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Building a Digital Information Infrastructure (Infostructure) for Health Handbook Acknowledgements Handbook International Telecommunication Union 2020 Digital Health Platform: Telecommunication Development Bureau Place des Nations Building a Digital CH-1211 Geneva 20 Switzerland Information Infrastructure www.itu.int (Infostructure) for Health ISBN: 978-92-61-26091-0 9 7 8 9 2 6 1 2 6 0 9 1 0 Published in Switzerland Geneva, 2020 for Health (Infostructure) Infrastructure Building a Digital Information Platform: Digital Health Digital Health Platform Handbook: Building a Digital Information Infrastructure (Infostructure) for Health Handbook Acknowledgements This handbook was developed in the context of the “Be Healthy, Be Mobile”, a joint ITU-WHO digital health initiative. The International Telecommunication Union and World Health Organization gratefully acknowledge the contributors, peer reviewers, and consultants whose dedication, expertise, and support made this Digital Health Platform Handbook possible. ITU-WHO team Led by Hani Eskandar (ITU), Sameer Pujari (WHO) Experts contributed to the first draft Ron Parker (Canada), Shashank Garg (India), Janek Metsallik (Estonia), Simao Campos (ITU), Suzanne Hodgkinson (ITU), Per Hasvold (WHO), JC Mestres (IBM), David Manset (France), YOO Done-Sik (Republic of South Korea), Matthew McDermott (Access Partnership), Beatriz de Faria Leão (Brazil), Helge T. Blindheim (Norway), Lars Kristian Roland (Norway), Martin Clark (Medtronic), Alan Payne (Bupa) Experts contributed to the second draft Dykki Settle (PATH), Elaine Baker (PATH), Sue Duvall (USA), Amanda BenDor (PATH), Hallie Goertz (PATH), Breese McIlvaine (PATH), Shannon Turlington (USA), Daidi Zhong (ITU-T), Michael Kirwan (PCHA) Reviewers for the first edition Edward Kelley (WHO), Diana Zandi (WHO), Ramesh Krishnamurthy (WHO), Garrett Mehl (WHO), David Novillo (PAHO), Derrick Muneene (WHO AFRO), Housseynou Ba (WHO AFRO), Tigest Tamrat (WHO), Mohamed Nour (WHO EMRO), Mark Landry (SEARO), Paul Biondich (Regenstrief Institute), Brian Taliesin (PATH), Carl Leitner (PATH), Caren Althauser (PATH), Merrick Schaefer (USAID), Jai Ganesh (AeHIN), Alvin Marcelo (AeHIN), P.S. Ramkumar (India), Wayan Vota (Intrahealth), Manish Kumar (MEASURE Evaluation), Sam Wambugu (MEASURE Evaluation), Javier Elkin (WHO), Surabhi Joshi (WHO), Melissa Harper Shehadeh (WHO), Violeta Pérez Nueno (WHO), Evan Pye (WHO) and Mariam Shokralla (WHO). Digital health platform handbook: building a digital information infrastructure (infostructure) for health ISBN (WHO) 978-92-4-001372-8 (Electronic version) ISBN (WHO) 978-92-4-001373-5 (Print version) ISBN (ITU) 978-92-61-26091-0 (Electronic version) ISBN (ITU) 978-92-61-26081-1 (Paper version) ISBN (ITU) 978-92-61-26101-6 (EPUB version) ISBN (ITU) 978-92-61-26111-5 (MOBI version) © World Health Organization and International Telecommunication Union, 2020 Some rights reserved. This work is available under the Creative Commons Attribution- NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https:// creativecommons .org/ licenses/ by -nc -sa/ 3 .0/ igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO or ITU endorses any specific organization, products or services. The unauthorized use of the WHO or ITU names or logos is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO) or the International Telecommunication Union (ITU). Neither WHO nor ITU are responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization (http:// www .wipo .int/ amc/ en/ mediation/ rules). Suggested citation. Digital health platform handbook: building a digital information infrastructure (infostructure) for health. Geneva: World Health Organization and International Telecommunication Union, 2020. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http:// apps .who .int/ iris. Sales, rights and licensing. To purchase WHO publications, see http:// apps .who .int/ bookorders. ITU Publications can be obtained from ITU Bookshop http:// www .itu .int/ en/ publications. To submit requests for commercial use and queries on rights and licensing, see http:// www .who .int/ about/ licensing. Third-party materials. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user. General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO or ITU concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO or ITU in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO and ITU to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO or ITU be liable for damages arising from its use. Foreword Welcome to Digital Health Platform Handbook, a new toolkit designed to help countries create and implement a digital health platform (DHP) to serve as the underlying infrastructure for an interoperable and integrated national digital health system. The COVID-19 global health emergency has dramatically underlined the importance of harnessing the full power of digital technologies to support public health programmes and outreach. Digital health platforms provide a vital central hub, linking together disparate and unconnected systems and applications, enabling faster, more efficient and more reliable information exchange, and promoting increased access to health data across a range of devices. Strong digital health systems can be instrumental in supporting progress towards the Sustainable Development Goals (SDGs) and the implementation of the Digital Health Resolution adopted by WHO’s World Health Assembly in 2018. But while a DHP primarily advances SDG 3 focused on health, this ‘platform concept’ can also be effectively applied to ICT systems supporting other SDGs. Taking a ‘whole of government approach’ and thinking holistically and flexibly about digital systems design is increasingly essential, given the limited resources – financial or otherwise – available for public sector digital development in many countries. A ‘platform concept’ design approach also makes sense from a technical standpoint: re-using platform components improves system efficiency, increases return on investment, and provides a coherent and consistent environment that promotes seamless interoperability and allows software developers to focus efforts on ongoing improvements and innovations. The publication of this new toolkit is particularly timely in the context of the adoption of WHO's Global Strategy on Digital Health 2020-2024. This strategy outlines the overarching vision, core principles and strategic objectives that should guide national digital health initiatives. This new Digital Health Platform Handbook complements that top-level vision, providing a detailed walkthrough of how to best design and implement appropriate technical solutions in the most cost-efficient and sustainable way. The Digital Health Platform Handbook represents the culmination of efforts by various organizations and experts from across the health and ICT sectors. It also builds on and supplements other important digital health resources, including the National eHealth Strategy Toolkit and the WHO Planning, Costing Guide for Digital Interventions for Health Programmes. Taken together, these materials constitute a comprehensive approach for harnessing ICT applications and digital technologies to strengthen health systems and, ultimately, deliver improved health and well-being to all. Doreen Bogdan-Martin Bernardo Mariano Junior Director Director Telecommunication Development Bureau (BDT) Digital Health & Innovation International Telecommunication Union (ITU) Chief Information Officer (CIO) World Health Organization v Executive Summary The Digital Health Platform Handbook [DHPH] aims to assist countries with the advancement of their national digital health system, specifically through the use of a digital health platform, or DHP. This digital platform provides
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