Opportunities and Challenges for E-health – Vietnam, a case study

1. ITU Workshop on “E-health services in low-resource settings: Requirements and ITU role” (Tokyo, Japan, 4-5 February 2013) Opportunities and Challenges for E-health – Vietnam, a case study Nguyen Quoc CUONG, Vice Director, VNPT Hanoi, cuongnq@vnpt.vn

2. Content • Developing countries & E-health • Vietnam’s characteristics • Health & ICT in Vietnam • VNPT & NTT cooperation

3. Developing countries • World Bank: GNI per capita • Low income $1,005 or less. • Middle income $1,005 - $12,276 • Lower middle $1,005 - $3975 • Vietnam $1,160 • E-Health • Weak health systems & infrastructure, Shortage of health workers, Incomplete legal & regulatory framework • Two facets: Public health & Healthcare

4. Vietnam - Characteristics VN LMI • Urban population 29% 39% • Adult literacy rate 93% 71% • Health expd./ GDP 6.9% 4.4% • Physicians/ 10K 12.2 7.8 • Nursing personnel 10.1 15.1 • Pharma. personnel 3.2 4.3

5. Vietnam - Telecom Standing out ! VN LMI • Fixed phone subs. 18.7% 6.0% • Fixed BB subs. 4.13% 1.04% • Mobile phone subs. 143% 77.8% • Mobile BB subs. 14.71%*8%** • H.hold w Int. 12.5% 7.5% • Ind.s using Int. 27.6%^ 13.5% * 2011 figure, Vietnam MIC ** Low and Middle income groups ^ 2011 figure: 34.05%

6. Health & ICT in Vietnam • Government • Plan for ICT in 2011-2015, established specific goals at different levels • WAN, LAN and website development • Internet access in health service offices • E-learning in medical universities • Standards adoption: ICD-10-CM, HL-7, DICOM etc. • E-healthcare, HIS etc. • Improvement of public health databases • Many data missed in WHO Statistics

7. Health & ICT in Vietnam • Hospitals & other health institution • Mainly business processes and management systems • Limited use of clinical applications: EHRs, order entry systems, decision support, pharmacy systems, etc. • More importantly: little integration! • Inside hospitals • Between hospitals and government • Between hospitals and social insurance

8. Health & ICT in Vietnam • Hospitals ICT – an example • 2000 beds, 3500+ out-patients/day • 35 servers, 1200 workstations, no DC • 17 separated softwares, developed by 7 companies • No common patient ID system  No interconnection b/w diagnosis, analysis, treatment, pharmacy… • No acceptance from Social Insurance Authority for electronic records

9. Health & ICT in Vietnam • Hospitals ICT – the visible outcome

10. VNPT & ICT for Health • VNPT • Flagship operator in Vietnam • Fixed, mobile, value-added… services • VNPT & MoH • Agreement with MoH on promoting ICT application in the health sector • Discount 25-50% on all services to all subscribers in health sector  • Join into projects at different levels and different fields

11. VNPT & NTT Cooperation • Implemented in Hanoi area, by • VNPT Hanoi • NTT East / NTT Vietnam • Public Health • Introduction of NTT+VNPT’s expertise & capability to local Health Service Office • Healthcare • Joint Study for e-Healthcare Service

12. Join Study for e-Healthcare • Field trial: 06/08 – 31/10/12 • Questionnaire Survey: 31/10-16/11/12 Implementation structure Implementation Image Data Management System In Japan Field Trial Users Internet VNPT Network Automatic Graphing Direction VNPT VNPT Hanoi FTTH FTTH Body composition monitor Health Advice Receiver Relay Key NTT Vietnam NTT East Blood pressure monitor Healthcare Advisers Hanoi Medical University, Hospital of Post and Telecoms etc Trial Users 50 sets (200 IDs for the maximum) e Healthcare Service

13. Join Study for e-Healthcare • Purpose: To confirm the demands for e-Healthcare service • Measurement items: • Body weight • Body fat percentage • Basal metabolism • Physical age • Estimated bone mass • Number of steps • Blood pressure-Pulse rate • Visceral fat level

14. Join Study for e-Healthcare • 98% care about something of their health

15. Join Study for e-Healthcare • 98% want to get advice from professionals

16. Join Study for e-Healthcare • Recognition of measures • 88% can tell their health condition from “blood pressure”. • Majority not familiar with the measures such as “body age”, “body fat percentage” and “muscle mass”. Can you perceive your health condition from the measured data? Do you know what the word means? High recognition Know Can perceive Body weight Blood pressure 90％ 88％ Blood pressure 69％ Body weight 65％ Blood sugar level Body age 68％ 63％ Blood sugar level Muscle mass 29％ 61％ Body fat percentage Body fat percentage 25％ 51％ Body age 25％ Muscle mass 37％ Low recognition Can’t perceive Don’t know

17. Conclusions and Recommendations The following points can be either a challenge or an opportunity • Government • E-health awareness • Necessary legal and regulatory framework • National strategies and capacity building • Integration of ICT into health systems

18. Conclusions and Recommendations • Hospitals & other health institutions • Transition/Integration of existing softwares to/into E-health systems • “First, do no harm" (primum non nocere) • Balance between current load of work & involvement of E-health

19. Conclusions and Recommendations • User • High interests in health, especially in healthy diet, improvement of blood pressure and weight reduction • Avoid complexity and inappropriateness to local needs • Need familiarization of unfamiliar terms and indexes • Reluctance in paying 

20. Conclusions and Recommendations • Technology • Optical fiber and Mobile trends • Health data integration and Coordination of health systems • Responsiveness to local demand: Localization and Operability of the devices and web application

21. THANK YOU !