurance
Vibrant private
sector offering
interoperable HIS
solutions

Fragmented HIS
that are not
interoperable
Lack of governance
for eHealth at same
time as appetite for
eGov is growing
Govts pass laws and
implement policies on
privacy and interoperability
and unique ID

TARGETS AND RESULTS

RESULT: AeHin funded by
ADB and PRC

Countries vertical disease

program funding to improve
e-infrastructure and
strengthen health systems

AeHin
incorporated and
sustainable

Health
infrastructure
used to improve
accountability of
public and private
sectors

Improved regional evidence base for eliminating malaria and

controlling other CD threats (data collection)
Improved t evidence base for costing malaria elimination and other
CD control in selected countries and in GMS
Introduce and/or pilot cost-effective technologies for data collection
for all stages of malaria control and elimination programs, including
case investigations, and program assessment, monitoring and
evaluating elimination interventions, and link them to national
eHealth plans and health sector reforms
Durable eHealth architecture investments started.

ADB Health
Blog:http://blogs.adb.org/author/healthteam