Trying to find the room for this panel was problematic – for an informatics conference, information and communication has been rather poor.

This panel session is titled “Open source eHealth applications and the Millennium Development goals for Africa”.

The first speaker (from Columbia University, in USA) talked bout mHealth as an extension of ehealth, and the Global Villages project funded through WHO. The Global Observatory for ehealth has mhealth for health promotion as its first priority action area (PAA). This covers increased demand for health services and preservation of well being, disease surveillance and control, and health promotion through targeted media, eg through SMS for behaviour change communications. PAA number 2 is around supporting the health work force, and addresses telehealth/medicine consultation being migrated to mobile devices, and point of care support tools. PAA 3 is mhealth for service delivery, though emergency response systems, patient tracking and supply chain management.

She pointed out that there are more mobile phones in Africa than in US and Canada together as of 2008.

Among the challenges:

• limited documentation and impact evaluation on what works in the many pilot projects;

• limited standards for implementation;

• increased trends to focus on mHealth without absorbing the lessons from ehealth;

• rapidly changing technologies;

• poor quality of health information and services, esp. in rural areas.

Other parts of the overall work are around supporting community health workers, eg through birth/death registries (linked to Open MRS).

Andy Kanter, from The Millennium Villages project (MVP), Earth Institute at Columbia University. MVP is a partnership between Columbia University and national governments where the project is based. Focus is on lifting communities out of poverty and using affordable, science-based solutions to address Millennium Development Goals (MDGs). 11 countries (inc Senegal, Mali, Ethiopia, Kenya, Malawi). Three of the 8 MDGs are health related, and aim to improve care. The MVP (http://www.millenniumvillages.org/) aims to establish one clinic per 5000 people, with community health workers (1 per 100-200 homes). The MVG-Net information system is a bottom-up initiative, locally-owned and integrated with global reach. Hub and spoke model, collecting knowledge locally in communities; clinics are location for servers (often using solar power), and use Open MRS and paper systems to gather data. Aim to use technology to build on and improve existing workflows, and use standardised data elements, with forms matching what is on the computer screens. Another aim is to make the forms multilingual, drawing on one common data dictionary.

Neal Lesh (D Tree International) talked about ‘Open source development of mobile applications to support community health workers (CHW)’. The idea is to develop a range of applications that can help CHW plan their work and collect data to help support treatment. Openrosa (www.openrosa.org) is a new consortium of organisations working on mobile applications to collect data; grew out of efforts to create mobile data collection for Open MRS.

Anna Kramers, from Ericsson, talked about their co-operation in the Millennium Village Project. Future growth for mobile operators is seen as coming from emerging markets, and looking at subscribers paying around $US5 per month or less. Among the applications Ericsson (and probably others) are looking into is micro-remittances of money between mobile phones, as well as delivering education via mobile devices. As well as involvement in the MVP, Ericsson has an initiative in the Lake Victoria area to support fishermen, and the Gramjyoti project in India (described as ‘India’s first HSPA village). Ericsson is working with Sun to develop an open source JavaEE telecom application server.

Technorati Tags: mhealth, ehealth, open source, MIE, MIE2008, Africa, Millennium Development Goals

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Well, final thoughts are now emerging as I sit in Detroit airport waiting to complete the last leg of the return home to Buffalo, NY, USA. Long day (aren’t all trans-oceanic ones?). Anyway, wanted to close out the blog for this conference.

First, the software used for this blog is not quite smooth - spaces between paragraphs are not ’staying’ when the entry is published. My apology. Secondly, we did not complete the last day of the conference. Myself and colleagues decided to be tourists but our plans for the day did not turn out as anticipated. We never did make Paris as there was not return TGV train for Friday. We could get to Paris but would have had to stay overnight and return Saturday morning. Instead we traveled to Vianden and tripped lightly up a long inclined road to walk through. A really cool site with great history and spectacular views! Nice quaint town to stroll through - no crowds, either, as it was off-season.

OK, enough of the touristy sidebar. On to final thoughts of the conference. First, the conference was an exceptional demonstration of the utility and need for telehealth and all of its associated sub-specialties on patient care around the world. There was a great diversity of attendees, too, with what I recall as over 50 countries represented. The conference was well run, too, with minimal technical difficulties noted (at least to me). Given the nature of the attendees the need for net access was a given. The wireless was of great quality compared to some conferences I have recently attended (no names, please). Public transportation was excellent to get around, too.

A few items offered as areas of improvement include the ‘group’ plenary session. This was a session on the opening day, which ran for 2 hours during which 8 keynote speakers each had 15 minutes (that was the plan). It was a tough sell and perchance consideration might be to space out these speakers so attendees can relish a ‘richer’ experience. A second item has to do with the environment. The 2 conference rooms (2 & 3) opened onto the exhibition / snack area. The room plan included no doors with a sound wall to deflect the incoming ambient noise. However, this did not happen. For the sessions I participated and or moderated the noise was more than moderately distracting; with no door to close the only alternative was to increase the volume of the speakers.

In spite of the devalue of the dollar I maintain this conference, as a first timer, was worth the investment. There is a concerted effort and desire by the conference administrators to encourage and promote the role of nurses in telehealth / telemedicine. The plan, as I understand, is for more nursing presentations at the next conference, April 1 - 3, 2009, once again in Luxembourg! See you then!

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Thoughts and notes regarding this session may be slightly asynchronous in nature. My battery is well below 50% so we’ll see how long I can go before shut down. It is also clear this session will not complete by its expected time.

There are a host of folks scheduled for this plenary session, which runs from 11am thru 1pm. Each person is allotted approximately 15 minutes. Doing the math there are 10 persons presenting during this time. Opening speaker is Dr. Yunkap Kwankam, eHealth Coordinator, Dept. of Knowledge Mgt & Sharing, WHO. Excellent speaker who covered few topics including AHI (African Health Infoway). He acknowledged this is modeled closely on the Canadian Infoway model. Focus of this project is sharing information and data across countries in Africa. Given the US situation why is not the US working or collaborating with the WHO’s efforts? There may be cooperation but I am unaware and apologize if in fact this is the case.

Nick Fahy is 2nd speaker. Talking only; no presentation. Fahy is the Head of Unit, Health Information Unit, DG Health and Consumer Protection, EC, Luxembourg. Cross border of ‘health care’ is a big concern of Fahy’s unit. Nick says 2017 there is no more growth because of less population; after this point less will be working to pay for the majority of health recipients.

Mr. David Whitlinger, Continua Health Alliance.
Continua is international organization, collaborative in nature and non-profit, with interest in telemedicine. Multiple vendors and other ‘entities’ comprise the alliance. The key for this group is interoperability and how this influences growth and innovation. He talked about personal telehealth; has 3 experiences of (1) health & wellness (the “worried well” are part of this), (2) disease management and (3) aging independently. The alliance is trying to create standards to allow for off-the-shelf applications or out of box development with limited issues related to ’setting up and running’. 22 companies comprised alliance in ‘06; now up to 150 companies in ‘08. Interestingly the members embrace free source code but only members, no ‘non-members’ can access this code.

Mr. Michael Palmer, Project officer, ICT for Health Unit, Belgium
This gentlemen tried to make up for lost time. Unfortunately a fair amount of his talk (primarily background) had been alluded to by the previous speakers. Also unfortunately he read from the slides, a style of some difficulty for the attendees.

Bill Crounse, MD, Senior Director, Worldwide Health, Microsoft Corp., USA
Excellent presenter; had past experience from broadcasting (TV) to draw on; good speaking voice, too. Almost charismatic in presentation. He has his own blog but not sure of title or URL. I’m sure one can locate it searching on his name, though. His (aka Microsoft’s) view of future telemedicine involves heavy cell/smart phone use as far as personal health records. Also briefly discussed was something titled “NxOpinion” (a decision-support company) working with MS for machine-aided diagnosis for 3rd world health providers. He then delved into the future (7 - 12 years hence) with a short video clip depicting this description. Very slick and nicely done. Clip depicted a lot of surface computing interfacing as well as very slick personal tablet for providers and almost instantaneous communication/connectivity. A lot of the technology is similar to their recently acquired multi-digit picture manipulation as well as Apple’s current iPhone presentation.

Jospeh Kvedar, MD, Director, Ctr for Connected Health, Partners, USA
Unfortunately I missed this gentleman’s presentation due to not being present.

Lloretta Schlachta-Fairchild, RN, PhD, FACHE, President & CEO, iTelehealth, USA
I caught the end of Dr. Schlachta-Fairchild’s presentation and wish I had caught all of it. The gist, to me that is, was the importane of nursing to telehealth and the increased activity, and soon to be created, special interest group within ISiTeH (I think this is the organization).

Prof. Harald Korb, MD, Medical Director, Telemedical Svc Ctr of Vitaphone, Germany
I caught some of Dr. Korb’s presentation, too, but only the end and not enough to write about.

Lunch was then held afterwards as part of the attendees’ registration package. During lunch networking among individuals and with vendors was encouraged and well received.

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Opening session is under way. Free WiFi at Luxexpo is a very, very nice touch. So far stability of connection is very nice, too. This opening session is listed as 1/2 hour in length and it appears to be closely following these time constraints in spite of about a 5 minute delay. Opening speakers include Alain Georges, Chairman, Luxexpo; Mars diBartolomeo, Minister of Health & Social Security, Luxembourg; Michael Nerlich, President, International Society for Telemedicine & eHealth; Yunkap Kwankam, eHealth Coordinator, WHO; and, Giuseppe Tritto, President, World Academy of Biomedical technologies (ICET/UNESCO). Also speaking is Nick Fahy, who is speaking later this morning. The conference official language is English, which makes blogging from me much easier. This is the 6th conference of Med-e-Tel.

Approximately 200 attendees at this opening session. Each speaker offers thanks to various persons and organizations. Mars outlines perspectives regarding eHealth both social and financial (added value). Nick Fahy, also, raised issue of solidarity of Europe regarding health care and society; eHealth is one of the key technologies for achieving this goal. Pre-recorded welcome (video clip) from Michael Nerlich as he will arrive tomorrow. Gisueppe Tritto closes the opening remarks. Yunkap Kwankam is unable to contribute at this point because he is on his way. Frank L. closes out the session by outlining various points and emphasis at this conference (students, 3rd World/country representation, and the idea of eHealth for the common good). A short tribute to Dr. Jean-Claude Healy who recently passed away on March 21st of this year. He was instrumental in having an eHealth bill passing in the EU.

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Well, here I am, in Luxembourg. A first timer at the conference as well as visiting the country. The conference (http://www.medetel.lu) is officially titled ” The International Educational and Networking Forum for eHealth, Telemedicine and Health ICT”. The opening page provides a lengthy description of what this organization is about. Take a moment to review as it covers a lot of ground.

Myself and colleagues (Kay Sackett, Rosemary Pope) will rest and recharge this evening to be ready for our contributions to this conference tomorrow afternoon. The gentleman responsible for our attendance, Mr. Bob Pyke, is also here and already hard at work.

More to follow - Scott

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