Fourth Regional e-Health Conference: Building the Electronic Health Record, Tehran, Islamic Republic of Iran, 7-9 September 2004
Regional Director's message
Your Excellency
Dear Colleagues
It gives me great pleasure to welcome you to the Fourth Regional Conference on E-Health: Building the Electronic Health Record. This conference comes after three successful conferences on various aspects of e-health held in Cairo, Riyadh and Dubai. In addition to a number of other conferences that were organized by the Regional Office in collaboration with other national, regional and international institutions over the last four years. This conference has been dedicated to the electronic health record (HER) and the different variations of names given to it including patient record and medical record. We have opted to use the health record to emphasize the fact that this record should include all health aspects of the individual whether he/she is healthy or sick and not merely a record of the health and medical problems that the individual has. We hope we reach a stage were the same record is used from birth to death and to make it a life-long health record. With the existing technology and the expected developments in both hardware and software this objective has become more realistic and is an attainable one.
I will not go into the details of the benefits of the EHR to both the citizen and the healthcare provider. It is worth mentioning that sharing of patient data among healthcare providers, the security features, and the accumulation of health data over the years for both care provision and research, the administrative functions and the ability to link HER content with other systems are among the few benefits of the EHR. Realization of these benefits makes the EHR as the best choice for achieving the e-health goals.
The efforts that are being extended in the Region to develop electronic health records (EHR) systems has been scattered and lack a lot of coordination, not only at the regional level, but even worse at the national level. We have seen examples of different systems being developed even within the same institution and funded by the same budget in the same country. This has lead to waste of time and resources and more important to develop systems and formats that are not compatible and data between them has not been transferable, which defeats the purpose of the electronic health record. The push by the private sector to develop EHR systems has been very strong for economical and financial reasons. The pull for EHR by the healthcare community is for professional and performance reasons. In many cases these reasons do not match, which requires national effort and high level of coordination, standardization and long-term vision.
I am pleased to note that this type of coordination and long-term vision is being applied here in the Islamic Republic of Iran. The TAKFAB project is an example of an integrated approach or a strategy for e-health in which the EHR represents the core of all health data of individuals. This Strategy underlines the fact that TAKFAB is:
Adopting a patient-centered approach to providing solutions for the Iran health information and information and communication technology (ICT) challenges;
Recognizing that EHRs will facilitate nation-wide capture, validation, storage, processing and access to relevant information to provide better healthcare to the individual, and
Recognizing that the processing of EHR data would contribute to improved surveillance, detection and measurement of trends and patterns of health problems and related services.
A nation-wide introduction of EHR means that the ways and means (procedures and ICT support) by which EHRs may be used and, as necessary, updated at the institutional level have been ascertained and/or planned. That is, the healthcare institutions would have the means to use and update EHRs and the infrastructure to reach, and be reached, by other healthcare institutions in the country.
Security of personal data on the EHR has been one of the main issues of concern by policy-makers, decision-makers, planners and professionals in the Region. This concern was raised in a number of occasions and one which we give utmost attention and would like to see governments and professionals dealing with it in a professional manner. We would like to ensure that necessary measures are taken to safeguard against potential abuses and attacks taking place anywhere in the system. In order to achieve maximum digital security the following measures should be ascertain both in the design stage of the EHR, and during its implementation:
- Authenticity: The ability to be totally certain of the identity of the origin, sender or initiator of the message or transaction and the identity of its destination, receiver or server;
- Integrity: The ability to be totally sure that the contents of the message or transaction have not been changed, either accidentally or maliciously, since it was originated;
- Confidentiality: The inability of anyone, other than the originator or sender and the intended recipient, to view, copy or otherwise know the contents of the message or transaction;
- Non-repudiation: The inability of the originator or a transaction or sender of a message to later deny having initiated the transaction or sent the message, and of its recipient to later deny having received it.
In our previous conferences the technical presentations, discussions, conclusions and recommendations were more oriented to the general telemedicine applications and the use of ICT for provision of medical services. In this conference we decided to concentrate on one aspect of e-health and make sure that this aspect is extensively discussed and long-term plans are made for the EHR in the Region. The objectives of the Conference are to:
Introduce participants to e-health applications and their link to EHR;
Introduce participants to electronic health record concepts, role, functions;
Discuss the infrastructure required for implementation of the electronic health record;
Discuss the structure of the electronic health record;
Discuss the link between telemedicine services and electronic health record;
Discuss the economic, legal and social aspects of the electronic health record;
Discuss the link between Enterprise Resource Planning and electronic health record;
Discuss security and privacy issues in electronic health record; and
Review international standards (XML, HL7) related to electronic health record.
I am quite sure that with the depth of the technical papers and the wealth and diversity of national experience to be presented and discussed during the conference coupled with the expertise of WHO staff and consultants, you will be able to grasp all the issues that revolve around the EHR and will be able to make recommendations and plan of action for future development of the EHR.
The World Health Organization in general and the Regional Office, as part of our support to move the healthcare sector to more use and utilization of knowledge through application of ICT and e-health, are committed to achieving this in a most collaborative and cost-effective manner.
Finally, I would like to thank the Government of Islamic Republic of Iran represented by the Ministry of Health and Medical Education for hosting this conference and for providing both the logistic and intellectual support for its success. I wish you a pleasant stay in Tehran and look forward to receiving your conclusions and recommendations for Building the Electronic Health Record in the Region.
God bless you and peace be upon you.