Geneva Health Forum Archive

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Public Health Capacity-Building and Web 2.0 – the Peoples-uni

Author(s): R. F. Heller1
Affiliation(s): 1Peoples-uni, Edinburgh, United Kingdom
Key messages:

1 – There is a wealth of educational resource freely available on the Internet, but to be really useful it needs to be set in the context of an educational programme.
2 – Peoples-uni helps to build Public Health capacity in low- to middle-income countries, using volunteers to develop and deliver modules and courses which use Open Educational Resources, and which are of much lower cost than courses offered by universities.
3 – The experience of the Peoples-uni so far, suggests that this model of capacity-building has considerable potential, even if there are difficulties in realising the full potential of the concept of Web 2.0.

Summary (max 100 words):

The Peoples-uni (http://peoples-uni.org) aims to help build Public Health capacity in low- to middle-income countries (LMIC). It is based on the existence of high quality, online Open Educational Resources (OER) freely available through the Internet. Use of OER and volunteer staff allows costs to be kept to those that can be met by the target audience. A group of nearly 70 volunteers are helping develop course modules, covering major Public Health problems and the foundation sciences of Public Health, leading to certificate and diploma awards to be offered by the UK Society of Public Health. A single course module covering Maternal Mortality, aimed at Public Health professionals, was piloted with 38 health professionals from 8 countries, using the open source educational platform, Moodle. An evaluation revealed that gaining knowledge and skills were rated as more important than academic credit, and the academic value of the course was judged excellent or good by the majority of the respondents, with a majority also reporting that this module was relevant to their job or career and that they would enrol in more course modules. In the spirit of Web 2.0, we have invited the students to recommend the topics of future course modules and to join in the course development and delivery, although most students so far have found it difficult to go beyond the role of the traditional student. We wish to be responsive to the real capacity-building needs of the communities in LMICs, and to ensure that the education is appropriately localised. For this purpose, and to ensure that we add value to local LMIC organisations, we seek to engage partners and collaborators in these countries.

Conclusion (max 400 words):

Peoples-uni is an Internet-based educational initiative, using Open Educational Resources, to assist with Public Health capacity-building in LMICs. A pilot course module was well received, and an international faculty has come together to develop and offer courses to the certificate and diploma level. Collaboration and participation between teachers and students, and with organisations in LMICs, are key goals.

Lessons learned:

On-line education, taking advantage of Open Educational Resources and volunteers, has considerable potential to contribute to capacity-building in low- to middle-income countries. Taking full advantage of the possibilities of Web 2.0 is difficult in the educational arena.

ICT and International Hospital Cooperation

Author(s): P. de Lorme1
Affiliation(s): 1International Affairs Department, Rouen University Hospital, France
Keywords:

ICT (Information Communication Technology), medical and nursing staff training, proximity health access, transfer of competences, public health, cultural dialogue, migrant’s health

Background:

Experience in international cooperation in health fields, Asia, Africa, Middle-East, Latin America, East European countries, European Union.

Summary/Objectives:

As regard to quick evolution of health systems and problems arisen from difficulties to insure equal access to healthcare and supplies for populations, which is a real challenge for health managers and politics everywhere, ICT may represent an interesting tool for improving health access and country planning, regulation and competences maintaining. Rouen University Hospital is implementing regularly ICT connexions: 2 examples: with our partner Belo Horizonte University Hospital (Hospital das Clinicas) in Brasil (Minais Gerais state) are performed medical and nursing staffs in different health fields and specialities like, radiology, surgery, paediatric, pneumology. Some of them are streamed to ‘favellas’ which are equipped and also to isolated surroundings. In nursing staffs, training meetings versed to operation rooms start in 2007, dealing with different topics as nursing competences, good practices, patient’s flow regulation, emergency medical system, standards applied, organization references, quality process, certification. IP standards connexions are used, timing is between 2 and 3 hours. Each meeting requires from both part preconditions of preparation. First of all, are discussed by internet, objectives and main contents, planning, one pre-connexion test is always performed taking into account time-lag, 1 technician online in case of communication-breakdown. Reciprocally, our partner in Brazil is performing ICT connexions with peripheral isolated primary health centres areas. Applications are focused to emergency diagnosis (cardiology tests), prevention programmes. Must be outlined a significant decreasing of patient’s transfers to upper health level. These experiences are very interesting for us in Europe too as regard to equivalent problems we have to face up linked to lack of health professionals, doctors and nurses badly distributed within certain areas which lead to unequal distribution and access to health deliveries. One main challenge is to answer to new health needs and demand (ageing) and to propose capacity of proximity healthcare supply. A second example is concerning the cultural dialogue. It has been realised through multipoint Visio conference with 3 African countries a debate following a movie projection dealing with IHV theme within its medico-psychological aspects as regard to orphan children suffering of this pathology. A workshop has been realised recently also in the same way versed to migrant’s health we meet in our hospitals, meeting attended between specialists in Rouen and Dakar (Senegal). Important point to be retained: ICT tools may represent a parameter of social cohesion for populations because, breaks isolation, allows dialogue between any health professionals and their recognition and more able afterwards to imply them in different public health programmes, maintains continue training and access to updated information, favours health access diagnosis and treatments which may introduce a better comfort for patients as well.

Results:

Patient’s transfers avoided, proximity health access favoured, better observance follow up, health comfort and social cohesion improved.

Connecting the Global Healthcare Workforce through e-Health

Author(s): A. Panjamapirom*1, J. L. Steward1, P. F. Musa2
Affiliation(s): 1PhD in Administration - Health Services, 2Management, Marketing and Industrial Distribution, University of Alabama at Birmingham, USA
Keywords: E-Health, continuing medical education, global healthcare workforce, tele-education
Background:

Like other resources, human resources are limited. The scarcity of resources leads to a number of social and economic issues. The healthcare sector around the world is confronting the crisis of inadequate supply of healthcare providers. At the same time, the demand of medical services is skyrocketing as a result of the aging population and numerous chronic diseases. Additionally, the world population is even more intimidated by the threats of mortal infectious diseases such as HIV/AIDS, malaria, pandemic flu, hunta virus, and severe acute respiratory syndrome (SARS). From the foregoing and as the supply and demand are growing apart, the crisis of global healthcare workforce importantly merits increased attention. Despite its significance, the number of healthcare workforce is not the only concern. Quality of care is among the top priority policy issues; the skills and capabilities of these providers are therefore of critical importance. World Health Organization (WHO) and World Bank have created a collaborative framework of e-Health development, which is perceived as a promising solution to various predicaments in healthcare. One of the e-Health applications is knowledge services. Since knowledge is power, we as a society are leaning toward creating and disseminating up-to-date information and innovative knowledge across all disciplines. Healthcare knowledge is completely valuable as it is directly used to save lives and improve their quality. Healthcare providers are required to maintain their knowledge, skills, and abilities necessary to successfully perform their tasks. As a result, continuing medical education plays a major role in supplying knowledge to the providers. Through tele-education, healthcare providers around the world can share a real-time experience in numerous diagnosis and treatment procedures. As such, the medical knowledge can be rapidly enhanced and diffused, which will be greatly valuable to the population of the world.

Summary/Objectives:

The issues of healthcare workforce, the number of supply and the skills and capabilities of healthcare provider, are discussed. The framework for using e-Health to address these issues is provided. The main objective of this poster presentation is to provide strategies to link global healthcare workforce through e-Health applications.

Lessons learned: 1 – E-Health applications enable the global healthcare workforce to gain new knowledge, share medical experiences, and develop higher skills and capabilities useful for their practices.
2 – The strategies provided will help accelerate the adoption of e-health applications among the content providers of continuing medical education.
3 – Both healthcare academicians and practitioners can greatly benefit from rapid diffusion of knowledge around the world.

Health System and Health Workers Capacity Building as a Strategy for Strengthening Health Systems in Developing Countries: What Roles can Mobile/Wireless Technologies Play?

Author(s): A. Iluyemi*1, J. Briggs1
Affiliation(s): 1Centre for Healthcare Modelling and Informatics, University of Portsmouth, UK
Keywords:

Strengthening health systems, health workers and health system capacity building, strategy and policy, Millennium Development Goals, developing countries, eHealth, mobile/wireless ICTs

Background:

Health systems in developing countries are groaning under the strain of combating the double burden of chronic and infectious diseases facing their populations. Scarce financial resources, coupled with the massive brain drain that has led to the loss of mostly high and medium level health workers, has further coloured this picture. The major burdens on the health system in Africa are the diseases highlighted in the UN Millennium Development Goals (MDGs). These diseases put national health systems under severe strain and have impacted on the fabric of society. For example in Africa, HIV/AIDS accounted for 2.4 million deaths in 2002, and malaria-related mortality is not far behind with one million deaths (mostly children) recorded yearly. These disease burdens have impacted negatively on health workforce capacity. For example also in Africa, deaths from AIDS have resulted in the depletion of skilled workforce especially health personnel due to high mortality rates. Statistically speaking, Africa is reported to have 10% of the world population but bears 25% of the global disease burden managed by only 3% of the global health workforce. These figures are presented here to vividly illustrate the poor state of Africa’s population health and also to highlight the need for exploring alternative strategies for healthcare delivery in Africa. Proffering solutions to these health problems will demand the strengthening the health system capacity in dealing with them. Strengthening the health systems means ensuring equitable delivery of healthcare to populations with most health needs. In addition, health systems are made up of health workers and without their efforts, building health system capacity might not be achievable. Therefore focusing health system strengthening strategy on building health workers’ capacity might result in long-lasting impact. This dual view of health system strengthening but with focus on health workers capacity building will henceforth be the focus of this paper. It is at this junction that ICTs have a major role to play. Using ICTs for the timely achievement of MDGs-health related ambitions is well in line with goal # 8, target # 18 of of MDGs. Hence, exploring of ICTs in the dualism of health system and workers’ capacity building will then be the focus of this article. Supporting this position is the strategic leadership of the World Health Organization (WHO) in ICTs for health (eHealth). eHealth according to the WHO has stakes in improving and extending quality service delivery to populations and also in enabling health workers’ capacity development. Specifically, in this paper, mobile/wireless ICTs will be the object of focus.

Summary/Objectives:

The aim of this paper is to explore the dynamics of using eHealth enabled by mobile/wireless ICTs (mHealth) in meeting the dual goals of health system and health workers capacity building in developing countries. This objective will be achieved by analysing some cases of mHealth programmes from developing countries.

Results:

In analysing these case studies, the process and outcome impacts of mHealth on health workers and health systems capacity building will presented as results.

Lessons learned:

It is hoped that lessons from these case studies will be able to inform global health policy on strengthening health systems especially in relation to developing countries.

A Technology Enabled Social Enterprise to Increase Access and Quality of Rural Healthcare

Author(s): M. Gautham*1, S. Prashant1, M. Ganesan1, A. Jhunjhunwala1
Affiliation(s): 1Rural Technology Business Incubator, Indian Institute of Technology Madras, Chennai, India
Keywords: Rural health providers, social enterprise, Information Communication Technology
Background:

Only 20% of India’s medical professionals serve in rural areas where 70% of the population resides. The bulk of rural primary healthcare is delivered by private providers trained through informal apprenticeships, who do not have a statutory medical qualification. Innovative, scalable strategies are needed for further training and regulating these providers.

Summary/Objectives:

To describe how Information Communication Technology is used to reach out a blended learning package, supportive supervision, and other service support to rural healthcare providers (RHPs) in a pilot venture in rural Tamil Nadu.

Results:

19 village clinic based RHPs with diverse paramedical, alternate healthcare and vocational nursing backgrounds are included. 10 RHPs are linked to existing internet kiosks in their villages and 9 have invested in setting up their own kiosks. RHPs have been trained in basics of computer use and receive locally relevant distance learning modules in the local language, fortnightly. Tutorial support is provided by a Field Coordinator and content support by medical experts through video/audio conference links. Every module has an online self assessment. Currently the venture is developing modalities for RHPs to: purchase essential quality medicines (modern and indigenous) online; monitor and maintain computerized child and maternal health records; use online and mobile referral links; and use computerized multi-modal treatment guidelines as procedural aids for standardizing service quality. Future plans are to develop a franchisee based social enterprise.

Lessons learned:

RHPs have shown great interest and motivation in improving their skills and quality of services through this venture, and it will be possible to establish quality regulation and rational drug use in rural areas through this approach. Use of technology will enhance the scalability and replicability of the venture and also keep the running costs low.

GHF2006 – PS19 – How to Increase Access to Medical Information?

Session Outline

Parallel session PS19, Friday, September 1 2006, 11:00-12:30
Chair(s): Guy Olivier Segond, Switzerland, Antoine Geissbuhler, Switzerland
The iPath Project: Global Exchange of Medical Knowledge and Information Using Virtual Communities
Kurt Brauchli, Pathology, University of Basel, Basel, Switzerland
Hopes: Lessons from a Practical Example
Line Kleinebreil, Direction informatique, Hôpital européen Georges Pompidou, Paris, France
The Raft Network: Five Years of Distance Continuing Medical Education and Tele-Consultations via the Internet in French-Speaking Africa
Cheick Oumar Bagayoko, Informatique Médicale, Hôpitaux Universitaires de Genève, Geneva, Switzerland
The Digital Solidarity Fund
Alain Clerc, Secretary-General, Digital Solidarity Fund, Switzerland

Session Documents

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Session Report

Submitted by: Jennie Hery-Jaona (ICVolunteers); Contributors: Lyne Calder (ICVolunteers)
Giving training not only on health care but also on the use of computers. Image: Jorge Garbino, ICVolunteers.org

As part of the broad topic on how to provide equal access to health, this symposium discussed how tools such as telemedicine can increase access to medical information and contribute to the reduction of the global digital gap. According to Guy Olivier Segond, former president of the State Council of Geneva and President of the Executive Committee of the Digital Solidarity Fund, information technology (IT) remains a "key tool to access health and improve the effectiveness of health systems".

In this context the four speakers presented different pilot projects to illustrate how Information Communication Technology (ICT) has positively influenced health care in rural areas.

Mr. K. Brauchli, a Swiss biologist and computer specialist, described the iPath project of global exchange of medical knowledge and information with virtual communities. He used the case of the Solomon Islands with a population of 450,000 to illustrate the challenges brought by limited resources and the shortage of trained staff and infrastructure, which lead to the lack of access to diagnosis. In this context, the telepathology service, launched in 2001, has been a successful experiment with more than 1,500 users and handling over 9,000 cases to date. Health workers are a major resource and they need access, not merely to information in general, but specifically to relevant and up-to-date information, as well as training and guidance. Mr. Brauchli argued that the key aspects of telemedicine are "its potential for sustainable transfer of knowledge, quality control and immediate feedback; the capacity to foster communication within the health system; overcoming professional isolation and, most importantly, to reduce the brain drain effect and the promotion of South-South collaboration". Telemedicine is also "accountable and transparent", and remains a useful tool as an "archive of material for later review and reference". He concluded that telemedicine can effectively contribute to strengthening health systems, because it "supports diagnosis and is timely and accurate" with a 90-97% concordance with clinical relevancy.

The second presentation, given by Dr. Line Kleinebreil of the Hôpital Européen Georges Pompidou, described another programme linked with ICTs and also using telemedicine. Health Operations Programme through Education and Sentinel networking (HOPES), originally started by Cheik Modibo Diarra in Mali, aims to contribute to the achievement of the Millennium Development Goals (MDGs) through updating and increasing the availability of training for primary care professionals. In 2003, HOPES entered into a partnership with the Université Numérique Francophone Mondiale (UNFM) based in Paris and is now essentially a North-South programme. Established in Mali and Burkina Faso since 2005, this programme sets up multi-media classrooms to create dialogue between medical students and professionals. Most of the teaching takes place at the Hôpital Européen Georges Pompidou through satellite video-conferencing. Although this technology is not new in itself, Dr. Kleinebreil stressed the programme's innovation in being linked with African universities and in giving training not only on health care but also on the use of computers. Recorded courses are also available offline on DVDs which have apparently proved very popular. This is a powerful way to disseminate information. Through re-watching the conferences, medical students and professionals are given the opportunity to discuss and comment. The programme is free of charge except for a registration fee for exams. Concerned with sustainability, HOPES shares classrooms with enterprises and aims to increase public-private partnerships. The goal is for the African centre to become independent after three years and to extend the system to other areas.

Trained in medical informatics, Dr. Cheick O. Bagayoko from Mali introduced the Réseau en Afrique Francophone pour la Télémédecine (RAFT) project, a "network for eHealth in Africa" and a key strategy in developing South-South training and links. Launched in Bamako, Mali, in 2001 the network soon expanded to reach countries like Mauritania, Senegal, Tunisia, Morocco, Burkina Faso, Niger and Madagascar. The training's main characteristic is its hybrid aspect, which encompasses "dialogue between concerned experts, the development of skills, fieldwork, collaboration with other projects and evaluation". Dr. Bagayoko emphasized the importance of telemedicine as a tool against professional isolation, which tends to discourage doctors from practicing in remote villages, where they are most needed. An important aspect of the RAFT project is the fact that the South can also share its experience with the North. For instance, some courses on tropical medicine are transmitted from Mali to the University Hospital of Geneva. On the whole the success of the project is illustrated by the 122 courses which took place between 2003 and 2006, 30% of which have been given from the South. However, challenges remain with organizational and individual problems; linked with a need for field knowledge. Dr. Bagayoko concluded his presentation by raising the question of ethics: "Is the installation of antennas and thus transmission of information more important than access to clean water?". There is no easy answer.

Mr. Alain Clerc, of the Digital Solidarity Fund (DSF), urged the information society to create a network to combine the various smaller projects involved in the same field, relating specifically to ICTs. He stressed equality of access as the main focus for spreading information. The DSF, recently inaugurated in Geneva after the two World Summits on the Information Society in Geneva and Tunis, is an organization aimed at reducing the global digital divide. The figures concerning this digital divide are striking: in developing countries only 2% of the population has access to new technologies whereas over 80% of the population does in more developed countries. The structure of the Digital Solidarity Fund is new in that it not only involves governments but also civil society and the private sector. The Fund does not operate on the ground; rather it is concerned with finding funds for local projects. It is aiming to establish an innovative financing mechanism: obtaining 1% of the value of all digital and material transactions to invest in the 80% of the population without access to new technologies. Mr. Clerc stressed that the Fund finances local projects in order to have a direct effect on the rural population and therefore help decrease or prevent brain drain. He concluded with a call to companies and hospitals which are not already doing so to invest 1% of their transaction costs according to the Fund's guidelines.

Following the presentations, important questions such as how to deal with the high cost of satellites and how to reach self-sufficiency were raised. It was noted that there is the prospect of launching an African satellite and that self-sufficiency will be boosted by communication centres funding multisectorial projects and by initiatives such as the Digital Solidarity Fund sponsoring South-South collaboration.

In conclusion, this symposium discussed the importance of IT particularly through telemedicine, and of the need for equity in the information society in order to achieve knowledge and health access for all.

The Raft Network: Five Years of Distance Continuing Medical Education and Tele-Consultations via the Internet in French-Speaking Africa

Author(s): Cheick Oumar Bagayoko1, O. Ly2, A. Geissbuhler1
Affiliation(s): 1Informatique Médicale, Hôpitaux Universitaires de Genève, Geneva, Switzerland, 2REIMICOM, Hôpital Mère Enfant, Bamako, Mali
Key issues:

Continuing education of healthcare professionals is a key element for the quality and efficiency of a health system. In developing countries, this activity is usually limited to capitals, and delocalized professionals do not have access to such opportunities, or to didactic material adapted to their needs. This limits the interest of such professionals to remain active in the periphery, where they are most needed to implement effective strategies for prevention and first-line healthcare. Telemedicine tools enable the communication and sharing of medical information in electronic form, and thus facilitate access to remote expertise. A physician located far from a reference centre can consult colleagues remotely in order to resolve a difficult case, follow a continuous education course on the Internet, or access medical information from digital libraries or knowledge bases. These same tools can also be used to facilitate exchanges between centres of medical expertise: health institutions of a same country as well as across borders. Since 2000, the Geneva University Hospitals have been involved in coordinating the development of a network for eHealth in Africa (the RAFT, Réseau en Afrique Francophone pour la Télémédecine), first in Mali, and now extending to 10 French-speaking African countries. The core activity of the RAFT is the webcasting of interactive courses. These sessions put the emphasis on knowledge sharing across care professions, usually in the form of presentations and dialogues between experts in different countries. The technology used for the webcasting works with a slow (25 kbits/second) internet connection. Other activities of the RAFT network include visioconferences, teleconsultations based on the iPath system, collaborative knowledge bases development, support for medical laboratories quality control, and the evaluation of the use of telemedicine in rural areas (via satellite connections) in the context of multisectorial development.

Meeting challenges: Equitable access to medical knowledge and information for the developing countries and valorization of the local content.
Conclusion (max 400 words):

Finally, a strong emphasis is put on the development of capacities for the creation, maintenance, and publication of quality medical didactic contents. Specific courses are organized for the national coordinators of the network to develop these competencies, with the help of the Health On the Net Foundation. The richness of the plurality of knowledge and know-how must be steered towards emulation and sharing, respectful of each partner’s identity and culture. Collaborative projects with UNESCO and the WHO have been initiated to address these challenges.

Hopes: Lessons from a Practical Example

Author(s): Line Kleinebreil1
Affiliation(s): 1Direction informatique, Hôpital européen Georges Pompidou, Paris, France
Key issues: How to increase access to medical information is an important issue. In most developing countries there is no postgraduate training organisation able to react to emerging diseases or severe epidemic. The digital world creates new opportunities.
Meeting challenges: Partnership between medical experts (public health, epidemiologists, internists) and IT experts is necessary to design, implement and evaluate programmes in the field. The design of HOPES (health operational programme through education and sentinel network) has addressed the following questions with following answers: (1) Final target? Reduce morbidity and mortality, especially child mortality. (2) Health care professionals to be reached by the programme? Primary care professionals, physicians, nurses, and midwives. (3) Topics? They have to be discussed with the countries. Since 2005, HOPES has developed 3 modules of 60 hours each addressing immunization, prevention of HIV transmission, and best practices for most frequent clinical situations. (4) Motivation? Partnership with local university and health ministry is crucial to organize the training and its recognition in the health system. (5) Technical solution? The most important issue is to have a stepwise approach, from DV/CD player, basic mobile phone, up to satellite videoconference. Flexibility is necessary to use existing infrastructure, overcome technical barriers and provide information where needed. (6) Resources? At least 50% of necessary human resources have to come from the developing country in order to disseminate valid medical information in the local context. Infrastructure budget should also be partially supported by the country, even if international agencies help in the initial phase. (7) Sustainability? Partnership is a key issue. North/south, medical and IT partnerships, but also outside the medical world. Extending the local use of communication channels for dissemination of information related to complementary areas is necessary to cover long-term financial costs.
Conclusion (max 400 words): After 18 months of deployment, the HOPES programme has provided medical information to primary health care professionals in Mali and Burkina Faso. Partnership with the RAFT programme is set up to extend geographical access to medical information and share scare pedagogical resources.

The iPath Project: Global Exchange of Medical Knowledge and Information Using Virtual Communities

Presenter: Kurt Brauchli
Author(s): Kurt Brauchli1, M. Oberholzer1
Affiliation(s): 1Pathology, University of Basel, Basel, Switzerland
Background:

Developing countries are facing various problems in delivering medical services to their population lack of resources as well as a dramatic shortage of trained and experienced doctors and nurses. Good quality services and medical specialists are often concentrated in urban areas only. Poor roads and limited transport and communication infrastructure are severe obstacles for providing health care services to rural communities. In addition, the few medical specialists are often working in severe professional isolation without access to senior colleagues, diagnostic support or continuous medical education. Objectives: The iPath project at the University of Basel, launched in 2001, aims at improving access to specialist diagnosis, second opinion consultations and medical information for health providers and medical specialists in developing countries by means of Information and Communication Technologies and to analyse and evaluate the feasibility, accuracy and sustainability of remote support and collaboration through telemedicine.

Results:

Since 2001, an open-source Internet-based collaboration platform for medical knowledge and information exchange between medical specialists in developing countries and their partners in Europe has been developed and operated by the iPath project. The platform is designed with an explicit focus on allowing access to users with limited connectivity. Collaboration is possible via email or a web browser and is organised in the form of virtual communities closed and moderated user groups in which participants can present and discuss cases. Asynchronous store-and-forward and synchronous or real-time collaboration is possible on the same data. Today, hundreds of participants from all continents are frequently using the platform. Over 9,000 cases with a total of over 60,000 images have been discussed. Participants are organised in several dozen virtual communities with activities ranging from diagnostic support for hospitals with limited resources, to specialist groups for enabling access to second opinion consultations, to providing continuous medical education. A particularly interesting application comprises specialist forums moderated by (retired) specialists from Europe who discuss difficult cases with colleagues in developing countries and provide diagnostic support, often with references to current literature. They also use the possibility to selectively refer very complex consultations to appropriate sub-specialist groups on the same platform and thus enable high quality second opinion consultations. Another application is the provision of diagnostic support for hospitals with limited resources by a group of volunteer specialists. Diagnostic accuracy of such remote consultations was assessed for the field of histopathology in two independent studies. Concordance levels were over 90%. Collaboration in virtual communities is also a viable source for quality assurance as well as for continuous medical education. An analysis of the user activities reveals that many do not submit consultations or diagnostic comments but are regularly reading the discussions. In addition, the platform is used for publishing live and distributed presentations and case discussions that can be followed from anywhere using a standard web browser and an ordinary internet connection (>25KB/s). Conclusions: Telemedical collaboration in the form of on-line virtual communities is a viable solution for supporting health care professionals in areas with limited resources by providing access to remote diagnosis, second opinions and continuous education, provided that the communities are appropriately moderated. A major advantage of the virtual community model over traditional point-to-point telemedicine consultations is that they allow and promote South-South collaboration. If properly organised, virtual communities can play an important role in capacity building and in establishing and maintaining fruitful partnerships between geographically separated partner institutions and individuals.

Opportunity Knocking: Exploiting e-Health for Global Health Human Resources Planning

Author(s): Kendall Ho1
Affiliation(s): 1Continuing Professional Development & Knowledge Translation, University of British Columbia, Vancouver, Canada
Key issues: Because of a worldwide shortage of health professionals, all levels of government and global organizations such as the World Health Organization have identified health human resources (HHR) availability and planning as a key health priority. Current international practices in health professional exchange and migration have also introduced sometimes difficult issues in the ethics of health professional recruitment and retention in different countries. The approach to HHR planning is also changing since future health professionals need to possess cross-professional core profi ciencies beyond competency in their own disciplines.
Meeting challenges:

E-Health the use of modern information and communication technologies for health is rapidly becoming a core part of the many health systems regionally and internationally, and can make significant and innovative contributions to HHR. This presentation examines key e-health literature and Canadian experiences to illuminate on how e-health can best assist HHR, especially considering the current acceleration of e-health introduction in different parts of the world.

Conclusion (max 400 words):

Based on the literature and existing body of experiences, e-health can contribute to HHR planning in three key strategic directions, including: 1) Using e-learning to create an innovative learning environment to increase capacity and improve recruitment and retention; 2) Using ICT as an unprecedented team building medium to overcome conventional practice boundaries; 3) Empowering communities and citizens to become knowledgeable health consumers. This presentation will expand on these three themes. Furthermore, the presentation will offer additional recommendations to promote national and international dialogue on HHR planning as it links to e-health. Finally, this presentation will make observations as to how the academy with the mandate to train and support health professionals, can contribute to global HHR planning through e-health so as to help respond to the global community’s needs.