mHealth Working Group Meeting Washington DC

1. ECA perspective:Utilizing ICT in the WB Human Development Projects- quick wins vs. comprehensive approach – ZlatanSabic mHealth Working Group MeetingWashington DC May 23, 2011

2. Utilizing ICT in the WB Human Development Projects – eHealth in ECA • Relevant • The WB is supporting eHealth project(s) in almost all ECA countries – major player • Current eHealth portfolio in WB projects > 100 mil. USD • Qualitative research on 6 projects; Identified key issues • Using the ICT as human development reforms enabler, not only as efficiency improvement tool • Limited Bank’s and Client’s knowledge capacities for better utilization of the ICT in HD projects; • Integrating managerial, sectoral and technical knowledge; Knowledge transfer barriers • Understanding the nature of information systems and nature of IS development process • How to approach to an ICT intensive project component implementation? Framework? ZlatanSabic, 2011

3. Identification/ Preparation/ Appraisal/ Approval • Implementation • Completion/ Evaluation The Value-Design-Process-Assets Framework for Utilizing ICT in The World Bank HD projects(some of the challenges) • What is the value added by e-services?Is ICT development/reform enabler , or just efficiency improver? • What is feasible scope/level of ambition? Technical options?Comprehensive vs. “quick win” approach?Data collection vs. process orientation? • Understanding peculiarities of information systems developmentNavigating process by government/WB One stage vs. incremental development? • Capabilities (management, organization, knowledge)Resources (information, solutions, infrastructure, financial capital)Country’s vs. WB capabilities/resources Value Design Process Assets ZlatanSabic, 2011

4. Quick win vs. comprehensive approach ZlatanSabic, 2011

5. Case of successful quick win: Infectious Diseases Surveillance System in Moldova • It is basically part of primary health care reporting, but no time/resources/capabilities for primary health care informatization – also, out of project scope • Quick win – simple Internet based reporting system; possible because the reporting on infectious diseases is separate business process • System response time shortened from 45 days to 1 day (daily, on-line information on commutable diseases) • Total budget: $400k spent • One of the most successful ICT implementations in Moldova • Inspiration for more ambitious projects ZlatanSabic, 2011

6. Case of non-successful quick win: DRG in Macedonia DRG input sw. as isolated stand-alone module: • 20 additional minutes for each record transformation, ... • Physicians have no time for that – residents are doing it, ... • Questionable coding of diagnoses … • Questionable data … • = Questionable budget • DRG record • Patient record • Will be SUCCESSFUL, but only after integration of DRG into comprehensive hospital IS ZlatanSabic, 2011

7. Relevance to mHealth? • mHealth solutions are sometimes quick wins • Cautious approach needed: • Online Access to Health Records – Access to what? • Appointment to Family Doctor – More important: Is GP HIS implemented at family doctor? • Related to status of: • reforms in sectors • back-end systems development • legal, regulatory and infrastructural environment • ECA specific: Infrastructural environment suitable for comprehensive approach ZlatanSabic, 2011