AeHIN celebrates its 10th year at AeHIN GM 2022

The Asia eHealth Information Network held its AeHIN General Meeting and Conference 2022 with the theme “Accelerating Digital Health Towards Universal Health Coverage (UHC)” from October 10-12 at Ascott in Makati, Philippines which was simultaneously streamed online via Zoom.

The conference coincided with the network’s 10th anniversary and Digital Health Week 2022. A total of 366 members participated in the conference; 246 joined via Zoom while 120 were present in the venue. There were 239 males and 127 female attendees.

The Department of Health Philippines co-hosted the event with support from the World Health Organization Country Office in the Philippines. The following organizations collaborated with AeHIN for this year’s conference: the Patrick J. McGovern Foundation, Fondation Pierre Fabre, Transform Health, the World Health Organization (Philippine Country Office and Western Pacific Regional Office), Digital Square, PATH, Digital Impact Alliance (DIAL), openIMIS and GIZ, OpenHIE, Digital Health Centre of Excellence (DICE)-UNICEF, the International Planned Parenthood Federation, UNITE Parliamentarians Network for Global Health, The Global Fund, USAID, and HealthEnabled.

DAY 1

On the first day of the conference, AeHIN held an exclusive partners’ day, wherein the community of donors and development partners in the regional digital health sphere discussed relevant digital health topics they have been working on to accelerate digital health towards UHC. Fourteen partners presented their digital health initiatives:

DAY 2

The second day of the conference formally launched the opening of the 2022 AeHIN GM. The opening ceremony acknowledged the co-hosts of the 2022 AeHIN GM namely, the Department of Health Philippines and World Health Organization Country Office in the Philippines. The opening ceremony included virtual keynote messages from Dr. Maria Rosario S. Vergeire, MPH, CESO II (Officer-in-Charge, Department of Health), Dr. Graham Harrison (Officer-In-Charge of the Office of the WHO Representative to the Philippines), and other partner representatives. 

Building upon AeHIN’s previous regional call to action to strengthen regional health systems response to pandemics through Governance, Architecture, People & Program Management, Standards & Interoperability (GAPS) Framework, AeHIN presented the GAPS 2.0, which synthesized the updated digital health needs in the region in the key themes/vision statements below based on preliminary findings:

• GOVERNANCE: Sustainable, Inclusive, and Collaborative Digital Health Decision-Making Body
  • Best practices
    • Organizing digital health decision making body based on a strategy that works for the country
    • Institutionalizing this decision making body for digital health governance
    • Defining shared digital health goals and responsibilities
    • Ensuring regulation and compliance by preparing and implementing relevant policies
    • Ensuring transparency and accountability by conducting public consultations
    • Organizing regular meetings and activities for digital health governance 
  • Challenges
    • No clear governance structure and roles for digital health
    • Lack of follow through in implementing plans and regulations
    • Lack of funding
    • No harmonization of insurance, providers, and the clients
    • No alignment with digital health priorities
    • Political changes and reforms that affect ongoing digital health governance mechanics
    • Siloed planning and decision making mechanisms for digital health
    • Challenges in making digital health governance more inclusive to private sector and general public
• ENTERPRISE ARCHITECTURE: Harmonization of IT and Health Workflows in a Simple, Laymanized, and Future-proof Digital Health Enterprise Architecture 
  • Best practices
    • Relabeling ‘enterprise architecture’ as ‘blueprint’ for simplicity and to easily advocate for what it stands for among various stakeholders
    • Developing a whole-of-government enterprise architecture 
    • Developing sectoral enterprise architecture and ensuring alignment with UHC
    • Ensuring enterprise architecture focuses on both business architecture and technology architecture (with business preceding technology)
    • Making enterprise architecture/blueprint a requirement for new digital health projects which then leads to stakeholders to work together
    • Setting up dedicated team for digital health enterprise architecture and ensuring they are well capacitated
  • Challenges
    • Misconception that enterprise architecture is limited to technology only which leads to lack of alignment to actual business process in the health sector
    • For technology, lack of reference architecture that ensure interoperability and security through standards
    • General resource constraints to implement enterprise architecture (funding, manpower, and capacity to streamline associated technologies)
    • Some enterprise architecture/blueprints remaining as ‘plans’ that are not comprehensive and not ready for implementation
    • Some enterprise architecture/blueprints not adaptive enough for emerging technologies (blockchain, etc)
• PEOPLE & PROGRAM MANAGEMENT: Organized, Competent, and Collaborative Digital Health Workforce
  • Best practices
    • Organizing digital health workforce based on a strategy that works for the country
    • Tailor fitting terms of references or responsibilities of persons and teams based on the nature of operations of the digital health office/unit
    • Strategic partnerships with external stakeholders (partners, academe, standards development organizations, interoperability labs, etc) to provide government staff with formal training/education in digital health
  • Challenges
    • Lack of organized digital health workforce due to competing interests of several agencies and stakeholders to dominate digital health development 
    • Lack of coordination between divisions and programs, which results in siloed systems that only address program-specific/division-specific objectives
    • Quick turnover of people working in digital health, including IT specialists opting to move to other sectors due to multiple reasons, including salary sale
    • Limited capacity in digital health people and program management
    • Dependent on vendors for big data analysis and visualization, etc
• Integrated Digital Health Systems Guided by Human Interoperability
  • Best practices
    • Policy support on standards and interoperability
    • Strengthening of health information management systems at the national level (ex: DHIS2)
    • Establishment of national health interoperability labs/regulatory sandboxes to collaborate with startups, test technologies, train digital health people
    • Establishment of national data warehouse to encourage use of operational data in the health sector
    • Standardization of terminology (ICD, LOINC, SNOMED)
    • Standardization of identifiers through health facility registries and national IDs
    • Standardization of data exchange by adopting and adapting international standards such as FHIR (80:20 rule)
    • Conformance to standards and interoperability (validation of systems before deployment
    • Use of single platform for EMR exchange
    • Use and localization of low-cost available technologies (global goods or commercial) and/or interoperating with other apps for specific functionalities rather than creating a new one
    • Ensuring security of data (ex: separating databases for clinical and socio-demographic data; data anonymization)
  • Challenges
    • Competing authorities on which standard/s to use (ex: insurance agency and health ministry)
    • Poor data quality
    • Multiple data formats 
    • Different ways for data collection/ data entry to different systems (risk of data duplication)
    • Different systems with redundant functionalities (risk of process duplication)
    • Even with HIE, integrating different systems is difficult
    • Long process for adopting standards in the health sector
    • Technology becomes obsolete quickly
    • Lack of good connectivity
    • Lack of trust in sharing data
    • Lack of endorsement of policies on standards and interoperability
    • No minimum set of standards

The GAPS 2.0 presentation set the stage for succeeding deep-dive sessions on each of the components, governance (G), enterprise architecture (A), people & program management (P),  standards & interoperability (S). In each of the component-based sessions, countries were able to further discuss the landscape of their digital health strategy and initiatives, what works, and what doesn’t in their given country contexts. 

Day 3

Finally, during the third day of the 2022 AeHIN GM, a business meeting was held to map potential development partner support to the priority needs of countries. The countries had an active dialogue with development partners present namely, Dr. Kidong Park (WHO WPRO), Merrick Schaefer (USAID), Sean Blaschke (DICE, UNICEF), Dr. Arin Dutta (ADB), Saurav Bhattarai (openIMIS, GIZ), Mark Landry (The Global Fund), and Léa Matel (Projects Manager, FPF). The event was formally closed by Dr. Enrique A. Tayag (Director, Knowledge Management and Information Technology Service, Department of Health Philippines) through a virtual closing message. 

Materials from the General Meeting are now available through the following pages/links:

• Recordings: https://www.youtube.com/channel/UCQX_ys7hL2L3k5SsxDy061Q
• Presentation slides: https://www.asiaehealthinformationnetwork.org/aehin10/presentations/
• Conference Proceedings: to follow