e-Readiness Assessment - A Health Perspective -

1. Global e-Health Research and Training Program  Health Telematics Unit www.ucalgary.ca/telehealth e-Readiness Assessment- A Health Perspective - Dr. Shariq Khoja; MD, MS, PhD Student Global e-Health Research and Training Program Health Telematics Unit, University of Calgary, Calgary, Alberta, Canada

2. e-Readiness- Definition - • e-Readiness • The degree to which a community is prepared to participate in the networked world. • Measured by assessing the community’s relative advancement in the areas that are most critical for Information and Communications Technology (ICT) adoption and most important applications of ICT. Source: Center of International Development’s ‘Readiness for the networked world’

3. e-Readiness- e-Readiness Assessment - • A method to assess if a community or institution is prepared to respond to a pre-identified problem, through ICT. • It is NOT classical ‘needs-assessment’ which identifies the issues or problems. • A strategy to identify gaps in the ability of a community or institution to implement an ‘e-health solution’ to its problems.

4. e-Readiness- Importance - • Has high value • For both the planners of an activity and the participating communities. • Avoids delays and disappointments • Identifies any lack of preparedness of a community to implement a virtual response at an early stage. • Avoids huge losses in time, money and effort. • Can prepare remote communities in developing countries, in order to reduce the digital divide.

5. e-Readiness- Importance - • Readiness is: • “An integral and preliminary step in successful adoption of an innovation”. (CANARIE report, 2002). • Required to successfully initiate a change process: Pre- contemplation Contemplation Preparation Action Maintenance Readiness Transtheoretical model of Behavioral Change (Richard W Scholl, 2002)

6. e-Readiness- Tools for e-Readiness Assessment - • 22 e-readiness tools available on www.bridges.org. • Some important ones are: • Computer Systems Policy Project (CSPP’s) - Readiness Guide for Living in a Networked World. • Crenshaw and Robinson’s – ‘Cyber-space and Post Industrial Transformations: Cross-network Analysis of Internet’. • Center of International Development (CID’s) Readiness for the Networked World: A Guide for Developing Countries.

7. e-Readiness- CID’s Guide for Developing Countries - • Creator: Center of International Development (CID) at Harvard University - 2000 (www.readinessguide.org) • Goal: To systemically organize the assessment of factors determining the network readiness of a community in the developing world. • Standards: ‘e-Ready’ society has: • Necessary physical infrastructure. • Integrated current ICT’s throughout communities and government • Strong telecommunications competition • Independent regulations with commitment to universal access • No limits on trade or foreign investments in ICT

8. e-Readiness- CID’s Developing Country Guide - • Measures: • 19 different categories covering: availability, speed, and quality of network access; use of ICT in schools, the workplace, economy, government and everyday life; ICT policies; ICT training programs; and the diversity of organizations. • Results: • CID’s grid: • 5 groupings: Access, Learning, Society, Economy and Policies). • 4 stages of advancement in each of 19 categories

9. e-Health Readiness- Definition - • e-Health Readiness: • Related to, but different from, e-readiness • Defined as: “The degree to which users, health care organizations, and the health system itself, are prepared to participate and succeed with e-health implementation”. (CANARIE- report, 2002) • Current activity: • Efforts underway to develop assessment tools for e-health / telehealth readiness.

10. e-Health Readiness- Current Tools - • Lead organization: • Health Telematics Unit, University of Calgary • Activity: • Development of ‘Telehealth Readiness’ assessment tools for organizations and practitioners in the developed world. (Jennett P, 2003). • Key Components: • a) Organization’s Core-readiness • b) Organization’s engagement / planning readiness • c) Workplace environment readiness

11. e-Health Readiness- Tool for Developing Countries - • Issue: • At this time there are no e-health readiness tools for developing countries • Study Goal: • Develop tools appropriate for developing countries • Study Team: • Collaboration of HTU, Supercourse and Institutions in Pakistan. • Setting: • To be tested in Pakistan using Supercourse

12. e-Health Readiness- Assessment in Pakistan -

13. e-Health Readiness- Assessment in Pakistan - • Process: • Building partnerships with the medical colleges and universities in Pakistan. • Collectively develop an ‘e-health readiness assessment tool’ for Supercourse. • Test the tool in various medical colleges in Pakistan. • Finalize a culturally sensitive tool for e-health readiness that can be used by participating institutions and Supercourse for other programs.

14. e-Health Readiness- Proposed Tool for Developing Countries - • 5 Components will be assessed: • Core readiness • Cultural readiness (Access) • Learning (Training in Media) • Society (Internet use and interaction) • Policy (at institutional and government levels)

15. Core Readiness- Component I - • Intended to measure basic characteristics of the target population: • Identification of need • Dissatisfaction with the status quo • Awareness • Comfort with language, and • Comfort with technology

16. Cultural Readiness - Component II - • Intended to measure the minimum necessary accessto adequate network infrastructure: • Speed (bandwidth) and quality of Internet • Service and support • Hardware and software • Internet availability and affordability • Regular usage of computer and internet

17. Learning Readiness- Component III - • Intended to measure the minimum required knowledge and training in the community to use ICT: • An institution’s access to ICT • Use of ICT to enhance education • The ICT workforce in the community

18. Society Readiness- Component IV - • Intended to measure the Community’s use of ICT in regular activities: • Online communication • Availability of locally relevant content • Use of ICT in everyday life

19. Policy Readiness- Component V - • Intended to measure creation of an enabling environment and culture at institutional and government levels: • ICT (telecommunications) regulations • Ethics • Mandatory courses and increasing availability • Influence of HFA over use of technology

20. References • Bridges.org: Spanning the International Digital Divide. www.bridges.org. • CID’s Readiness for the Networked World: A Guide for Developing Countrieswww.readinessguide.org. • CANARIE report: Framework for Rural and Remote Readiness in Telehealth. June 2002.

21. Acknowledgements • Dr. Richard Scott. Associate Professor and Harkness Associate. Global e-Health Research and Training Program, University of Calgary, Calgary, Alberta, Canada. • Ronald E. LaPorte. Director, Disease Monitoring and Telecommunications. WHO Collaborating Center. University of Pittsburgh, Pittsburgh, PA., USA • Dr Sunita Dodani. Department of Epidemiology, Graduate School of Public Health. Pittsburgh, PA., USA