{ "$schema": "folio-library-entry/v1", "id": "9789240010567-eng", "blocks": [ { "id": "library/9789240010567-eng/blocks/prose-page-001", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 1", "pageStart": 1, "pageEnd": 1, "target": "../sections/page-001.md", "narrative": null, "content": "Digital \nimplementation \ninvestment guide (DIIG):\nintegrating digital interventions \ninto health programmes", "truncated": false, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-002", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 2", "pageStart": 2, "pageEnd": 2, "target": "../sections/page-002.md", "narrative": null, "content": "b", "truncated": false, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-003", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 3", "pageStart": 3, "pageEnd": 3, "target": "../sections/page-003.md", "narrative": null, "content": "Digital \nimplementation \ninvestment guide (DIIG):\nintegrating digital interventions \ninto health programmes", "truncated": false, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-004", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 4", "pageStart": 4, "pageEnd": 4, "target": "../sections/page-004.md", "narrative": null, "content": "Digital implementation investment guide (DIIG): integrating digital interventions into health programmes\nISBN 978-92-4-001056-7 (electronic version)\nISBN 978-92-4-001057-4 (print version) \n© World Health Organization 2020. \nSome rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence \n(CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo/). \nUnder the terms of this licence, you may copy, redistribute and adapt the work for noncommercial purposes provided the work \nis appropriately cited, as indicated below. I", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-005", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 5", "pageStart": 5, "pageEnd": 5, "target": "../sections/page-005.md", "narrative": null, "content": "iii\nList of figures, tables and boxes\nv\nForeword\nvii\nAcknowledgements\nviii\nList of abbreviations\nix\nCHAPTER 1: INTRODUCTION\n1\n1.1 \t The Guide’s role in planning and implementing a digital health enterprise. . . . . . . . . . . . . . . . . . . . . . . 4\n1.2 \t How to use this Guide. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8\n1.3 \t Key terms for using this Guide. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11\n1.4 \t W", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-006", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 6", "pageStart": 6, "pageEnd": 6, "target": "../sections/page-006.md", "narrative": null, "content": "iv\nCHAPTER 6: LINK THE DIGITAL HEALTH IMPLEMENTATION TO THE ENTERPRISE ARCHITECTURE\n81\n6.1\t\nAssess the digital health enterprise architecture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83\n6.2\t Identify common and enabling components and shared services (digital health platform). . . . . . 86\n6.3\t Link your digital health investments to the enterprise architecture. . . . . . . . . . . . . . . . . . . . . . . . . . . . 88\nCHAPTER 7: DEVELOP A BUDGET\n91\n7.1\t\nPhases of implementation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-007", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 7", "pageStart": 7, "pageEnd": 7, "target": "../sections/page-007.md", "narrative": null, "content": "v\nFigures, tables and boxes\nFig. 1.1.1.\t\nPlanning and implementing a digital health enterprise: phases, steps and resources.. . . . . . . . . . . . . . . . 5\nTable 1.1.2.\t Resources for planning and implementing a digital health enterprise.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6\nBox 1.1.3.\t\nResources detailing content for specific health programme areas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7\nFig. 1.1.4.\t\nEssential processes of national digital health implementations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7\nFig.", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-008", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 8", "pageStart": 8, "pageEnd": 8, "target": "../sections/page-008.md", "narrative": null, "content": "vi\nFig. 5.1.\t\nEssential components of a digital health implementation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66\nTable 5.2.\t\nIllustrative implementation considerations for digital health.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66\nBox 5.3.\t\nDescription of digital health interventions reviewed in the WHO guideline. . . . . . . . . . . . . . . . . . . . . . . 68\nBox 5.1.1.\t\nResource on hardware management.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69\nBox 5.", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/figure-img-p009-1", "types": [ "folio-assistant-core:Figure", "doco:Figure" ], "kind": "figure", "title": "", "pageStart": 9, "pageEnd": 9, "target": "../images/img-p009-1.png", "narrative": "draft", "content": "A portrait photograph of a woman with short grey curly hair wearing a red scarf over a blue patterned top. The surrounding text identifies her as Dr Soumya Swaminathan, Chief Scientist, WHO, author of the Foreword.", "truncated": false, "provenance": "ingested", "summary": null }, { "id": "library/9789240010567-eng/blocks/prose-page-009", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 9", "pageStart": 9, "pageEnd": 9, "target": "../sections/page-009.md", "narrative": null, "content": "vii\nForeword \nThe transformative nature of digital technologies for health is undeniable. Today, over \nhalf of the world’s population have access to a mobile phone. Increasing access to \nmobile technologies has radically changed the way in which people may manage their \nown health, as well as the way in which health services are delivered. Health systems \nrecognize that digital health technologies are critical for accelerating progress towards the \nachievement of the Sustainable Development Goals. Greater investment, however, will be \nneeded to elevate the role of digital health in health syst", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-010", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 10", "pageStart": 10, "pageEnd": 10, "target": "../sections/page-010.md", "narrative": null, "content": "viii\nAcknowledgements\nThe World Health Organization (WHO) and PATH thank the contributions of many individuals across different \norganizations. This Guide was authored by Garrett Mehl, Maeghan Orton, Natschja Ratanaprayul and Tigest Tamrat of \nthe WHO Department of Sexual and Reproductive Health and Research; Hallie Goertz, Celina Kareiva, Carl Leitner and \nBrian Taliesin of PATH; and Smisha Agarwal and Alain Labrique of the Johns Hopkins Bloomberg School of Public Health.\nThe following individuals reviewed and provided feedback for this Guide (in alphabetical order): Onyema Ajubor \n(WHO), Pet", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-011", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 11", "pageStart": 11, "pageEnd": 11, "target": "../sections/page-011.md", "narrative": null, "content": "ix\nList of abbreviations\nADB\t\nAsian Development Bank\nAEHIN\t\nAsia eHealth Information Network\nBID\t\nBetter Immunization Data\nCRDM\t\nCollaborative Requirements Development \nMethodology\nCRVS\t\ncivil registration and vital statistics\nDHA\t\nDigital Health Atlas\nDHI\t\ndigital health intervention\nDIIG\t\nDigital Implementation Investment Guide\nDPPI\t\nDirectorate of Planning, Policy and \nInformation\nEIR\t\nelectronic immunization application\nEPI\t\nExpanded Programme on Immunization\nFHIR\t\nFast Healthcare Interoperability Resource\nHIS\t\nhealth information system\nHL7\t\nHealth Level 7\nHMIS\t\nhealth management informati", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-012", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 12", "pageStart": 12, "pageEnd": 12, "target": "../sections/page-012.md", "narrative": null, "content": "x", "truncated": false, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-013", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 13", "pageStart": 13, "pageEnd": 13, "target": "../sections/page-013.md", "narrative": null, "content": "1\nA digital health enterprise comprises the business processes, data, systems and technologies used to support \nthe operations of the health system, including the point-of-service software applications, devices and \nhardware and the underlying information infrastructure (such as the digital health platform) that deliver health \nservices accelerated and amplified by digital and data technologies. Digital health enterprise architectures \nhave varying degrees of maturity and institutionalization within the broader ecosystem. This document \nmakes a distinction between siloed digital health system", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/figure-img-p014-1", "types": [ "folio-assistant-core:Figure", "doco:Figure" ], "kind": "figure", "title": "", "pageStart": 14, "pageEnd": 14, "target": "../images/img-p014-1.png", "narrative": "draft", "content": "A decorative graphic showing a stylized world map rendered in glowing blue tones, overlaid with a bright cyan heartbeat (ECG) waveform line running horizontally across it and a white medical caduceus (staff with wings) symbol at the center.", "truncated": false, "provenance": "ingested", "summary": null }, { "id": "library/9789240010567-eng/blocks/figure-img-p014-2", "types": [ "folio-assistant-core:Figure", "doco:Figure" ], "kind": "figure", "title": "", "pageStart": 14, "pageEnd": 14, "target": "../images/img-p014-2.png", "narrative": "draft", "content": "A very small, plain light-blue circular icon with no discernible internal detail; its specific content could not be determined from the extracted image. It appears alongside a list of key WHO source documents (National eHealth Strategy Toolkit, WHO guideline on digital interventions) and functions as a minor decorative or bullet-style graphic element rather than a substantive figure.", "truncated": false, "provenance": "ingested", "summary": null }, { "id": "library/9789240010567-eng/blocks/prose-page-014", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 14", "pageStart": 14, "pageEnd": 14, "target": "../sections/page-014.md", "narrative": null, "content": "2\nDigital implementation investment guide\nThis Guide serves as a companion to the WHO guideline: \nrecommendations on digital interventions for health \nsystem strengthening (1) and provides a pragmatic \nprocess for reviewing WHO guideline–recommended \ndigital health interventions and incorporating them \ninto harmonized plans grounded in national systems \nand policy goals. Additionally, this document builds \non Planning an information systems project: a toolkit for \npublic health managers (2), commissioned by Optimize: \nImmunization Systems and Technologies for Tomorrow, \na previous collaboratio", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-015", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 15", "pageStart": 15, "pageEnd": 15, "target": "../sections/page-015.md", "narrative": null, "content": "3\nIntroduction\nThe process outlined in the Guide is also informed \nby the Principles for Digital Development, which \nhelp stakeholders effectively and appropriately apply \ndigital technologies in their health programmes \n(digitalprinciples.org/principles). Core tenets of \nthese nine principles will be referenced throughout \nthis Guide.\n\t Design with the User: User-centered design \nstarts with getting to know the people you are \ndesigning for through conversation, observation \nand co-creation.\n\t Understand the Existing Ecosystem: Well-\ndesigned initiatives and digital tools consider the \npartic", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-016", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 16", "pageStart": 16, "pageEnd": 16, "target": "../sections/page-016.md", "narrative": null, "content": "4\nDigital implementation investment guide\n1.1 \t The Guide’s role in planning and \nimplementing a digital health enterprise\nA fully realized digital health enterprise delivers health in the digital age. The implementation of a digital \nhealth enterprise includes the people who design, build, deploy and maintain the systems, accompanied by a \ngovernance framework, an enabling policy environment and an operational plan. The process of planning and \nimplementing an appropriate digital health enterprise within the broader ecosystem includes several phases:\n1.\t\nassessing the current state and enabli", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-017", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 17", "pageStart": 17, "pageEnd": 17, "target": "../sections/page-017.md", "narrative": null, "content": "5\nIntroduction\nWHO Core \nindicator \nsets\nGlobal \nDigital \nHealth \nIndex\nWHO Digital \nHealth Atlas\nDigital \nHealth \nInvestment \nReview Tool\nHIS Stages of \nContinuous \nImprovement\nSTEPS\n+\tConduct an inventory of existing or previously \nused software applications, ICT systems \nand other tools to better understand the \nrequirements for reuse and interoperability.\nSTEPS\n+\tDevelop a national digital health strategy \noutlining overarching needs, desired activities \nand outcomes.\n+\tDefine a vision for how the health system will \nbe strengthened through the use of digital \ntechnology.\nSTEPS\n+\tFormulat", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-018", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 18", "pageStart": 18, "pageEnd": 18, "target": "../sections/page-018.md", "narrative": null, "content": "6\nDigital implementation investment guide\nTable 1.1.2. \tResources for planning and implementing a digital health enterprise.2\n2\t\n Additional resources for further reading included in Annex 1.2.\nPhase \nResources\nPHASE 1\nAssessing the \ncurrent state \nand enabling \nenvironment\n\t» WHO/ITU National eHealth strategy toolkit (3)\n\t» WHO Digital Health Atlas (8)\n\t» Global Digital Health Index (9)\n\t» Digital health investment review tool (10)\n\t» HIS stages of continuous improvement toolkit (11)\nPHASE 2\nEstablishing \na shared \nunderstanding \nand strategic \nplanning\n\t» Digital implementation investment gu", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-019", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 19", "pageStart": 19, "pageEnd": 19, "target": "../sections/page-019.md", "narrative": null, "content": "7\nIntroduction\nBox 1.1.3. \t Resources detailing content for specific health programme areas.\n\t+ Civil registration and vital statistics (CRVS) digitisation guidebook (31)\n\t+ Common requirements for maternal health information systems (32)\n\t+ Electronic immunization registry: practical considerations for planning, development, implementation and \nevaluation (33)\n\t+ Electronic recording and reporting for tuberculosis care and control (34)\n\t+ Mobile solutions for malaria elimination surveillance systems: a roadmap (35)\nThe development of a digital health enterprise is a \ndynamic process (Fig. 1.1", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-020", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 20", "pageStart": 20, "pageEnd": 20, "target": "../sections/page-020.md", "narrative": null, "content": "8\nDigital implementation investment guide\n1.2\t How to use this Guide\nThis Guide covers the different phases outlined in Fig. 1.1.1 by leveraging supporting resources, focusing the most \ndetail on phases 2–5. This document is designed to be used in two ways:\n\t+ to support a facilitated planning process, resulting in a costed implementation plan suitable for a funder, whether \na government finance ministry or an agency (such as the World Bank, Gavi, The Global Fund or Bill & Melinda Gates \nFoundation).\n\t+ to provide stand-alone topical information and outputs, organized by chapter, for establish", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-021", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 21", "pageStart": 21, "pageEnd": 21, "target": "../sections/page-021.md", "narrative": null, "content": "9\nIntroduction\nFig. 1.2.1. \t Overview of the chapters in this Digital Implementation Investment Guide.\nBy the end of this Guide, you will be able to complete essential activities (see Fig. 1.2.1) that produce outputs that \ncomprise a costed implementation plan (see Fig. 1.2.2).\nCHAPTER 04\nINPUTS\n\t+\tTargeted health programme processes\n\t+\tCurrent state task flows, user journeys, \nand programme processes\n\t+\tPrioritized pain points and health system \nchallenges\nDETERMINE APPROPRIATE \nDIGITAL HEALTH INTERVENTIONS\nOUTPUTS\n\t+\tPrioritized digital health intervention(s)\n\t+\tFuture state user journey / t", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-022", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 22", "pageStart": 22, "pageEnd": 22, "target": "../sections/page-022.md", "narrative": null, "content": "10\nDigital implementation investment guide\nFig. 1.2.2. \t Summary of outputs within a costed implementation plan. \n01\t\n\nActors\n04\nDigital Context\n05\t\n\nImplementation\n02\t\n\nPriorities\n06\nArchitecture\n07\t\n\nBudget\n08\t \nMonitoring\n09\t \nValue \nProposition\n03\t\n\nProgramme Context\nCommon \nServices \nAcross \nSectors\n4.3\t Functional \nRequirements\n4.1\t Prioritized Digital \nInterventions\n6.1\t Current \nArchitecture\n6.4\t Point of Service \nApplications\n6.5\t Shared Services\n6.2\t Future \nArchitecture\n6.3\t Standards & \nInteroperability\n4.2\t Maturity and \nReadiness\n4.4\t Future-\nstate \nWorkflow\n4.5\t Digital \nInvento", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-023", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 23", "pageStart": 23, "pageEnd": 23, "target": "../sections/page-023.md", "narrative": null, "content": "11\nIntroduction\n1.3 \tKey terms for using this Guide\nA full glossary is included as Annex 1.1, but several key terms are useful to understand at the outset. \nThis Guide assists readers to develop a costed \nimplementation plan to support a digital health \nenterprise comprising appropriate digital health \ninterventions targeting health system challenges and \ndeployed within digital applications to strengthen the \nperformance of one or more health programmes and \nrealize digital health outcomes within national digital \nhealth strategies. \nBOTTLENECKS: Specific gaps or problems in the \nworkflow of", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-024", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 24", "pageStart": 24, "pageEnd": 24, "target": "../sections/page-024.md", "narrative": null, "content": "12\nDigital implementation investment guide\nusing standards to connect through a health \ninformation exchange to address collective \nneeds across the health system, operating in \na coordinated manner within a digital health \narchitecture. \nDIGITAL HEALTH IMPLEMENTATION: The development \nand deployment of digital health application(s) and/\nor platform(s) to support and strengthen a health \nenterprise within a given context, accompanied by \na governance framework, operational plan, human \nresources and related activities for its successful \nexecution. \nDIGITAL HEALTH INTERVENTION: A discrete \ntec", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-025", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 25", "pageStart": 25, "pageEnd": 25, "target": "../sections/page-025.md", "narrative": null, "content": "13\nIntroduction\nFig. 1.3.1. \t Digital health enterprise system architectures.\nALIGNMENT WITH DIGITAL HEALTH STRATEGY\nHEALTH USE CASE\nHEALTH PROGRAMME\nAPPLICATION\nAPPLICATION\nAPPLICATION\nPROJECT GOALS\nHEALTH \nPROGRAMME GOALS\nSILOED\nA digital health enterprise system architecture \ncomposed of standalone application(s). A digital \nhealth project is a time-bound implementation \nof a siloed digital health enterprise, usually to \ndemonstrate proof of concept. \nMUD \nMonolithic Un-architected \nsoftware Distribution. Applications \ncharacterized by an evolving agglomeration of \nfunctions, originating w", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-026", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 26", "pageStart": 26, "pageEnd": 26, "target": "../sections/page-026.md", "narrative": null, "content": "14\nDigital implementation investment guide\n1.4 \tWhen to use this Guide\nThere are several situations where you might find this guide useful.\nWhen identifying how best to apply the WHO guideline: \nRecommendations on digital interventions for health \nsystem strengthening (1). For example, the guideline \nrecommends the use of digital decision-support tools \nfor health workers within a health programme area; \nyou would like to implement this recommendation but \nneed to better understand whether it is the appropriate \ndigital health intervention to address your health system \nchallenges, as well as", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-027", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 27", "pageStart": 27, "pageEnd": 27, "target": "../sections/page-027.md", "narrative": null, "content": "15\nForm the team and establish goals\nCHAPTER \n02\nFORM THE TEAM AND \nESTABLISH GOALS\nOnce you are ready to start using this Guide, the first step is to form the team \nand establish goals for your investments in the digital health enterprise. In this \nchapter, you will determine team roles and responsibilities, develop a common \nunderstanding of the health programme’s goals, and begin to understand how the \nhealth programme functions across all levels of the health system.\nTOOLS\n\t+ Common key roles and responsibilities (Table 2.1.1)\n\t+ Planning and implementation charter (Annex 2.1)\n\t+ Persona", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/figure-img-p028-1", "types": [ "folio-assistant-core:Figure", "doco:Figure" ], "kind": "figure", "title": "", "pageStart": 28, "pageEnd": 28, "target": "../images/img-p028-1.png", "narrative": "draft", "content": "The 'Principles for Digital Development' logo: an irregular grid of solid colored squares (blue, green, orange, red, dark teal, light blue) arranged asymmetrically, used as a recurring header graphic for sections presenting individual Principles for Digital Development, here principle 3, 'Be collaborative'.", "truncated": false, "provenance": "ingested", "summary": null }, { "id": "library/9789240010567-eng/blocks/prose-page-028", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 28", "pageStart": 28, "pageEnd": 28, "target": "../sections/page-028.md", "narrative": null, "content": "16\nDigital implementation investment guide\nPRINCIPLES FOR \nDIGITAL DEVELOPMENT\n \nBE COLLABORATIVE3\n\t+ Understand how your work fits into the global development landscape. Identify \nothers working on the same problem in other geographies and determine if there \nis a community of practice that relates to your work. Find the technical leaders \nthrough virtual networks or communities of practice, such as the Global Digital \nHealth Network, the Asia eHealth Information Network (AeHIN), Global Digital \nHealth Partnership, Digital Health and Interoperability Working Group, Health Data \nCollaborative,", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-029", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 29", "pageStart": 29, "pageEnd": 29, "target": "../sections/page-029.md", "narrative": null, "content": "17\nForm the team and establish goals\n2.1 \t Determine roles and responsibilities\nBefore embarking on the full planning process, you should form your team. Consider what skills, functions \nand knowledge may help when crafting a comprehensive costed implementation plan for a funder. Seek out \nindividuals with adequate dedicated time who are qualified, motivated and knowledgeable over three areas: \ngovernance, management and operations. \nGOVERNANCE: Consult a national digital health \ngovernance committee or other government technical \noversight mechanism (see Fig. 1.1.4), if one exists, to \nensur", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-030", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 30", "pageStart": 30, "pageEnd": 30, "target": "../sections/page-030.md", "narrative": null, "content": "18\nDigital implementation investment guide\nplanning process. Table 2.1.1 describes each of these roles \nin detail to guide recruitment of the required skill sets. \nAlthough your digital health implementation may not \nrequire every role, these are perspectives that should \nbe considered either internally or through external \nmechanisms, such as proposals for technical assistance.\nTable 2.1.1. \tKey roles and their descriptions.\nFunctional \narea\nRole \nDescription\nGOVERNANCE\nDigital health \ngovernance \nmechanisms\nMay include a sponsor from a senior ministry and representatives from other relevant", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-031", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 31", "pageStart": 31, "pageEnd": 31, "target": "../sections/page-031.md", "narrative": null, "content": "19\nForm the team and establish goals\nFunctional \narea\nRole \nDescription\nOPERATIONS\nBusiness analyst\nAnalyses and documents workflow of the clinical care and health programme \nprocesses and recommends digital health interventions relative to the prioritized \nbusiness requirements.\nSoftware \ndevelopers\nTransform requirements into specifications for information systems and \nexecutable code. \nQuality assurance \ntesters\nValidate that the requirements have been met by the software developers and \noversee testing of the applications for bugs and functionality issues before \ndeployment.\nSecurity and", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-032", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 32", "pageStart": 32, "pageEnd": 32, "target": "../sections/page-032.md", "narrative": null, "content": "20\nDigital implementation investment guide\nCASE STUDY\nConvening stakeholders and determining governance \nstructure in Sierra Leone\nIn 2016 following the Ebola viral disease outbreak, WHO facilitated a planning process with the Ministry \nof Health and Sanitation (MOHS) for informing prioritization of digital systems addressing national health \npriorities, in line with directives from the President’s Recovery Plan (40). This process sought to align the \nuse of digital tools with defined health system challenges in response to the immediate national priorities \nof restoring health services, parti", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-033", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 33", "pageStart": 33, "pageEnd": 33, "target": "../sections/page-033.md", "narrative": null, "content": "21\nForm the team and establish goals\nBID INITIATIVE \nCASE STUDY\nBID Initiative: User advisory groups and goals\nThe BID Initiative was designed to be country led and country owned, with partnership and \ncollaboration elevated as core values. In Tanzania, the Immunization and Vaccine Development \nprogram (a department of the Ministry of Health, Community Development, Gender, Elderly and \nChildren) oversaw the overall governance of the BID Initiative, and a user advisory group (UAG) was \nestablished to play a critical role in the prioritization, design and development of proposed approaches \nand", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-034", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 34", "pageStart": 34, "pageEnd": 34, "target": "../sections/page-034.md", "narrative": null, "content": "22\nDigital implementation investment guide\n2.2 \tDevelop a common understanding of the \nhealth programme’s needs and goals \nOnce you have formed the planning team, convene them and any necessary additional stakeholders to \narticulate a common understanding of the main goals of the health programme and how they align with \nyour country’s national digital health strategy (if there is one). The team should also review core programme \ndocuments, data and assessment reports that describe the programme’s goals and objectives, including how it \nhas performed to date. \nIn this review of health programm", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-035", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 35", "pageStart": 35, "pageEnd": 35, "target": "../sections/page-035.md", "narrative": null, "content": "23\nForm the team and establish goals\n2.\t\nHealth programme indicators, or measures of \nsuccess, and evaluations to help assess whether \nhealth programme goals are being met, which \nwill help establish deficiencies within the \nhealth programme and begin to identify where \nto target potential digital health investments\na.\t Team members focused on M&E should \nidentify and summarize appropriate health \nprogramme performance reports prior to the \nstakeholder meeting.\nb.\t Assess whether data to understand \nprogramme performance are adequate and \nroutinely collected or whether additional \ndata are re", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-036", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 36", "pageStart": 36, "pageEnd": 36, "target": "../sections/page-036.md", "narrative": null, "content": "24\nDigital implementation investment guide\nFig. 2.3.1. \t Illustrative example of a health system organogram and relationships.\nMinistry of Health & Family Welfare (MoHFW)\nDirector General of Family \nPlanning (DGFP)\nImmunization and Vaccine \nDevelopment (IVD)\nNational Manager \nfor EPI\nNational \nLogistics \nManager\nRegional \nImmunization and \nVaccine Officer \n(RIVO)\nDistrict \nImmunization \nand Vaccine \nOfficer (DIVO)\nVillage \nExecutive Officer\nCommunity \nHealth Worker\nRural \nClinic Nurse\nUrban \nClinic Nurse\nAssistant Director,\nFamily Planning\nDeputy Director,\nFamily Planning\nAssistant Director,\nC", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-037", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 37", "pageStart": 37, "pageEnd": 37, "target": "../sections/page-037.md", "narrative": null, "content": "25\nForm the team and establish goals\nOnce you have mapped the general health system, \nidentify the range of end-users and beneficiaries of the \nspecific health programme. These individuals may be \nthe same ones identified in the organogram – health \nworkers, community-level supervisors, clinical staff \nand district-level managers – and they may include \nindividuals from NGOs and other sectors of government. \nTo help understand specific end-users and beneficiaries \nof the health programme, you should create personas, \nwhich are generic aggregate descriptions of the different \ntypes of people i", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-038", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 38", "pageStart": 38, "pageEnd": 38, "target": "../sections/page-038.md", "narrative": null, "content": "26\nDigital implementation investment guide\nTable 2.3.2. \t\nExamples of personas developed when planning an immunization programme. \nMANAGER PERSONA: Dr Regina Flowers, Regional Immunization Officer\nRESPONSIBILITIES\nReports and communicates district-level lessons to policy-makers at the national level. \nOversees funding for and supply of vaccines.\nDEMOGRAPHICS\nAge: 50+\nEducation: MD \nFluent in English. Uses computers and smartphones regularly.\nCHALLENGES\nVaccine use and supply data are frequently missing or erroneous. Data reports are delayed and \ndifficult to synthesize. Field staff are not wel", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-039", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 39", "pageStart": 39, "pageEnd": 39, "target": "../sections/page-039.md", "narrative": null, "content": "27\nForm the team and establish goals\nThis information can be collected in the worksheet in Annex 2.1.\nYou should \nnow have an \nunderstanding \nof the following:\n\t\nˆ Members of your team (Output 1.1)\n\t\nˆ Stakeholders to engage throughout the planning and implementation \nprocess (Output 1.2)\n\t\nˆ Key outcomes from the national digital health strategy (if one exists) that \nyou intend to build on\n\t\nˆ Priority goals (Outputs 2.1, 2.2), organogram (Output 3.1) and personas \n(Outputs 3.1, 1.3) within the health programme(s) you are addressing.", "truncated": false, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-040", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 40", "pageStart": 40, "pageEnd": 40, "target": "../sections/page-040.md", "narrative": null, "content": "28\nDigital implementation investment guide", "truncated": false, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-041", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 41", "pageStart": 41, "pageEnd": 41, "target": "../sections/page-041.md", "narrative": null, "content": "29\nCHAPTER \n03\nIDENTIFY HEALTH SYSTEM \nCHALLENGES AND NEEDS\nIn the previous chapter, you aligned a team around the primary goals of the \nhealth programme and identified key national strategies (health programme and \ndigital health) to guide the planning process. In this chapter, you will pinpoint \nspecific health programme processes and articulate the bottlenecks that you \nseek to improve, which will set the stage for selecting appropriate digital health \ninterventions.\nTOOLS\n\t+ Process matrix (Annex 3.1)\n\t+ Root causes of common bottlenecks (Fig. 3.2.1)\n\t+ Bottleneck-mapping worksheet (Annex", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-042", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 42", "pageStart": 42, "pageEnd": 42, "target": "../sections/page-042.md", "narrative": null, "content": "30\nDigital implementation investment guide\nPRINCIPLES FOR \nDIGITAL DEVELOPMENT\n \nUNDERSTAND THE \nEXISTING ECOSYSTEM4\n\t+ Engage with your target end-users and consult existing research to develop an \nunderstanding of the people, networks, cultures, politics, data needs, infrastructure \nand markets that make up your ecosystem before designing your initiative or tool.\n\t+ Coordinate with other implementing organizations, civil society and the \ngovernment early on to learn from successful and unsuccessful initiatives in the \necosystem, to avoid duplicating efforts and to integrate with existing tec", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-043", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 43", "pageStart": 43, "pageEnd": 43, "target": "../sections/page-043.md", "narrative": null, "content": "31\nIdentify health system challenges and needs\nIn this chapter, you will pinpoint specific health programme processes and articulate the bottlenecks that you \nseek to improve, which will set the stage for selecting appropriate digital health interventions (see Fig. 3.1). \nThis process builds on the Public Health Informatics Institute’s Collaborative Requirements Development \nMethodology (CRDM), a commonly used approach for defining the problem, identifying how it could be \nimproved, and describing how the improved process would need to function (50). \nFig. 3.1. \t\nAdaptation of CRDM approach fo", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-044", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 44", "pageStart": 44, "pageEnd": 44, "target": "../sections/page-044.md", "narrative": null, "content": "32\nDigital implementation investment guide\n3.1.1\t\nDETERMINE THE HEALTH PROGRAMME PROCESSES TO TARGET\nHealth programme processes, also called business \nprocesses, consist of a set of activities or tasks \nperformed together to achieve the objectives of the \nhealth programme area or health system (51). Processes \ninvolve different personas and may cross multiple levels \nof the health system. For example, within the area of \nantenatal care, health programme processes can include \nactivities associated with identifying pregnant women, \ngenerating demand for services, monitoring supplies and \ncommod", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-045", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 45", "pageStart": 45, "pageEnd": 45, "target": "../sections/page-045.md", "narrative": null, "content": "33\nIdentify health system challenges and needs\n3.1.2 \t\nMAP THE WORKFLOWS FOR TARGETED PROCESSES\nNow that you have identified and described important \nprocesses in the health programme, you can further \nexamine the user journey to understand where to make \nimprovements. Describing these processes as they occur, \nwith as much input from programme implementers with \non-the-ground experience as possible, is vital to capture \nevents as they typically happen, rather than how they are \nofficially supposed to happen or imagined to happen in \ntheory. Detailing tasks, or the specific activities within a", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-046", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 46", "pageStart": 46, "pageEnd": 46, "target": "../sections/page-046.md", "narrative": null, "content": "34\nDigital implementation investment guide\nFig. 3.1.2.1. \tExample workflow diagram for a service-delivery process.\nSource: Adapted from WHO/PATH Planning an information systems project, 2013 (2)\n.\nBox 3.1.2.2. \t\nConventions that are generally used when mapping workflows.\n\t» Tasks are represented as boxes.\n\t» Diamonds represent decision points.\n\t» Boxes with double lines represent bundles of numerous subtasks.\n\t» Circles represent start and end points of the workflow.\nFor more information on standard notation for workflow diagrams, see the CRDM website (50) \nand WHO’s Optimizing person-centric", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-047", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 47", "pageStart": 47, "pageEnd": 47, "target": "../sections/page-047.md", "narrative": null, "content": "35\nIdentify health system challenges and needs\nBID INITIATIVE \nCASE STUDY\nBID Initiative: Business processes\nIt was hard for Oliver Mlemeta, the sister in charge at the Usa River Health Facility in Tanzania, to know how \nmany children to expect on immunization day. To figure out which children were due, she would spend hours \nsifting through dense immunization registries and tallying numbers. Then she had to make sure she had \nadequate supplies on hand. If her vaccine stock was low, she would spend more time calling other clinics and \nretrieving what she needed by motorbike. Sometimes, she wou", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-048", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 48", "pageStart": 48, "pageEnd": 48, "target": "../sections/page-048.md", "narrative": null, "content": "36\nDigital implementation investment guide\n3.1.3 \t\nIDENTIFY AND CONFIRM BOTTLENECKS \nAs you create the workflows, challenges – or bottlenecks \n– should emerge. These are areas where failures in \nservice delivery occur, where health workers experience \nfrustrations or even where patients may be lost to \nfollow-up. Bottlenecks are the specific gaps that \nprevent personas from reaching their goals of success \nand achieving positive health outcomes. Bottlenecks \ncontribute to the suboptimal implementation of health \nprogrammes and are often causes of the failure to meet \nthe programme’s goals. \nFo", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-049", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 49", "pageStart": 49, "pageEnd": 49, "target": "../sections/page-049.md", "narrative": null, "content": "37\nIdentify health system challenges and needs\nFig. 3.2.1. \t Using the 5 Whys model to identify the root cause of bottlenecks.\nSource: iSixSigma: Determine the root cause: 5 whys (54).\nFind more examples and worksheets to support the 5 Whys process in the iSixSigma online library (54).\n3.3 \tPrioritize bottlenecks\nNow that you have a better understanding of their root causes, you can rank the bottlenecks, identifying those \nthat contribute the most to preventing success of the health programme. Although you may ideally like to \naddress every bottleneck, limits on resources often require focusin", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-050", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 50", "pageStart": 50, "pageEnd": 50, "target": "../sections/page-050.md", "narrative": null, "content": "38\nDigital implementation investment guide\nTable 3.3.1. \tFormula for scoring and ranking bottlenecks, with examples.\nBottleneck\n1. \nHow much \nimpact \ndoes this \nbottleneck \nhave on the \nprocess? \n(1–3) \n2. \nWhat is the \nlikelihood of \novercoming \nthis \nbottleneck? \n(1–3)\n3. \nIs this \nimportant to a \nwide range of \nstakeholders?\n(1–3)\nScore\nPrioritized \nRanking\nExample\nAggregating data \nfrom paper forms is \nburdensome and rarely \ndone correctly.\nLow (1)\nHigh potential (3)\nYes (3)\n1+3+3=7\nHIGHEST\nExample\nMother’s belief that \nnewborns should not be \nimmunized if they seem \n“small” in size.\nMediu", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-051", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 51", "pageStart": 51, "pageEnd": 51, "target": "../sections/page-051.md", "narrative": null, "content": "39\nIdentify health system challenges and needs\n Fig. 3.4.1. \t WHO classification of health system challenges.\n1\nInformation\n3\nQuality\n6\nEfficiency\n7\nCost\n8\nAccountability\n2\nAvailability\n4\nAcceptability\n5\nUtilization\n1.1\nLack of population \ndenominator \n1.2\nDelayed reporting \nof events\n1.3\nLack of quality/\nreliable data\n1.4\nCommunication \nroadblocks\n1.5\nLack of access to \ninformation or data\n1.6\nInsufficient utilization of \ndata and information\n1.7\nLack of unique identifier\n3.1\nPoor patient experience\n3.2\nInsufficient health \nworker competence\n3.3\nLow quality health \ncommodities\n3.4\nLow health", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-052", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 52", "pageStart": 52, "pageEnd": 52, "target": "../sections/page-052.md", "narrative": null, "content": "40\nDigital implementation investment guide\nBox 3.4.2. \t Linking health system challenges to universal health coverage.\nAlthough you have gone through an extensive process to identify the key bottlenecks and health system \nchallenges, you may have overlooked some areas. You may want to take the further step of mapping your \nbottlenecks to the different contributors to achieving universal health coverage (UHC). The goals of UHC aim to \nensure access to all individuals who need services and that these services are delivered with the intended quality \nand do not cause financial hardship (55). \nThe", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-053", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 53", "pageStart": 53, "pageEnd": 53, "target": "../sections/page-053.md", "narrative": null, "content": "41\nIdentify health system challenges and needs\nFig. 3.4.3. \t Health system needs for universal health coverage.\nSource: Mehl & Labrique, 2014 (56).\nHealth System Goal\nAccountability coverage\nThe proportion of those in the target population registered into \nthe health system\nAccountability\nFinancial coverage \nThe proportion of patients protected \nfrom impoverishment due to health-\nrelated costs\naffordability\nTarget Population\nHealth system challenges \nlimiting UHC for target population\nContact coverage \nProportion of clients who have contact with \nrelevant facilities, providers and services", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-054", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 54", "pageStart": 54, "pageEnd": 54, "target": "../sections/page-054.md", "narrative": null, "content": "42\nDigital implementation investment guide", "truncated": false, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-055", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 55", "pageStart": 55, "pageEnd": 55, "target": "../sections/page-055.md", "narrative": null, "content": "43\nCHAPTER \n04\nDETERMINE APPROPRIATE \nDIGITAL HEALTH INTERVENTIONS \nIn the previous chapter, you examined different health programme processes and \nidentified key health system challenges. In this chapter, you will rethink the way \nthese tasks are performed and reflect on interventions to address the identified \nbottlenecks.\nTOOLS\n\t+ Bottleneck-mapping worksheet (Annex 3.2)\n\t+ WHO Classification of digital health interventions (4)\n\t+ Digital health intervention selection matrix (Fig. 4.1.3)\n\t+ Digital Health Atlas (8) or digital landscape review \n\t+ Global Digital Health Index (9) or other dig", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-056", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 56", "pageStart": 56, "pageEnd": 56, "target": "../sections/page-056.md", "narrative": null, "content": "44\nDigital implementation investment guide\nPRINCIPLES FOR \nDIGITAL DEVELOPMENT\n \nUSE OPEN \nSTANDARDS, \nOPEN DATA, \nOPEN SOURCE, AND \nOPEN INNOVATION6\n\t+ Define and communicate what being open means for your initiative.\n\t+ Adopt and expand on existing open standards, such as Health Level 7 Fast \nHealthcare Interoperability Resource (HL7 FHIR): specifications developed by, \nagreed to, adopted by and maintained by a community that enable sharing of data \nacross digital applications and the digital health platform.\n\t+ Share nonsensitive data after ensuring that data privacy needs are addressed; to", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-057", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 57", "pageStart": 57, "pageEnd": 57, "target": "../sections/page-057.md", "narrative": null, "content": "45\nDetermine appropriate digital health interventions\nIn the previous chapter, you examined different health programme processes and identified key health system \nchallenges. In this chapter, you will rethink the way these tasks are performed and reflect on interventions to \naddress the identified bottlenecks (see Fig. 4.1). This is called business process redesign. It is at this stage where \nyou will critically assess whether and how digital health applications may be used to alleviate the identified \nbottlenecks. Then, based on your decision, you can begin to describe what digital health app", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-058", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 58", "pageStart": 58, "pageEnd": 58, "target": "../sections/page-058.md", "narrative": null, "content": "46\nDigital implementation investment guide\nIdentifying and selecting digital health interventions \nincludes the following steps. \n1.\t\nSelect one or more digital health interventions \nto address the prioritized health system \nchallenges (if digital is appropriate). If digital \nis appropriate, select interventions that have \ndemonstrated effectiveness, and determine \nhow these interventions can address your \nhealth system challenges. \n2.\t\nDetermine whether the enabling environment \ncan support the selected digital health \ninterventions. This includes understanding \nthe ecosystem and absorptive c", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-059", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 59", "pageStart": 59, "pageEnd": 59, "target": "../sections/page-059.md", "narrative": null, "content": "47\nDetermine appropriate digital health interventions\n2.1\nClient \nidentification and \nregistration\n2.5\nHealthcare \nprovider \ncommunication\n2.6 Referral \ncoordination\n2.7\nHealth worker \nactivity planning \nand scheduling\n2.8 Healthcare \nprovider training \n2.9\nPrescription \nand medication \nmanagement\n2.10\nLaboratory and \nDiagnostics \nImaging \nManangement \n2.2 Client health \nrecords \n2.3\nHealthcare \nprovider decision \nsupport\n2.4 Telemedicine\n2.1.1\nVerify client \nunique identity\n2.1.2\nEnrol client for health \nservices/clinical care plan\n2.5.1\nCommunication from \nhealthcare provider(s) to \nsupervi", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-060", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 60", "pageStart": 60, "pageEnd": 60, "target": "../sections/page-060.md", "narrative": null, "content": "48\nDigital implementation investment guide\nFig. 4.1.2. \t Linkage between health system challenges and digital health interventions.\nWhen determining which digital health interventions \nare appropriate, consider reviewing the WHO Guideline: \nRecommendations on Digital Interventions for Health \nSystem Strengthening (1), which lists evidence-based \ndigital health interventions and considerations for \nimplementation. Should WHO recommendations on \ndigital health interventions not yet exist for the health \nsystem challenges you have identified, you could draw \nfrom research evidence and regional ex", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-061", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 61", "pageStart": 61, "pageEnd": 61, "target": "../sections/page-061.md", "narrative": null, "content": "49\nDetermine appropriate digital health interventions\nFig. 4.1.3. \t Digital health intervention selection matrix.\nSource: Adapted from the WHO Classification of digital health interventions, 2018 (4).\nConsider the range of digital health interventions that \nmay be appropriate for your identified health system \nchallenges. Cross-checking these against the WHO \nevidence-based recommendations and any country \nexperiences will help you identify a set of digital health \ninterventions suitable for the expressed needs. \n2.3\nDecision \nsupport \nfor health \nworkers\n1.1\nTargeted client \ncommunication, \ns", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-062", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 62", "pageStart": 62, "pageEnd": 62, "target": "../sections/page-062.md", "narrative": null, "content": "50\nDigital implementation investment guide\nCASE STUDY\nDetermining appropriateness of digital health interventions \nfor health system challenges \nAs part of the joint process with the Ministry of Health and Sanitation in Sierra Leone for identifying \nhealth system challenges and assessing the appropriateness of digital health interventions, WHO \nconvened stakeholders to review challenges faced within the health system and across different \nprogrammatic areas. This was a consultative process to identify areas of improvement and assess \nwhether digital health interventions may play a role in addr", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-063", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 63", "pageStart": 63, "pageEnd": 63, "target": "../sections/page-063.md", "narrative": null, "content": "51\nDetermine appropriate digital health interventions\n4.2\t Determine whether the enabling \nenvironment can support the identified \ndigital health interventions \nDigital health interventions are delivered through digital health applications, which ideally are linked to a \nsupportive digital health platform comprising shared services and enabling components (in cases where \nthere are multiple applications); together with the people, processes and policies that support and use them \nto deliver health services to clients, these applications and platform make up the digital health enterprise. \nSucc", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-064", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 64", "pageStart": 64, "pageEnd": 64, "target": "../sections/page-064.md", "narrative": null, "content": "52\nDigital implementation investment guide\nFig. 4.2.1.\t\nRoles and contributions of component “building blocks” to the enabling environment for \ndigital health enterprises.\nSource: WHO/ITU National eHealth strategy toolkit, 2012 (3).\n\t+ Direct and coordinate eHealth at the national level; ensure \nalignment with health goals and political support; promote \nawareness and engage stakeholders.\n\t+ Use mechanisms, expertise, coordination and partnerships to \ndevelop or adopt eHealth components (e.g. standards). \n\t+ Support and empower required change, implementation \nof recommendations and monitoring", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-065", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 65", "pageStart": 65, "pageEnd": 65, "target": "../sections/page-065.md", "narrative": null, "content": "53\nDetermine appropriate digital health interventions\nDepending on your timeline, you may want to develop \nshort-term plans that take into account the current \nenabling environment, while contemplating medium- \nand long-term plans that benefit from your deliberate \nnew investments to catalyse some components of \nthe environment to mature further. A comprehensive \nanalysis of the enabling environment will also help \nyou document the nonfunctional requirements, \nwhich describe general attributes and features to \nensure usability and overcome technical and physical \nconstraints. Examples of nonfu", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-066", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 66", "pageStart": 66, "pageEnd": 66, "target": "../sections/page-066.md", "narrative": null, "content": "54\nDigital implementation investment guide\n4.3 \tDetermine what the interventions will need to do\nOnce you have selected which types of digital health interventions will appropriately address your health \nsystem challenges and their suitability for your context, you can start defining the requirements of each \nintervention and the digital health application that will be used to execute the intervention. \nThe requirements should not be just digitizing the \nprocesses identified in the current-state workflows \ndeveloped in Chapter 3; also think through ways that \nintroducing efficiencies can optim", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-067", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 67", "pageStart": 67, "pageEnd": 67, "target": "../sections/page-067.md", "narrative": null, "content": "55\nDetermine appropriate digital health interventions\nTable 4.3.1.1. \t An example scenario for a pregnancy-support digital health intervention.\nEND-USER \nREQUIRED FUNCTIONALITY \nREASON\nAs a \ncommunity nurse\nI need a list of my clients whose \nantenatal visits are due today\nSo that I can plan my day accordingly, including adequate \nsupplies to conduct antenatal care checkups.\nAs a \ncommunity nurse\nI need to look up a client’s past \nhealth record\nSo I can evaluate whether the client is in a high-risk \ncategory and needs additional advice.\nAs a \ncommunity nurse\nI need to be able to send my client", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-068", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 68", "pageStart": 68, "pageEnd": 68, "target": "../sections/page-068.md", "narrative": null, "content": "56\nDigital implementation investment guide\nFig. 4.3.2.1. \tExamples of different personas interacting with digital health interventions.\nGROUP\nDESCRIPTION\nPOTENTIAL RESPONSE TO DIGITAL HEALTH INTERVENTIONS \n(POSITIVE AND NEGATIVE)\nStakeholder\nCommunity \nleader\nMay be excited to have an innovative project in the community. Will \nwant to understand the information given to end-users. Will want to be \ninvolved in or leading all planning meetings.\nStakeholder\nDistrict \nprogramme \nmanager\nMay need information from the digital health intervention at an aggregate \ngeographic level to manage programme", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-069", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 69", "pageStart": 69, "pageEnd": 69, "target": "../sections/page-069.md", "narrative": null, "content": "57\nDetermine appropriate digital health interventions\nFig. 4.3.3.1. \tBottleneck and future-state workflow diagrams.\nHEALTH FACILITY\nHEALTH FACILITY\nClerk\nClerk\nClient\nClient\nStart\nStart\nArrive at \nfacility\nArrive at \nfacility\nClient \nreceives SMS \nreminder\nGather client \ndetails\nBottleneck where digital health \nintervention would add value\nGather client \ndetails\nSearch \nfor client\nSearch \nfor client\nCheck in \nclient\nCheck in \nclient\nEnd\nEnd\nMatch \nfound?\nMatch \nfound?\nCreate client \nrecord\nCreate client \nrecord\nNO\nNO\nSEARCH USING UNIQUE ID\nYES\nYES\n1.\n2.\n1.\n2.\n3.\n3.\n4.\n6.\n7.\n5.\n6.\n4.\n5.\n!\n!\n1", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-070", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 70", "pageStart": 70, "pageEnd": 70, "target": "../sections/page-070.md", "narrative": null, "content": "58\nDigital implementation investment guide\nBID Initiative: Data quality and use interventions\nTogether with end-users from all levels of the health system, the BID Initiative collaboratively developed \na comprehensive set of tools and approaches to improve immunization data collection, quality and use \nspanning data-management policies and practices, information system products and training on the tools, \nas well as methods for better using data to make critical decisions about immunization services. These \nimprovements included the following:\n\t» an electronic immunization application (EIR) li", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/figure-img-p071-1", "types": [ "folio-assistant-core:Figure", "doco:Figure" ], "kind": "figure", "title": "", "pageStart": 71, "pageEnd": 71, "target": "../images/img-p071-1.png", "narrative": "draft", "content": "A screenshot of the WHO Digital Health Atlas web application, showing a map of parts of East Africa (South Sudan, Ethiopia, Somalia, Uganda, Kenya, Democratic Republic of the Congo, Burundi) with numbered blue pin markers indicating counts of cataloged digital health implementations at each location (values visible include 2, 4, 6, 30, 34 and 83). A side panel lists implementations for Rwanda, including 'E-Heza Data Solutions', 'Rwanda Health Analytics Platform (RHAP)', 'Rwanda HMIS' and 'DHIS2 for COVID-19 Surveillance', with a toggle to switch the map between 'Sub-national' and 'National' views.", "truncated": false, "provenance": "ingested", "summary": null }, { "id": "library/9789240010567-eng/blocks/prose-page-071", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 71", "pageStart": 71, "pageEnd": 71, "target": "../sections/page-071.md", "narrative": null, "content": "59\nDetermine appropriate digital health interventions\nBox 4.4.1.\t\nThe Digital Health Atlas and other repositories of digital health \nimplementations.\nIdentifying existing digital health interventions to use for your planned work can be challenging. WHO’s \nDigital Health Atlas (DHA) can help you conduct a digital health inventory (8). The DHA is a web-based tool for \ncataloguing and tracking digital health implementations. Searching the DHA for implementations filtered by \nhealth domain, health system challenge area, software applications or context may reveal opportunities for reuse \nand colla", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-072", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 72", "pageStart": 72, "pageEnd": 72, "target": "../sections/page-072.md", "narrative": null, "content": "60\nDigital implementation investment guide\nYour investment in digital health implementations may \noffer opportunities to contribute new functionality to \nsoftware global goods that may offer benefits beyond \nyour programme area, and similarly, your implementation \nmay benefit greatly from linking to or using existing \nfunctionalities, which can reduce costs and accelerate \ndeployment timelines. Additionally, for interventions \nfocused on health workers, you could determine which \nexisting ICT tools (hardware and applications) various \ncadres have experience with to maximize appropriateness \nof", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-073", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 73", "pageStart": 73, "pageEnd": 73, "target": "../sections/page-073.md", "narrative": null, "content": "61\nDetermine appropriate digital health interventions\nFig. 4.5.1 highlights the major considerations discussed so \nfar when selecting digital health interventions and the \ndigital health applications and platform in which they \nwill be implemented. As you review these factors, check \nthat the digital health interventions you have selected \nare still the most appropriate. Also consider how the \ninterventions you have selected will work with currently \ndeployed applications and fit within the larger digital \nhealth ecosystem. Chapter 5 will go into greater detail \non other considerations when im", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-074", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 74", "pageStart": 74, "pageEnd": 74, "target": "../sections/page-074.md", "narrative": null, "content": "62\nDigital implementation investment guide", "truncated": false, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-075", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 75", "pageStart": 75, "pageEnd": 75, "target": "../sections/page-075.md", "narrative": null, "content": "63\nCHAPTER \n05\nPLAN THE IMPLEMENTATION\nThe previous chapters helped you identify which digital health interventions \nto implement and why. This chapter examines more closely how to plan for \nimplementing your prioritized interventions within a digital health enterprise, \nrecognizing the iterative nature of the implementation process. \nTOOLS\n\t+ Questions to ask technology vendors (Annex 5.1)\n\t+ Key considerations for implementing a digital health intervention (Annex 5.3)\nOBJECTIVES\n\t+ Review critical factors to consider when planning to implement a digital health \nintervention.\n\t+ Develop a rea", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-076", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 76", "pageStart": 76, "pageEnd": 76, "target": "../sections/page-076.md", "narrative": null, "content": "64\nDigital implementation investment guide\nPRINCIPLES FOR \nDIGITAL DEVELOPMENT\n \nBUILD FOR \nSUSTAINABILITY8\n\t+ Plan for sustainability from the start.\n\t+ Develop a definition of sustainability for your initiative.\n\t+ Identify and implement a sustainable business model.\n\t+ Use and invest in local ICT service providers.\n\t+ Engage local governments and integrate national strategies into programming.\n\t+ Collaborate instead of competing, and partner to identify the best approach with \nthe greatest impact.\n\t+ Build a programme that can be adapted as end-user needs and the context change.\n8 Text ada", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-077", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 77", "pageStart": 77, "pageEnd": 77, "target": "../sections/page-077.md", "narrative": null, "content": "65\nPlan the implementation\nThe previous chapters helped you identify which digital health interventions to implement and why. This \nchapter examines more closely how to plan for implementing your prioritized interventions within a digital \nhealth enterprise, recognizing the iterative nature of the implementation process. \nDigital health implementations are broadly based on the \nfollowing critical components (see Fig. 5.1):\n1.\t\nappropriate and accurate health content and \ninformation, defined based on the health \nprogramme guidelines and related evidence-\nbased practices, and data needs for the", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-078", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 78", "pageStart": 78, "pageEnd": 78, "target": "../sections/page-078.md", "narrative": null, "content": "66\nDigital implementation investment guide\nFig. 5.1. \t\nEssential components of a digital health implementation.\nIn this chapter, you will explore the different \nconsiderations and key questions that can help guide \nyour digital health implementation (see Table 5.2). These \nconsiderations are based on the seven foundational \nbuilding blocks, as well as additional factors that may \ninfluence the success of your implementation. After \ncompleting this chapter, you may want to reassess \nwhether the digital health interventions you selected are \nstill feasible for your context based on your evaluati", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-079", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 79", "pageStart": 79, "pageEnd": 79, "target": "../sections/page-079.md", "narrative": null, "content": "67\nPlan the implementation\nFactor\nIllustrative considerations\nLEADERSHIP AND \nGOVERNANCE \n\t» Is there a national digital health governance framework or action plan, such as technical \nworking groups? \n\t» Are partnership terms and formal collaborations documented in a memorandum of \nunderstanding?\n\t» Do separate departments or divisions oversee ICT and digital health? \n\t» Is there a group or committee that combines ICT staff and staff from public health vertical \nprogrammes (such as malaria, tuberculosis, HIV/AIDS or maternal and child health) that you \nshould include? \nWORKFORCE \n\t» Are traini", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-080", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 80", "pageStart": 80, "pageEnd": 80, "target": "../sections/page-080.md", "narrative": null, "content": "68\nDigital implementation investment guide\nBox 5.3. \t\nDescription of digital health interventions reviewed in the WHO guideline.\nAnnex 5.3 expands on additional implementation considerations for specific digital health interventions prioritized in \nthe WHO guideline (1). If you are considering one of these interventions, review Annex 5.3 for a more nuanced list of \nfactors that could affect your implementation.\nDigital health \nintervention\nDefinition\nSynonyms and \nother descriptors\nBirth notification\nDigital approaches to support the notification of births, \nto trigger the subsequent steps of", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-081", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 81", "pageStart": 81, "pageEnd": 81, "target": "../sections/page-081.md", "narrative": null, "content": "69\nPlan the implementation\n5.1 \t Infrastructure considerations\nMany digital health applications and platforms have seen limited adoption and success because they \nwere piloted in areas that had inadequate access to electricity and mobile networks or were otherwise \ninappropriately designed for the context. Understanding the available infrastructure is foundational to defining \nthe scope and feasibility of the digital health application. Several practical approaches help alleviate constraints \nposed by infrastructural limitations. For example, erratic power supply and Internet connectivity may", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-082", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 82", "pageStart": 82, "pageEnd": 82, "target": "../sections/page-082.md", "narrative": null, "content": "70\nDigital implementation investment guide\n5.2\t Legislation, policy and compliance considerations\nIt is important to understand the national policies and regulations that may apply and explore relevant global \nbest practices when national policies are lacking. These could include regulations for hosting data and using \npersonally identifiable information, processes for informed consent, relevant standards and linkages with other \nsystems. A successful digital health implementation plan will assess the current policy environment, adapt the \ndesign to that environment and ensure that policies ar", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-083", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 83", "pageStart": 83, "pageEnd": 83, "target": "../sections/page-083.md", "narrative": null, "content": "71\nPlan the implementation\n5.2.2 \t\nREGULATION OF NEW DIGITAL HEALTH TECHNOLOGIES\nMany countries are developing national regulatory \nsystems for health-related technology. Regional \ngroups, such as the Digital Regional East African \nCommunity Health Initiative and the African Union’s \nNew Partnership for Africa’s Development, encourage \nregional-level regulation or qualification of new \ntechnologies for their member countries. Although \nstill emerging, international regulatory bodies are also \nestablishing measures for quality assurance and safety of \n“software as a medical device” (75), such a", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-084", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 84", "pageStart": 84, "pageEnd": 84, "target": "../sections/page-084.md", "narrative": null, "content": "72\nDigital implementation investment guide\nregulation that you will need to examine and determine \nhow to balance. (For more information about regulations \nof medical technologies, see Box 5.2.2.1.)\nAs technology continues to evolve, the procedures and \npolicy considerations for introducing new technologies \nwill also likely need to accelerate. The implementation \nleadership teams may want to consider how new \ntechnologies are integrated into the health system \nand what the policy foundation is for regulating the \ntechnologies. Consider the following questions when \nplanning to meet regulatory", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-085", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 85", "pageStart": 85, "pageEnd": 85, "target": "../sections/page-085.md", "narrative": null, "content": "73\nPlan the implementation\n5.3.2 \t\nEXTERNAL PARTNERSHIPS\nImplementing digital health interventions often \nrequires working with a range of partners in addition \nto governmental organizations that are traditionally \nconsidered the public health sector. These partners \ncan include NGOs, academic institutions, civil society \norganizations, donor organizations, and technology \nand software companies. Also consider local MNOs, \ntelecommunications groups, the consumer products \nindustry and pharmaceutical companies. Identify \nthe resources, competencies and capacity needed \nto complement implementat", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-086", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 86", "pageStart": 86, "pageEnd": 86, "target": "../sections/page-086.md", "narrative": null, "content": "74\nDigital implementation investment guide\n5.4 \tWorkforce and training considerations\nChapter 2 listed the key governance, management and operations personnel needed for a digital health \nimplementation. At this point, you will focus on the workforce directly involved in the digital health enterprise, \nsuch as community and facility health workers and healthcare managers. Although some health workers will \nshow great enthusiasm for new technologies, introducing and institutionalizing the intervention with all of the \nworkforce or client end-users can be challenging. \nEstablish training program", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-087", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 87", "pageStart": 87, "pageEnd": 87, "target": "../sections/page-087.md", "narrative": null, "content": "75\nPlan the implementation\nBID INITIATIVE\nCASE STUDY\nBID Initiative: Workforce implementation\nThe BID Initiative developed a workforce implementation strategy (80) informed by John Kotter’s eight-step \nmodel for change management (see Fig. 5.4.1). “Touches”, or visits, were used to introduce and provide training \non new tools and approaches, allowing health workers time to internalize the practice of data analysis and \nuse (see Fig. 5.4.2). Successful implementation requires buy-in from local health workers, so BID centred its \napproach on health workers, both as trainers and trainees. Instead", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-088", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 88", "pageStart": 88, "pageEnd": 88, "target": "../sections/page-088.md", "narrative": null, "content": "76\nDigital implementation investment guide\nFig. 5.4.2. \t Linking Kotter’s change model to BID’s touch strategy.\nSource: BID Initiative briefs: recommendations and lessons learned: change management (80). \nThe following are additional BID Initiative tools and resources for workforce implementation: \n\t» Rollout strategy (81)\n\t» Facility and district visit strategy (82)\n\t» Spotting and addressing resistance to change (83)\n\t» Change readiness assessment tool (84)\n\t» Coaching/supportive supervision job aid (85).\nROUTINE BID \nACTIVITIES \nKOTTER’S \nSTEPS\nOBJECTIVES\nCHANGE MANAGEMENT \nACTIVITIES\nTouch", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-089", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 89", "pageStart": 89, "pageEnd": 89, "target": "../sections/page-089.md", "narrative": null, "content": "77\nPlan the implementation\n5.5 \tServices and applications \nServices and applications are the devices and tools, including software, used to collect, transmit, access and \nmaintain health information, including the ICT systems that your digital health interventions will integrate \nwith and leverage (3). Services include digital registries for health workforce, master patient indexes and health \nfacilities, and applications include a variety of software and ICT systems that may be operating in your country, \nsuch as HMIS, indicator-reporting dashboards, and terminology and identity management se", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-090", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 90", "pageStart": 90, "pageEnd": 90, "target": "../sections/page-090.md", "narrative": null, "content": "78\nDigital implementation investment guide\n\t» Throughout this process, put in place mechanisms \nto collect and respond to end-user issues, \nparticularly in the early stages of piloting and \ndeployment. This mechanism will need to describe \nhow end-users are expected to report problems, \nwho investigates and responds, and how quickly \nthey should respond. \nEnsure that the health content is in line with evidence-\nbased recommendations and best practices. Based on \nthe health programme area where your digital health \nintervention is focused, consult relevant resources and \ncountry experts to ensu", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-091", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 91", "pageStart": 91, "pageEnd": 91, "target": "../sections/page-091.md", "narrative": null, "content": "79\nPlan the implementation\n5.6 \tStandards and interoperability \nStandards and interoperability are also critical factors for ensuring the success of digital health \nimplementations. For different systems to be interoperable, or to meaningfully exchange information with one \nanother, procedures and data standards must be established that ensure a common language and facilitate data \nexchange. Interoperability is not only critical for driving cost efficiencies and reducing fragmentation across \ndifferent digital systems, but is also necessary to support the continuity of care as patients engage", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/figure-img-p092-1", "types": [ "folio-assistant-core:Figure", "doco:Figure" ], "kind": "figure", "title": "", "pageStart": 92, "pageEnd": 92, "target": "../images/img-p092-1.png", "narrative": "draft", "content": "The OpenHIM logo: a green double-chevron (forward-arrow) icon beside the wordmark 'OpenHIM'. It represents one of the three component technologies, an interoperability layer for standards-compliant health information exchange, shown as part of Fig. 5.6.2 illustrating how mHero integrates digital health interventions using standards.", "truncated": false, "provenance": "ingested", "summary": null }, { "id": "library/9789240010567-eng/blocks/figure-img-p092-2", "types": [ "folio-assistant-core:Figure", "doco:Figure" ], "kind": "figure", "title": "", "pageStart": 92, "pageEnd": 92, "target": "../images/img-p092-2.png", "narrative": "draft", "content": "The iHRIS logo: a colorful aperture/lens-style icon beside the wordmark 'iHRIS'. It represents one of the three component technologies, an open source health workforce information system, shown as part of Fig. 5.6.2 illustrating how mHero integrates digital health interventions using standards.", "truncated": false, "provenance": "ingested", "summary": null }, { "id": "library/9789240010567-eng/blocks/figure-img-p092-3", "types": [ "folio-assistant-core:Figure", "doco:Figure" ], "kind": "figure", "title": "", "pageStart": 92, "pageEnd": 92, "target": "../images/img-p092-3.png", "narrative": "draft", "content": "The OpenHIE logo: a teal and blue circular/plus-shaped icon beside the wordmark 'OpenHIE'. It represents the interoperability framework referenced in Fig. 5.6.2, which illustrates how mHero integrates digital health interventions using standards.", "truncated": false, "provenance": "ingested", "summary": null }, { "id": "library/9789240010567-eng/blocks/figure-img-p092-4", "types": [ "folio-assistant-core:Figure", "doco:Figure" ], "kind": "figure", "title": "", "pageStart": 92, "pageEnd": 92, "target": "../images/img-p092-4.png", "narrative": "draft", "content": "The RapidPro logo: a small blue square icon beside the wordmark 'RapidPro'. It represents one of the three component technologies, an open source interactive messaging platform, shown as part of Fig. 5.6.2 illustrating how mHero integrates digital health interventions using standards.", "truncated": false, "provenance": "ingested", "summary": null }, { "id": "library/9789240010567-eng/blocks/figure-img-p092-5", "types": [ "folio-assistant-core:Figure", "doco:Figure" ], "kind": "figure", "title": "", "pageStart": 92, "pageEnd": 92, "target": "../images/img-p092-5.png", "narrative": "draft", "content": "The mHero logo: the wordmark 'mHero' in blue and grey text with a small wifi/signal-style icon. mHero is the combined communication tool described on the page, built from iHRIS, RapidPro and OpenHIM, shown as a component of Fig. 5.6.2 illustrating how mHero integrates digital health interventions using standards.", "truncated": false, "provenance": "ingested", "summary": null }, { "id": "library/9789240010567-eng/blocks/prose-page-092", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 92", "pageStart": 92, "pageEnd": 92, "target": "../sections/page-092.md", "narrative": null, "content": "80\nDigital implementation investment guide\nCASE STUDY\nmHero – using data standards to effectively integrate \ndifferent digital health interventions\nmHero combines three technologies – IntraHealth’s iHRIS software, UNICEF’s RapidPro and Jembi’s OpenHIM \n– into a powerful communication tool for ministry and health workers (90). \niHRIS is open source health workforce information system software used to capture and maintain \ninformation for planning, managing, regulating and training the health workforce. RapidPro is an open source \nplatform for building an interactive messaging system. OpenHIM is", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-093", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 93", "pageStart": 93, "pageEnd": 93, "target": "../sections/page-093.md", "narrative": null, "content": "81\nCHAPTER \n06\nLINK THE DIGITAL HEALTH \nIMPLEMENTATION TO THE \nENTERPRISE ARCHITECTURE\nOver the course of the previous chapters, you developed a plan for a digital health \nimplementation focused on addressing identified health system challenges, with \na clear understanding of the digital health interventions and other functionalities \nrequired. To advance this from being a siloed digital health implementation to \nan exchanged digital health system architecture, it is also important to consider \nthe costs and implementation requirements that would enable you to cohesively \nbenefit from and supp", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-094", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 94", "pageStart": 94, "pageEnd": 94, "target": "../sections/page-094.md", "narrative": null, "content": "82\nDigital implementation investment guide\nPRINCIPLES FOR \nDIGITAL DEVELOPMENT\nREUSE AND \nIMPROVE1\n\t+ Identify the existing technology tools (local and global), data and frameworks being \nused by your target population, in your geography or in your sector. Evaluate how \nthese could be reused, modified or extended for use in your program.\n\t+ Develop modular, interoperable approaches instead of those that stand alone or are \nattempting to be all-encompassing in their features. Interoperability will ensure that \nyou can adopt and build on components from others and that others can adopt and \nbuil", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-095", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 95", "pageStart": 95, "pageEnd": 95, "target": "../sections/page-095.md", "narrative": null, "content": "83\nLink the digital health implementation to the enterprise architecture\nOver the course of the previous chapters, you developed a plan for a digital health implementation focused on \naddressing identified health system challenges, with a clear understanding of the digital health interventions \nand other functionalities required. To advance this from being a siloed digital health implementation to an \nexchanged digital health system architecture (see Fig. 1.3.1), it is also important to consider the costs and \nimplementation requirements that would enable you to cohesively benefit from and sup", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-096", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 96", "pageStart": 96, "pageEnd": 96, "target": "../sections/page-096.md", "narrative": null, "content": "84\nDigital implementation investment guide\nFig. 6.1.1. \t Digital health architectural approach.\nAlthough this type of architectural vision may not \nexist or be fully developed for your context, you could \nconsult the TOGAF and OpenHIE framework in Fig. 6.3.2 \nto understand the different components typically \nfound in developing a shared digital health enterprise \narchitecture. Understanding the current architecture \nand its constituent functional and technical component \nparts will facilitate understanding the gap between what \ncurrently exists and can be leveraged and what may be \nmissing, re", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-097", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 97", "pageStart": 97, "pageEnd": 97, "target": "../sections/page-097.md", "narrative": null, "content": "85\nLink the digital health implementation to the enterprise architecture\nBID INITIATIVE\nCASE STUDY\nBID Initiative: Enterprise architecture approach\nMultiple disconnected health data systems can stunt the efforts and potential of new technologies. \nSuccessful digital health enterprises take stock of the existing landscape and build upon it, with the goal of \nsustaining efforts well beyond a project life span. The BID Initiative worked closely with the governments \nof Tanzania and Zambia to integrate interventions into the broader health system and overarching health \nstrategies.\nThe BID Initiat", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-098", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 98", "pageStart": 98, "pageEnd": 98, "target": "../sections/page-098.md", "narrative": null, "content": "86\nDigital implementation investment guide\n6.2 \tIdentify common and enabling components and \nshared services (digital health platform)\nWhen linking your digital health implementation to the broader digital health enterprise architecture, consider \nthe core functionalities, or components, that are unique to your use case or health programme, as well as \nthe components that can be generalized and reused in other health programme areas or even beyond the \nhealth sector. These common components (also called reusable components) represent opportunities for \njoint investment, allowing you to stitch", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-099", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 99", "pageStart": 99, "pageEnd": 99, "target": "../sections/page-099.md", "narrative": null, "content": "87\nFig. 6.2.2. \t Digital health investments within the digital health enterprise architecture. \nSHARED SERVICES\nDATA SERVICES\nDATA SOURCES\nInstitution-Based \nHIS & Data Sources\nPopulation-Based \nHIS & Data Sources\nAnalytics, \nDashboards, Aids, \nRepositories \nDigital Health Platform\nShared Services\nBusiness \nDomain Services\nRegistry Services\nTerminology \nServices\nHealth Worker \nRegistry\nClient \nRegistry\nProduct Registry\nFacility \nRegistry\nLogistics Mgmt \ninfo system\nShared \nHealth Record\nHealth Mgmt \ninfo system\nDigital and non-\ndigital datasets \nsourced from \nprocesses that \nsystematically \nr", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-100", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 100", "pageStart": 100, "pageEnd": 100, "target": "../sections/page-100.md", "narrative": null, "content": "88\nDigital implementation investment guide\n6.3 \tLink your digital health investments to the \nenterprise architecture\nThis Guide provides only an introductory overview for linking digital health investments within health \nprogrammes to the broader national digital health enterprise architecture. Executing this process will require \nmore detailed consultations with personnel who have expertise in developing national digital health enterprise \narchitectures. Box 6.3.1 highlights key resources that can facilitate this process. \nIt is recommended that you identify or develop a \ndiagram reflecting t", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-101", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 101", "pageStart": 101, "pageEnd": 101, "target": "../sections/page-101.md", "narrative": null, "content": "89\nBox 6.3.1. \t Key resources for building towards a digital health enterprise architecture. \n\t» Digital health platform handbook: building a digital information infrastructure (infostructure) for health \nfocuses on combining digital health interventions into an interoperable whole, identifying the standards \nand interoperability requirements for enabling a cohesive digital health enterprise architecture (14).\n\t» OpenHIE describes a reusable architectural framework that leverages health information standards, \nenables flexible implementation by country partners and supports exchange of individ", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-102", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 102", "pageStart": 102, "pageEnd": 102, "target": "../sections/page-102.md", "narrative": null, "content": "90\nDigital implementation investment guide\nFig. 6.3.3. \t Myanmar example of a national digital health enterprise architecture blueprint. \nIn the current state, there is a limited use of data \nexchange standards, and digital systems use a direct \n(integrated) connection to shared services. In the \nfuture state, data exchange standards and enabling \ncomponents are used to facilitate interoperability across \ndifferent digital health implementations and shared \nservices. \nFUTURE STATE\nDigital Health Platform\nENTERPRISE\nINTER-\nOPERABILITY \nLAYER\nEnabling \nComponents\nDIGITAL HEALTH APPLICATIONS WITH", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-103", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 103", "pageStart": 103, "pageEnd": 103, "target": "../sections/page-103.md", "narrative": null, "content": "91\nCHAPTER \n07\nDEVELOP A BUDGET\nThis chapter will help you develop a budget for implementing and sustainably \noperating your digital health intervention within your specific digital health \necosystem. You will identify cost drivers for each phase of the digital health \nimplementation, including budget considerations related to interoperability, and \nyou will develop a budget for the life span of the investment. Cost considerations \nfor specific digital health interventions are further detailed in Annex 5.3.\nTOOLS\n\t+ Budget template (Annex 7.1)\nOBJECTIVES\n\t+ Understand cost drivers by implement", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-104", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 104", "pageStart": 104, "pageEnd": 104, "target": "../sections/page-104.md", "narrative": null, "content": "92\nDigital implementation investment guide\nPRINCIPLES FOR \nDIGITAL DEVELOPMENT\nDESIGN FOR \nSCALE1\n\t+ Plan and design for scale from the start.\n\t+ Develop a definition of scale for your initiative.\n\t+ Keep your design simple, flexible and modular to make it easy to change your \ncontent and adapt to other contexts.\n\t+ As you make technology choices, think about whether those choices will make it \neasier or harder to scale.\n\t+ Identify partners early who can help scale your tool or approach.\n\t+ Consider your funding model, including the cost per end-user, options for \ngenerating revenue, social b", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-105", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 105", "pageStart": 105, "pageEnd": 105, "target": "../sections/page-105.md", "narrative": null, "content": "93\nDevelop a budget\nThis chapter will help you develop a budget for implementing and sustainably operating your digital health \nintervention within your specific digital health ecosystem. You will identify cost drivers for each phase of the \ndigital health implementation, including budget considerations related to interoperability, and you will develop \na budget for the life span of the investment. Cost considerations for specific digital health interventions are \nfurther detailed in Annex 5.3.\n7.1 \t Costs by phase of implementation \nFig. 7.1.1. \t\nPhases of implementation.\nThe full costs of im", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-106", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 106", "pageStart": 106, "pageEnd": 106, "target": "../sections/page-106.md", "narrative": null, "content": "94\nDigital implementation investment guide\nDEPLOYMENT: During this phase, the digital health \nimplementation goes live, often in a pilot setting. It is \nimportant to budget resources to support end-user \ntesting and iteration for refinement during this phase. \nINTEGRATION AND INTEROPERABILITY: Although \nthese elements should be addressed during design \nand deployment, they are so important to long-term \nsustainability that they have been called out in a \nseparate phase, as they may need to be reviewed and \nupdated continuously. As your deployment expands \nand the digital health enterprise arch", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-107", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 107", "pageStart": 107, "pageEnd": 107, "target": "../sections/page-107.md", "narrative": null, "content": "95\nDevelop a budget\nTable 7.2.1. \tIllustrative costs throughout the implementation life cycle.3\nCost \nCategories Cost Drivers\nConsiderations\nUp-front \nversus \nrecurring\n \nONGOING/ALL PHASES\nManagement \nand staffing \n\t» Complexity of intervention\n\t» Full-time Equivalents \n(FTEs) needed \n\t» Staff training needed\n\t» Turnover \n\t» Overhead \n\t» What is the level of effort for programme management staff \nassociated with training, vendor relationship management and \nother meetings? \n\t» Does staff capacity already exist on your team? Will you need to \nshift tasks or hire and train new resources? \n\t» I", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-108", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 108", "pageStart": 108, "pageEnd": 108, "target": "../sections/page-108.md", "narrative": null, "content": "96\nDigital implementation investment guide\nCost \nCategories Cost Drivers\nConsiderations\nUp-front \nversus \nrecurring\nInter-\noperability \nwith other \nsystems\n\t» Use of standards or lack \nthereof\n\t» Maturity of interoperability \nstandards used \n\t» What is the cost to interoperate with existing systems? \n\t» What efforts will be needed to ensure that the system complies \nwith relevant standards, including open standards?\nRecurring\nHardware\n\t» Existence of “Bring your \nown device” policies/\nnumber of devices needed \n\t» Sophistication of device(s) \nneeded \n\t» Where will data be stored (for example, i", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-109", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 109", "pageStart": 109, "pageEnd": 109, "target": "../sections/page-109.md", "narrative": null, "content": "97\nDevelop a budget\nCost \nCategories Cost Drivers\nConsiderations\nUp-front \nversus \nrecurring\n \nSUSTAINED OPERATIONS\nVoice and data \nservices \n(mobile data \nplan, Internet, \nnumber of text \nmessages)\n\t» Number of end users\n\t» Size of data collected and \nstored \n\t» Amount of information \nneeded to disseminate \n\t» How many text messages and voice minutes will be used?\n\t» How much mobile data will be needed for each end-user? \n\t» Can you negotiate a below-market rate with an MNO?\nRecurring\nHardware \nmaintenance, \nongoing administration \nand replacement rate \n\t» Number of end users and \ndevices man", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-110", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 110", "pageStart": 110, "pageEnd": 110, "target": "../sections/page-110.md", "narrative": null, "content": "98\nDigital implementation investment guide\nBID INITIATIVE \nCASE STUDY\nBID Initiative: How much does an EIR cost?\nHow much does it cost to implement BID Initiative interventions in the test sites in Tanzania and Zambia? \nWhat are the up-front and recurring costs of operating BID interventions? What are the resources required \nto implement interventions in each district? How do the costs of providing immunization services and \nreporting compare before and after BID interventions are implemented?\nThese are some of the key costing questions the BID team asked as it planned to implement interventio", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-111", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 111", "pageStart": 111, "pageEnd": 111, "target": "../sections/page-111.md", "narrative": null, "content": "99\nDevelop a budget\nCost category\nCost description\n \nDEPLOYMENT\nTraining\nTraining of staff responsible for rolling out the interventions to the health facilities\nRoll-out\nPer diems, lodging and transport associated with deployment of the EIR to health \nfacilities and district immunization offices; transport includes vehicles purchased \n(one for each country) and expenditures for fuel and maintenance of those vehicles, \nas well as hiring other vehicles used for the deployment\n \nSUSTAINED OPERATIONS\nInternet connectivity\nAccess to Internet for uploading data and transferring data to higher leve", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-112", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 112", "pageStart": 112, "pageEnd": 112, "target": "../sections/page-112.md", "narrative": null, "content": "100\nDigital implementation investment guide\n7.3 \t Budget matrix\nOnce you have identified your cost categories by investment phase and the related drivers of those cost \ncategories, use a budget matrix (see Table 7.3.1) to create a detailed budget for your implementation across the \nexpected life span before the intervention will require significant updates. This time frame is typically about five \nyears but could be longer or shorter depending on the selected intervention. Budget matrices are also useful \nfor comparing costs across digital health interventions. You could use financial data in", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-113", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 113", "pageStart": 113, "pageEnd": 113, "target": "../sections/page-113.md", "narrative": null, "content": "101\nCHAPTER \n08\nMONITOR THE IMPLEMENTATION \nAND USE DATA EFFECTIVELY\nMonitoring and evaluation and continuous improvement by responding to the \nchanges induced by the digital health implementation, also known as adaptive \nmanagement, are necessary components of ensuring the viability and ultimate \nimpact of your efforts. \nTOOLS\n\t+ Monitoring and evaluating digital health interventions: a practical guide to conducting \nresearch and assessment (26)\n\t+ Adaptive management checklist (Annex 8.1)\n\t+ Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework \n(98)\n\t+ Logic mode", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-114", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 114", "pageStart": 114, "pageEnd": 114, "target": "../sections/page-114.md", "narrative": null, "content": "102\nDigital implementation investment guide\nPRINCIPLES FOR \nDIGITAL DEVELOPMENT\n \nBE DATA \nDRIVEN1\n\t+ Design programmes so that impact can be measured continually and \nincrementally, focusing on outcomes, not just outputs.\n\t+ Make use of existing data, including open data sets and data from interoperable \nsystems.\n\t+ Use rigorous data collection methods. Consider and address potential biases \nand gaps in the data collected, perform data quality checks, and maintain strong \ndocumentation behind collected data.\n\t+ Close knowledge gaps by contributing data to the development community and \nusing", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-115", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 115", "pageStart": 115, "pageEnd": 115, "target": "../sections/page-115.md", "narrative": null, "content": "103\nMonitor the implementation and use data effectively\nAfter going through the steps to plan the digital health implementation but prior to deploying the \nimplementation, you can embed mechanisms to monitor the implementation, such as collecting baseline data, \nand use the insights from the emerging data to increase your implementation’s impact and efficiency. Continual \nmonitoring of activities at different stages of the implementation is critical for ensuring its long-term success, as \nis responding to external changes and new learnings. \nFig. 8.1.\t\nM&E and adaptive management as continual", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-116", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 116", "pageStart": 116, "pageEnd": 116, "target": "../sections/page-116.md", "narrative": null, "content": "104\nDigital implementation investment guide\n8.1 \t Establish a logic model for your implementation\nDefining a framework in the form of a logic model will \nhelp you refine and understand your programme’s goals \nand objectives and conceptualize the relationship \nbetween them, the underpinning programme activities \nrequired to achieve them and the anticipated outcomes. \nLogic models aim to clarify programme objectives and \naid in identifying expected causal links from inputs, \nprocesses, outputs, outcomes and impacts (4). They \nprovide a graphical representation, which may serve as \na catalyst for", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-117", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 117", "pageStart": 117, "pageEnd": 117, "target": "../sections/page-117.md", "narrative": null, "content": "105\nMonitor the implementation and use data effectively\nLogic models link inputs (programme resources) with \nprocesses (activities undertaken in the delivery of \nservices), outputs (products of processes), outcomes \n(intermediate changes) and impact. \nIn the context of digital health implementations, \nINPUTS encompass all resources that go into the \nprogramme. In this model, technology inputs are \ndifferentiated from programmatic inputs aimed at \nproviding health services. Programmatic inputs (human \nresources, training and other materials development) \nare also distinguished from policy input", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-118", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 118", "pageStart": 118, "pageEnd": 118, "target": "../sections/page-118.md", "narrative": null, "content": "106\nDigital implementation investment guide\n8.2 \tPlan how you will conduct the \nmonitoring and evaluation\nPlanning to deploy a digital health intervention includes \ndetermining what to monitor to ensure that the \nintervention is working as planned and what to evaluate \nto ensure that it is having the effects you expected. \nThese efforts may include tracking performance, \nchanges in processes, health outcomes, end-user \nsatisfaction with health systems, cost-effectiveness or \nshifts in knowledge and attitudes. \nMONITORING helps answer the question: Is the \nintervention working as intended? Moni", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-119", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 119", "pageStart": 119, "pageEnd": 119, "target": "../sections/page-119.md", "narrative": null, "content": "107\nMonitor the implementation and use data effectively\nIdeally, M&E occur in close balance with each other \nand are structured to answer questions that are most \nrelevant at each stage of the implementation. At the \nearly stages, you could use M&E results to iteratively \nredesign and test the digital health intervention \nto better meet the needs of end-users and the \norganization. Fig. 8.2.1 illustrates the evolution of M&E \nneeds during the development and deployment stages \nof implementation.\nFig. 8.2.1. \t Intervention maturity over time.\nMaturity models can serve as measuring sticks or \nin", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-120", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 120", "pageStart": 120, "pageEnd": 120, "target": "../sections/page-120.md", "narrative": null, "content": "108\nDigital implementation investment guide\nFig. 8.2.2. \t Implementation maturity continuum.\nSource: Adapted from WHO Monitoring and evaluating digital health interventions, 2016 (26).\n \nComponent\nWhen\nPotential Measures\nImplementation Maturity Continuum \n& Guiding Questions\nQUALITY\nPre-launch \n& during \nimplementation\n•\t End-user entry of phone number \nis correct\n•\t Rate of agreement in data \nrecording between training rounds \n(i.e. end-user accuracy)\n•\t Quality control reports on \nend-users\nHow well and consistently are \nend-end-users able to operate \nthe system?\nAre the content and use of t", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-121", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 121", "pageStart": 121, "pageEnd": 121, "target": "../sections/page-121.md", "narrative": null, "content": "109\nMonitor the implementation and use data effectively\nCASE STUDY\nMyanmar “Learning for Impact” model of continuous monitoring\nUNFPA Myanmar developed the Love Question, Life Answer (LQLA) mobile application to promote \naccessibility of evidence-based information about life skills and sexual and reproductive health and rights \nto adolescents and young people in and out of school in Myanmar. Through active promotion on different \nchannels, the number of downloads reached more than 43 000 end-users by the end of 2018. As the app was \nbeing deployed, UNFPA determined that it would not be suffici", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-122", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 122", "pageStart": 122, "pageEnd": 122, "target": "../sections/page-122.md", "narrative": null, "content": "110\nDigital implementation investment guide\nThe RE-AIM framework may also be considered as a \ncomprehensive way to think through your M&E needs as \nyou scale up the implementation. The following are the \ncomponents of the RE-AIM framework (98):\nReach: the level of penetration of an intervention in \nterms of the proportion of eligible participants who \nreceive the intervention \nEffectiveness: the impact on targeted outcomes, \nincluding potential negative effects\nAdoption: the absolute number and proportion of \norganizational units, individuals or settings that adopt a \ngiven intervention\nImplem", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-123", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 123", "pageStart": 123, "pageEnd": 123, "target": "../sections/page-123.md", "narrative": null, "content": "111\nMonitor the implementation and use data effectively\nFig. 8.3.1. \t Examples of data use.\nBENEFIT\nEXAMPLES\nHOW TO EVALUATE SUCCESS\nBETTER INDICATORS \nFOR STRATEGIC \nPLANNING\n•\t Targeted advocacy efforts help to address higher-than-\naverage vaccination dropout rates in specific population \ngroups.\n•\t Credible estimates of vaccine wastage rates for each \nhealth centre lead to tailored vaccination strategies to \nreduce wastage.\n•\t High failure rates in certain types of cold chain equipment \nlead to the discontinuation of that equipment.\n•\t Did the system produce credible data for these \nindicat", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-124", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 124", "pageStart": 124, "pageEnd": 124, "target": "../sections/page-124.md", "narrative": null, "content": "112\nDigital implementation investment guide\nAlthough the high quality of data is important, quality \ndoes not guarantee data use at an individual, facility, \ncommunity or organizational level. Additionally, while \na trained cadre of data end-users is critical, data must \nmeet the requirements of multiple end-users and \nend-user scenarios, informing both national policy and \nservice delivery among health workers. Furthermore, \nthe right people (at all levels) must be able to get the \ninformation they need, when they need it, for their \npurposes. \nData must be translated into information at the", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-125", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 125", "pageStart": 125, "pageEnd": 125, "target": "../sections/page-125.md", "narrative": null, "content": "113\nMonitor the implementation and use data effectively\nFour other factors can help complete cultural change, as described in Table 8.3.4.\nTable 8.3.4. \t\nCultural change factors.\nAwareness of \nneed\nEarlier, you identified your health system challenges, along with the information needed to \naddress these challenges. Implementing an awareness campaign that builds a case for action \nappropriate across different levels of the health system can increase support for the digital \nhealth intervention.\nMotivation to \nact\nMotivation can come from both external drivers (such as job performance indicators", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-126", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 126", "pageStart": 126, "pageEnd": 126, "target": "../sections/page-126.md", "narrative": null, "content": "114\nDigital implementation investment guide\nThe following are key learnings from implementing these data-use interventions in Tanzania and Zambia. \n\t» Teach data-analysis skills with the facility’s existing data to help nurses identify challenges \ncurrently affecting service delivery and pinpoint ways to address those issues. This foundation in \ndata analysis better prepares nurses to adopt new tools and to adapt their data-analysis skill sets to \ndifferent service areas, such as malaria.\n\t» Electronic tools, as well as revised paper forms, must go through an iterative process with \nfeedback f", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-127", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 127", "pageStart": 127, "pageEnd": 127, "target": "../sections/page-127.md", "narrative": null, "content": "115\nMonitor the implementation and use data effectively\n8.4 \tAdaptive management: \nUse data to optimize interventions \nAdaptive management requires realizing that change \nhappens and building in the ability to respond to the \nchange (106). Emerging from the interdisciplinary \nneed and understanding that complex development \nissues require nimble solutions, adaptive management \ncalls for incremental, steady iteration (107). Adaptive \nmanagement ensures that M&E plan outputs are \ncontinuously used to improve the digital health \nintervention or larger digital health investment.\nAdaptive managemen", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-128", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 128", "pageStart": 128, "pageEnd": 128, "target": "../sections/page-128.md", "narrative": null, "content": "116\nDigital implementation investment guide\n\t» Does your team have mechanisms for translating \nlearnings into change? If so, how do you integrate \nchange at an implementation, programme or \norganizational level?\n\t» What tools and mechanisms does your team \nuse to determine the appropriate approach to \ninterventions (such as theories of change, benefit \nanalyses, stakeholder analyses and so on)?\n\t» How do you evaluate progress, taking into account \nuncertainties and repeated cycles of learning and \nchange?\n\t» How do you analyse and communicate results?\nA full checklist of considerations can be", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-129", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 129", "pageStart": 129, "pageEnd": 129, "target": "../sections/page-129.md", "narrative": null, "content": "117\nMonitor the implementation and use data effectively\n8.5 \tProgress check \nAt this point in the \nprocess, you should \nhave the following \noutputs:\n\t\nˆ Problem statement detailing specific challenges and needs in \nthe health system\n\t\nˆ Identified digital health interventions to address the current \nchallenges\n\t\nˆ Enabling-environment assessment defining possible constraints\n\t\nˆ Implementation plan that is appropriate for the environmental \nlimitations\n\t\nˆ Linkages of this specific investment to the broader set of digital \nhealth activities and enterprise architecture\n\t\nˆ High-level financial", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-130", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 130", "pageStart": 130, "pageEnd": 130, "target": "../sections/page-130.md", "narrative": null, "content": "118", "truncated": false, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-131", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 131", "pageStart": 131, "pageEnd": 131, "target": "../sections/page-131.md", "narrative": null, "content": "119\nCHAPTER \n09\nVALUE PROPOSITION AND \nNEXT STEPS\nFig. 9.1 provides an overview of the key components to complete as you finalize \nyour costed implementation plan. You may use this costed implementation \nplan to obtain the necessary digital health investment for your proposed \nimplementation. Beyond resource mobilization, following this process should \ngive you more confidence that the selected digital health interventions that you \nplan to implement within a larger digital health enterprise architecture:\n\t» address identified bottlenecks and health programme needs\n\t» align with the existing n", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-132", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 132", "pageStart": 132, "pageEnd": 132, "target": "../sections/page-132.md", "narrative": null, "content": "120\nDigital implementation investment guide\nFig. 9.1. \t\nSummary of outputs towards a costed investment plan.\nHealth Goals\n\t» Form the team and establish goals\n\t» Establish personas and needs in health \nstructure\n\t» Assess and document user and data \nworkflows\n\t» Identify pain points and health system \nchallenges\n\t» Articulate expected outcomes, benefits, \nimpact\n01\t\n\nActors\n04\nDigital Context\n05\t\n\nImplementation\n02\t\n\nPriorities\n06\nArchitecture\n07\t\n\nBudget\n08\t \nMonitoring\n09\t \nValue \nProposition\n03\t\n\nProgramme Context\nCommon \nServices \nAcross \nSectors\n4.3\t Functional \nRequirements\n4.1\t Prioriti", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-133", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 133", "pageStart": 133, "pageEnd": 133, "target": "../sections/page-133.md", "narrative": null, "content": "121\nValue proposition and next steps\nBID INITIATIVE \nCASE STUDY\nBID Initiative: Sustainability\nAn important component of sustaining a digital health enterprise is sharing lessons learned with the larger \ncommunity. Here are a few from the BID Initiative that consider policy, technical, institutional and financial \nelements (see Fig. 9.2).\nFig. 9.2. \t\nCritical sustainability elements.\nWork from the beginning with a core group of stakeholders across the government and other key \norganizations. This will ensure a complete understanding of the challenges to be addressed and that the \nsolutions add", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-134", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 134", "pageStart": 134, "pageEnd": 134, "target": "../sections/page-134.md", "narrative": null, "content": "122\nDigital implementation investment guide\n\tReferences\n1. \t\nWHO guideline: recommendations on digital interventions \nfor health system strengthening. Geneva: World Health \nOrganization; 2019. Licence: CC BY-NC-SA 3.0 IGO.\n2. \t\nWorld Health Organization, PATH. Planning an information \nsystems project: a toolkit for public health managers. \nSeattle: PATH; 2013 (https://path.org/resources/planning-\nan-information-systems-project-a-toolkit-for-public-\nhealth-managers/, accessed 18 February 2020).\n3. \t\nWorld Health Organization, International \nTelecommunication Union. National eHealth strategy \nto", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-135", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 135", "pageStart": 135, "pageEnd": 135, "target": "../sections/page-135.md", "narrative": null, "content": "123\nReferences\n30. \t Standards and Interoperability Lab – Asia. Digital health \ninvestment: costing tool. Manila: Asian Development Bank; \n2020 (http://sil-asia.org/costing-tool/, accessed 17 February \n2020).\n31. \t CRVS digitisation guidebook: a step-by-step guide to \ndigitising civil registration and vital statistics processes \nin low resource settings. African Programme for the \nAccelerated Improvement of CRVS (http://www.crvs-dgb.\norg/en/, accessed 18 February 2020).\n32. \t Common requirements for maternal health information \nsystems: produced with the Collaborative Requirements \nDevelopment", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-136", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 136", "pageStart": 136, "pageEnd": 136, "target": "../sections/page-136.md", "narrative": null, "content": "124\nDigital implementation investment guide\n59. \t Batavia H, Mechael P. Toolkit: assessing the enabling \nenvironment for establishing a contextualized national \ndigital health strategy. Washington (DC): United Nations \nFoundation; 2016 (http://ict4somlnigeria.info/wp-content/\nuploads/2016/03/Toolkit-assessing-enabling-environment_\nFINAL.pdf, accessed 18 February 2020).\n60. \t Information and communication technologies for women’s \nand children’s health: a planning workbook. Geneva: \nWorld Health Organization (https://www.who.int/pmnch/\nknowledge/publications/ict_mhealth.pdf, accessed 18 \nFebrua", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-137", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 137", "pageStart": 137, "pageEnd": 137, "target": "../sections/page-137.md", "narrative": null, "content": "125\nReferences\n89. \t What is interoperability in healthcare? In: HIMSS Resource \nLibrary [website]. Chicago: Healthcare Information and \nManagement Systems Society; 2019 (https://www.himss.\norg/what-interoperability, accessed 18 February 2020).\n90. \t mHero [website]. Chapel Hill (NC): IntraHealth \nInternational; 2017 (https://www.mhero.org/, accessed 18 \nFebruary 2020).\n91. \t OpenHIE architecture specification, version 2.0. OpenHIE; \n2019 (https://ohie.org/architecture-specification/, accessed \n17 February 2020).\n92. \t TOGAF content metamodel [presentation]. In: TOGAF \nstandard courseware V9 e", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-138", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 138", "pageStart": 138, "pageEnd": 138, "target": "../sections/page-138.md", "narrative": null, "content": "126\nDigital implementation investment guide\nAnnex 1.1 \t Glossary\n1\t\n Adapted from Digital health terminology guide. AeHIN; 2018 (https://aehin.hingx.org/Share/Details/3819/, accessed 24 January 2019). \n2\t\n Consensus definition of digital health, Digital Health and Interoperability Working Group Key terms and theory of change small working group; \n[Presentation] 2019 (https://docs.google.com/presentation/d/1TnTFaunk-1WLlG4sKJQ_aSfjmfmivvcENil4mY4XxJs, accessed 18 February 2020).\n3\t\n Adapted from Digital health platform handbook: building a digital information infrastructure (infostructure) for", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-139", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 139", "pageStart": 139, "pageEnd": 139, "target": "../sections/page-139.md", "narrative": null, "content": "127\nAnnexes\nDIGITAL HEALTH ENTERPRISE. The business processes, \ndata, systems and technologies used to support \nthe operations of the health system, including the \ndigital health applications, point-of-service software \napplications, other software, devices, hardware, \nstandards, governance and underlying information \ninfrastructure (such as the digital health platform) \nfunctioning in a purposeful and unified manner. This \nguide distinguishes between four different types of \ndigital health enterprise system architectures along a \ncontinuum of maturity: siloed, ball of mud, integrated \nand exc", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-140", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 140", "pageStart": 140, "pageEnd": 140, "target": "../sections/page-140.md", "narrative": null, "content": "128\nDigital implementation investment guide\nENTERPRISE ARCHITECTURE. A blueprint of business \nprocesses, data, systems and technologies used to help \nimplementers design increasingly complex systems \nto support the workflow and roles of people in a large \nenterprise, such as a health system.8\nEVALUATION. The systematic assessment of an ongoing \nor completed intervention to determine whether \nthe intervention is fulfilling its objectives and to \ndemonstrate an effect on health outcomes.9\nEXCHANGED SYSTEM ARCHITECTURE. A system \narchitecture consisting of multiple applications \nconnected through", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-141", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 141", "pageStart": 141, "pageEnd": 141, "target": "../sections/page-141.md", "narrative": null, "content": "129\nAnnexes\nLOGIC MODEL. A graphic depiction of the shared \nrelationships between the resources, activities, outputs, \noutcomes and impact of a health programme, showing \nthe relationship between the programme’s activities and \nits anticipated effect.13\nMATURITY MODEL. A framework used in ICTs and \ndigital health to help situate implementations based \non technological, organizational or environmental \ncharacteristics.\nMONITORING. The process of collecting and analysing \nroutinely collected data to compare how well an \nintervention is being implemented against expected \nresults and measure chan", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-142", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 142", "pageStart": 142, "pageEnd": 142, "target": "../sections/page-142.md", "narrative": null, "content": "130\nDigital implementation investment guide\nAnnex 1.2 \t Additional resources for planning and \nimplementing a digital health enterprise\nPhase \nSteps\nResources\nPHASE 1\nAssessing the \ncurrent state \nand enabling \nenvironment\nConduct an inventory of existing \nor previously used software \napplications, ICT systems and \nother tools to better understand \nthe requirements for reuse and \ninteroperability.\n\t» Health information systems interoperability maturity \ntoolkit: assessment tool. MEASURE Evaluation; 2017 \n(https://www.measureevaluation.org/resources/\npublications/tl-17-03b).\n\t» Information and", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-143", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 143", "pageStart": 143, "pageEnd": 143, "target": "../sections/page-143.md", "narrative": null, "content": "131\nAnnexes\nPhase \nSteps\nResources\nPHASE 6\nM&E of \ndigital health \nimplementations \nand fostering \ndata use\nMonitor your implementation to \nensure systems are functioning as \nintended and having the desired \neffect. \nFoster data-driven adaptive \nchange management within the \noverall health system.\n\t» Bridging real-time data and adaptive management: ten \nlessons for policy makers and practitioners. US Agency for \nInternational Development; 2018 (https://www.usaid.gov/\ndigital-development/rtd4am/policy-design-lessons/).\n\t» Defining and building a data use culture. PATH; 2017 \n(https://www.path.o", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-144", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 144", "pageStart": 144, "pageEnd": 144, "target": "../sections/page-144.md", "narrative": null, "content": "132\nDigital implementation investment guide\nAnnex 2.1 \t Planning and implementation charter\nAs you determine roles and responsibilities and develop a common goal, you can you use this charter template to list \nout the overall vision, scope, health programmes to be targeted and other key information related to your planning and \nimplementation efforts. See Chapter 2 for more details.\nVISION/OBJECTIVES\nA concise description of what outcomes \nare expected from the planning and \nimplementation. Describe how the \norganization will benefit at the end of the \nproject.\nBACKGROUND\nCurrent situation tha", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-145", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 145", "pageStart": 145, "pageEnd": 145, "target": "../sections/page-145.md", "narrative": null, "content": "133\nAnnexes\nAnnex 2.2 \t Persona worksheet\n18\t For more examples of persona-mapping templates, please see Demand for health services workbook: a human-centred approach. UNICEF \n(http://hcd4i.org/wp-content/uploads/2018/10/unicef_digitalhealthinterventions_final2018-1.pdf).\nThis persona worksheet can be used to think through the different potential end-users and better understand their \nneeds and challenges as you design the digital health implementation. Use this persona worksheet as a starting point; \nyou may conduct more detailed persona descriptions as you engage further with the end-users.", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-146", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 146", "pageStart": 146, "pageEnd": 146, "target": "../sections/page-146.md", "narrative": null, "content": "134\nDigital implementation investment guide\nAnnex 3.1 \t Process matrix worksheet \nThis process matrix worksheet will allow you to identify the different health programme processes and tasks, so you \ncan map the workflow and identify bottlenecks within these processes. See Chapter 3 for more details. \n#\nProcess\nObjective\nTask set\nOutcomes\nBottlenecks\nHealth system \nchallenge\nA \nAntenatal \ncare \nreferral\nTo provide timely \nand appropriate \nreferrals to a \nhigher level facility \nor healthcare \nprovider.\n\t» Assess \npregnant \nwoman’s \ndanger signs.\n\t» Stabilize \npregnant \nwoman’s \nconditions. \n\t» A", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-147", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 147", "pageStart": 147, "pageEnd": 147, "target": "../sections/page-147.md", "narrative": null, "content": "135\nAnnexes\nAnnex 3.2 \t Worksheet for mapping bottlenecks to \t \t\n\t\n\t\n\t\nhealth system challenges \nThis worksheet continues from Annex 3.1, where you identified key tasks within the targeted processes, as well as \npossible bottlenecks. Use this worksheet to elaborate on the different bottlenecks within your workflows and begin \ndetermining which ones you will address. See Chapter 3 for more detail.\nUHC Layer \naffected\nIllustrative bottleneck\nHealth system \nchallenge\nRank \nby stakeholder team\nEFFECTIVE \nCOVERAGE/ \nQUALITY \n\t» “Health workers do not show at their health \nposts/facilities.”\n\t» “Hea", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-148", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 148", "pageStart": 148, "pageEnd": 148, "target": "../sections/page-148.md", "narrative": null, "content": "136\nDigital implementation investment guide\nAnnex 5.1 \t Questions for software developers\n19\t Source: Planning an information systems project: a toolkit for public health managers, Annex 7. PATH; 2013 (https://path.azureedge.net/media/\ndocuments/TS_opt_ict_toolkit.pdf).\nAs you select the specific applications that you will use in the digital health implementation, it is critical to have some \nbackground information on the level of support that software developers will provide, as well as the capabilities of the \nsoftware application. This worksheet provides key questions that can be used to gu", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-149", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 149", "pageStart": 149, "pageEnd": 149, "target": "../sections/page-149.md", "narrative": null, "content": "137\nAnnexes\nAnnex 5.2 \t Implementation considerations \n\t\n\t\nsummary template\nUsing the following worksheet, compile your implementation considerations for each digital health intervention, \ntaking into account the different factors within the enabling environment. \nSee Chapter 5 for more detail, as well as the Who Guideline: Recommendations on Digital Interventions for Health System \nStrengthening for implementation considerations for selected interventions. \nEnabling environment \nfactors \nImplementation considerations \nfor digital health intervention 1\nImplementation considerations \nfor digita", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-150", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 150", "pageStart": 150, "pageEnd": 150, "target": "../sections/page-150.md", "narrative": null, "content": "138\nDigital implementation investment guide\nAnnex 5.3 \t Implementation considerations for \n\t\n\t\nspecific digital health interventions\n20\t Adapted from Classification of digital health interventions: a shared language to describe the uses of digital technology for health. Geneva: WHO; \n2018 (https://www.who.int/reproductivehealth/publications/mhealth/classification-digital-health-interventions/en/).\nThis annex describes specific implementation considerations for a selected set of digital health interventions. These \nspecific considerations are in addition to the factors discussed in Chapter 5 th", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-151", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 151", "pageStart": 151, "pageEnd": 151, "target": "../sections/page-151.md", "narrative": null, "content": "139\nAnnexes\nCONSIDERATIONS \nDURING \nDEPLOYMENT\n\t» Consider mechanisms to ensure the completeness of the data and whether demand-generation \nactivities are needed to incentivize reporting by explaining its benefits. Implementers should \nbe aware, however, of any reporting targets placed on health workers and ensure that birth and \ndeath data are validated before being released to the civil registration system.\n\t» Consider processes for deduplication/validation of the notification. Strengthen processes to \nensure that all notifications lead to both legal registration and issuance of certificates", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-152", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 152", "pageStart": 152, "pageEnd": 152, "target": "../sections/page-152.md", "narrative": null, "content": "140\nDigital implementation investment guide\n \nDEPLOYMENT \nEquipment/ hardware\nDevices (such as mobile phones, tablets and computers) used by key informants for conducting \nbirth notifications\nSetup of cloud hosting or physical server, which would require physical and virtual security and \nauthentication\nInitial training \nDevelopment/adaptation of training curricula and standard operating procedures, which can \ninclude materials for train-the-trainer approaches\nTraining on standard operating procedures for the recipient of the birth/death notifications (health \nworkers and civil registrar pers", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-153", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 153", "pageStart": 153, "pageEnd": 153, "target": "../sections/page-153.md", "narrative": null, "content": "141\nAnnexes\nCommunication/ \ndata exchanges \nSMS text message, USSD voice call and/or data transmission charges based on volume of \ncommunication content and communication channel; note that both SMS and USSD are unsecure \nchannels and that, unlike with USSD, with SMS an unencrypted record will remain on the sender’s \nphone, creating an additional risk\nShort code maintenance fee, which represents a simplified number for clients to use when \nregistering for the service\nAggregator maintenance fees, which enable communication across multiple network carriers\nTechnology \nmaintenance \nData hosting (", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-154", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 154", "pageStart": 154, "pageEnd": 154, "target": "../sections/page-154.md", "narrative": null, "content": "142\nDigital implementation investment guide\nConsiderations for cost categories for stock notification\nCost category\nDescription\n \nONGOING/ALL PHASES\nGovernance\nPersonnel for partnership building and coordination meetings to align with stakeholders (such as \nTechnical Working Group members, implementing partners and MNOs)\nMeeting costs (e.g. transportation, personnel time)\nManagement and \nstaffing\nPersonnel to oversee overall programme\nPersonnel for system setup and end-user support (such as monitoring stability of software and \ntroubleshooting system failures)\nPersonnel to monitor data genera", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-155", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 155", "pageStart": 155, "pageEnd": 155, "target": "../sections/page-155.md", "narrative": null, "content": "143\nAnnexes\n \nSCALE\nTraining and adaptive \nmanagement \nAdditional training for personnel interacting with the LMIS \nAdditional training for supervisory personnel on continuous monitoring of the LMIS \nAdditional training for ICT support staff to provide end-user support, troubleshooting, backup and \nrecovery\n \nSUSTAINED OPERATIONS \nRefresher training and \nadaptive management\nRefresher training for health workers interacting with the system\nRefresher training for supervisory staff on continuous monitoring and use of data emerging from \nthe system\nPeriodic review meetings to discuss feedback on", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-156", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 156", "pageStart": 156, "pageEnd": 156, "target": "../sections/page-156.md", "narrative": null, "content": "144\nDigital implementation investment guide\nOPPORTUNITIES \nFOR INTEROPERABILITY AND LINKAGES TO OTHER \nDIGITAL HEALTH \nINTERVENTIONS\nIntegrate with provider-to-provider telemedicine in cases where referral to another health worker is \nrequired.\nLink with targeted client communication to follow up on clients/patients following the consultation.\nRISKS AND \nMITIGATION \nSTRATEGIES\nThere may be risks with unaccredited or unlicensed health workers using a client-to-provider \ntelemedicine system. Establish a clear legal framework for implementing telemedicine, including \nlicensing and regulation of h", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-157", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 157", "pageStart": 157, "pageEnd": 157, "target": "../sections/page-157.md", "narrative": null, "content": "145\nAnnexes\n \nDEPLOYMENT \nEquipment/ hardware\nComputer with dedicated software system for audio and/or video connections for health workers \nto conduct the consultation\nAudio- or videoconferencing equipment, which may include headsets and trunk lines (central \nlines that can direct voice calls, images and video to multiple lines and across different network \noperators)\nInitial training \nDevelopment/adaptation of training protocols and standard operating procedures, including call \nintake, consent and referral processes\nInitial training to health workers on how to use the telemedicine system", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-158", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 158", "pageStart": 158, "pageEnd": 158, "target": "../sections/page-158.md", "narrative": null, "content": "146\nDigital implementation investment guide\nINTERVENTION 4: PROVIDER-TO-PROVIDER TELEMEDICINE\n24\t Adapted from Classification of digital health interventions, 2018.\nDESCRIPTION \nOF THE DIGITAL \nHEALTH \nINTERVENTION\nThe delivery of healthcare services where two or more health workers are separated by distance, often \na lower level health worker consulting with a specialist or more skilled health worker24 \nCOMMONLY \nASSOCIATED \nHEALTH SYSTEM \nCHALLENGES \n\t» Insufficient supply of qualified health workers\n\t» Insufficient (coverage) supply of services\n\t» Geographic inaccessibility\n\t» Insufficient", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-159", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 159", "pageStart": 159, "pageEnd": 159, "target": "../sections/page-159.md", "narrative": null, "content": "147\nAnnexes\nTechnology \nadaptation \nSoftware customization for communication and exchanging health content, which may be based \non the modalities/communication channels to be used for videoconferencing, transmission of data \nor images and voice calls\nSecurity features, such as end-user authentication schemes, when relaying clients’ health \ninformation\nEnd-user testing among health workers to ensure optimal end-user experience and alignment with \nworkflows\nRefinement in response to feedback from end-user testing to ensure that requirements and \ncontext are taken into account\n \nDEPLOYMENT \nEqui", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-160", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 160", "pageStart": 160, "pageEnd": 160, "target": "../sections/page-160.md", "narrative": null, "content": "148\nDigital implementation investment guide\nINTERVENTION 5: TARGETED CLIENT COMMUNICATION \n25\t Adapted from Classification of digital health interventions, 2018.\nDESCRIPTION \nOF THE DIGITAL \nHEALTH \nINTERVENTION\nTransmission of customized health information for different audience segments (often based on health \nstatus or demographic categories), which may include transmission of \n1.\t health-event alerts to a specific population group; \n2.\t health information based on health status or demographics; \n3.\t alerts and reminders to clients; and \n4.\t diagnostic results (or the availability of result", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-161", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 161", "pageStart": 161, "pageEnd": 161, "target": "../sections/page-161.md", "narrative": null, "content": "149\nAnnexes\nADDITIONAL \nRESOURCES \nmHealth mobile messaging toolkit. PATH; 2014 (https://www.path.org/publications/files/TS_mhealth_\nmobile_messaging_toolkit.pdf).\nMaking content meaningful: a guide to adapting existing global health content for different audiences. \nJohns Hopkins Center for Communication Programs; 2014 (https://www.kmtraining.org/sites/default/\nfiles/supplement-making-content-meaningful.pdf).\nConsiderations for cost categories for targeted client communication\nCost category\nDescription\n \nONGOING/ALL PHASES\nGovernance\nPersonnel for partnership building and coordination meetin", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-162", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 162", "pageStart": 162, "pageEnd": 162, "target": "../sections/page-162.md", "narrative": null, "content": "150\nDigital implementation investment guide\n \nINTEGRATION AND INTEROPERABILITY\nContent adaptation\nContent may be adapted to reflect direct linkages to medical records\nTechnology \nadaptation\nIntegration of client identification: unique client identification, ideally by means of a unique \npersonal identifier, needs to be built into the system design and registration process to ensure the \nfidelity of message delivery; in some cases, a proxy identifier, such as a mobile phone number, is \nused where it can be ascertained that it is valid and consented\nIntegration and interoperability standards, p", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-163", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 163", "pageStart": 163, "pageEnd": 163, "target": "../sections/page-163.md", "narrative": null, "content": "151\nAnnexes\nINTERVENTION 6: HEALTH WORKER DECISION SUPPORT\n26\t Adapted from Classification of digital health interventions, 2018.\nDESCRIPTION \nOF THE DIGITAL \nHEALTH \nINTERVENTION\nDigitized job aids that combine an individual’s health information with the health worker’s knowledge \nand clinical protocols to assist health workers in making diagnosis and treatment decisions26\nCOMMONLY \nASSOCIATED \nHEALTH SYSTEM \nCHALLENGES \n\t» Poor adherence to guidelines\n\t» Inadequate supportive supervision\n\t» Lack of or inappropriate referrals\n\t» Insufficient supply (coverage) of qualified health workers\n\t» In", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-164", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 164", "pageStart": 164, "pageEnd": 164, "target": "../sections/page-164.md", "narrative": null, "content": "152\nDigital implementation investment guide\nConsiderations for cost categories for health worker decision support\nCost category\nDescription\n \nONGOING/ALL PHASES\nGovernance\nPersonnel for partnership building and coordination meetings to align with stakeholders (such as \nTechnical Working Group members, implementing partners and MNOs)\nMeeting costs (transportation, personnel time)\nManagement and \nstaffing\nPersonnel to oversee overall programme\nPersonnel for system setup and end-user support (such as monitoring stability of software and \nappropriate functioning of algorithms and troubleshooting", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-165", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 165", "pageStart": 165, "pageEnd": 165, "target": "../sections/page-165.md", "narrative": null, "content": "153\nAnnexes\n \nSUSTAINED OPERATIONS \nRefresher training and \nadaptive management\nRefresher training for health workers interacting with the decision-support system\nPeriodic review meetings to discuss feedback on system performance and challenges\nTechnology \nmaintenance \nSoftware maintenance and licence fees\nHardware maintenance, including insurance and repair/replacement of hardware\nOngoing adaptation and updating of decision-support logic as new clinical recommendations \nemerge\n27\t Adapted from Classification of digital health interventions, 2018.\nINTERVENTION 7: \t DIGITAL TRACKING OF CLIENTS", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-166", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 166", "pageStart": 166, "pageEnd": 166, "target": "../sections/page-166.md", "narrative": null, "content": "154\nDigital implementation investment guide\nRISKS AND \nMITIGATION \nSTRATEGIES\nHealth workers may face the added work burden of operating a dual system when using both a \nmanual/paper-based system and the digital tool. Establish a plan or processes to replace manual/\npaper-based systems or account for the dual burden of managing these two systems.\nConsider local policies on digital identities when designing a programme to ensure that the \nprogramme does no harm. Digital tracking of individuals’ health status may be controversial in some \ncircumstances, such as among refugees or other groups who", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-167", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 167", "pageStart": 167, "pageEnd": 167, "target": "../sections/page-167.md", "narrative": null, "content": "155\nAnnexes\n \nDEPLOYMENT \nEquipment/ hardware\nDevices (such as mobile phones and tablets) for operating the decision-support system used by the \nhealth workers \nSecurity features, such as end-user authentication schemes, passwords and data encryption for \nrecording and sharing client health information\nComputers for monitoring system performance and viewing reporting dashboards\nInitial training \nDevelopment/adaptation of training curricula and standard operating procedures for using the \nsystem\nInitial training for health workers interacting with the system\nTraining for supervisory staff on s", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-168", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 168", "pageStart": 168, "pageEnd": 168, "target": "../sections/page-168.md", "narrative": null, "content": "156\nDigital implementation investment guide\nINTERVENTION 8: \tDIGITAL PROVISION OF TRAINING AND EDUCATIONAL \nCONTENT TO HEALTH WORKERS\n28\t Adapted from Classification of digital health interventions, 2018.\nDESCRIPTION \nOF THE DIGITAL \nHEALTH \nINTERVENTION\nManagement and provision of education and training content in electronic form for health \nprofessionals; in contrast to decision support, health worker training does not need to be used at the \npoint of care28\nCOMMONLY \nASSOCIATED \nHEALTH SYSTEM \nCHALLENGES \n\t» Insufficient health worker competence\n\t» Poor adherence to guidelines\n\t» Inadequate", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-169", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 169", "pageStart": 169, "pageEnd": 169, "target": "../sections/page-169.md", "narrative": null, "content": "157\nAnnexes\nConsiderations for cost categories for mLearning\nCost category\nDescription\n \nONGOING/ALL PHASES\nGovernance\nPersonnel for partnership building and coordination meetings to align with stakeholders (such as \nMOH counterparts, other implementing partners and MNOs)\nMeeting costs (transportation, personnel time)\nManagement and \nstaffing\nPersonnel for system setup and end-user support (such as monitoring stability of software and \ntroubleshooting system failures)\nPersonnel to provide technical support related to exams and feedback on assignments\n \nDEVELOPMENT AND SETUP\nContent adaptatio", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-170", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 170", "pageStart": 170, "pageEnd": 170, "target": "../sections/page-170.md", "narrative": null, "content": "158\nDigital implementation investment guide\nAnnex 5.4 \t Illustrative considerations to mitigate \n\t\n\t\ndata management risks\nThe following is a list of illustrative considerations to think through when mitigating risks associated with data \nmanagement and protecting data privacy broken down by phases: before, during and after data collection. Note \nthat this is not an exhaustive list, and it will have to be reviewed alongside national policies, where available. \nPlease see Chapter 5 for more information.29,30\nBEFORE DATA COLLECTION\n29\t Adapted from Ali J, Labrique AB, Gionfriddo K, Pariyo G, Gib", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-171", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 171", "pageStart": 171, "pageEnd": 171, "target": "../sections/page-171.md", "narrative": null, "content": "159\nAnnexes\nDURING DATA COLLECTION\n1\n\t\nˆ How will you obtain and store the personal data? \n2\n\t\nˆ Where will personal data be stored?\n3\n\t\nˆ What measures will be taken to obtain informed consent?\n4\n\t\nˆ Who will own the data? Will the data subjects have access to their own data? \nAFTER DATA COLLECTION\n1\n\t\nˆ Do you expect the personal data to move internationally? How will the data be processed? (This \nmay possible require information notice or determine need for particular legal clauses.)\n2\n\t\nˆ Who will have access to personal data? Who will the data be shared with? How will the data \nbe shared?", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-172", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 172", "pageStart": 172, "pageEnd": 172, "target": "../sections/page-172.md", "narrative": null, "content": "160\nDigital implementation investment guide\nAnnex 6.1 \t Linking digital health implementations \n\t\n\t\nto a national digital health enterprise\n\t\n\t\narchitecture\nThis template aims to transition the digital health implementation that you have designed to one that links to the \nbroader architectural requirements within an exchanged digital health system architecture.\nThe current state depicts how different systems are currently implemented, which may be as disparate applications \nthat are siloed or at best paired directly with other applications.\nIn the future-state diagram, highlight planned new an", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-173", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 173", "pageStart": 173, "pageEnd": 173, "target": "../sections/page-173.md", "narrative": null, "content": "161\nAnnexes\nCURRENT STATE\nINTER-\nOPERABILITY \nLAYER\nEnabling \nComponents\nDIGITAL HEALTH APPLICATIONS WITH DIGITAL INTERVENTION FOR: \nHealth programmes / Use cases\nHealth Programme\nUse Case\nHealth Programme\nUse Case\nA\nB\nC\nD\nEXTERNAL \nSYSTEMS\nSHARED SERVICES\nDATA SERVICES\nDATA SOURCES\nInstitution-Based \nHIS & Data Sources\nPopulation-Based \nHIS & Data Sources\nAnalytics, \nDashboards, & \nDigital Aids\nDigital Health Platform\nShared Services\nBusiness Domain \nServices\nRegistry Services\nTerminology \nServices\nHealth Worker \nRegistry\nClient \nRegistry\nProduct Registry\nFacility \nRegistry\nLogistics Mgmt \nin", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-174", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 174", "pageStart": 174, "pageEnd": 174, "target": "../sections/page-174.md", "narrative": null, "content": "162\nDigital implementation investment guide\nFUTURE STATE\nINTER-\nOPERABILITY \nLAYER\nEnabling \nComponents\nDIGITAL HEALTH APPLICATIONS WITH DIGITAL INTERVENTION FOR: \nHealth programmes / Use cases\nHealth Programme\nUse Case\nHealth Programme\nUse Case\nA\nB\nC\nD\nEXTERNAL \nSYSTEMS\nSHARED SERVICES\nDATA SERVICES\nDATA SOURCES\nInstitution-Based \nHIS & Data Sources\nPopulation-Based \nHIS & Data Sources\nAnalytics, \nDashboards, & \nDigital Aids\nDigital Health Platform\nShared Services\nBusiness Domain \nServices\nRegistry Services\nTerminology \nServices\nHealth Worker \nRegistry\nClient \nRegistry\nProduct \nRegistry\nFacil", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-175", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 175", "pageStart": 175, "pageEnd": 175, "target": "../sections/page-175.md", "narrative": null, "content": "163\nAnnexes\nAnnex 7.1 \t Budget template\nThis template can be used to estimate costs across common cost categories outlined in Chapter 7. You may also \nconsider reviewing Annex 5.3 to identify costs for interventions for specific digital health interventions. A digital version \nmay be downloaded here: https://tinyurl.com/DIIGBudgetTemplate. \nPhase\nCost driver\nUp-front \nversus \nrecurring\nYear 1 Year 2 Year 3 Year 4 Year 5 TOTAL\nONGOING/\nALL PHASES \nManagement and staffing \nRecurring\nGovernance\nRecurring\nDEVELOPMENT \nAND SETUP\nSoftware licensing \ncost per environment and \nper end-user\nUp-front\nSo", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-176", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 176", "pageStart": 176, "pageEnd": 176, "target": "../sections/page-176.md", "narrative": null, "content": "164\nDigital implementation investment guide\nPhase\nCost driver\nUp-front \nversus \nrecurring\nYear 1 Year 2 Year 3 Year 4 Year 5 TOTAL\nSUSTAINED \nOPERATIONS\nVoice and data services \n(mobile data plan, Internet, \nnumber of text messages)\nRecurring\nHardware maintenance, \nongoing administration \nand replacement rate \nRecurring\nSubscriptions\nRecurring\nSoftware maintenance \n(fixing bugs, adding features, \nmaintaining customizations)\nRecurring\nTransfer of ownership\nRecurring\nRefresher training and \nadditional training \nactivities\nRecurring\nM&E and data-use \nactivities\nRecurring\nCollective benefit, such", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-177", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 177", "pageStart": 177, "pageEnd": 177, "target": "../sections/page-177.md", "narrative": null, "content": "165\nAnnexes\nAnnex 8.1 \t Adaptive management checklist\nThis checklist includes specific adaptive management practices that you can integrate into your planning and \nimplementation processes. \nPLANNING\nBudget for \nadaptive \nmanagement\n\t\nˆ Ensure there is a dedicated budget for time to implement your adaptive \nmanagement processes.\n\t\nˆ Allow for some flexibility in the overall budget to enable course correction \nas needed.\nEngage \nstakeholders\n\t\nˆ Identify key stakeholders and decision-makers, including data generators, \ndata analysts, decision-makers reviewing progress and authorities who can \na", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-178", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 178", "pageStart": 178, "pageEnd": 178, "target": "../sections/page-178.md", "narrative": null, "content": "166\nDigital implementation investment guide\nFrom the M&E \nplan, identify and \nmap monitoring \nmeasures and \nspecific assessments \nrequired to assess \nimplementation \nfidelity, whether \noutputs are being \nrealized and if risks \nare arising that need \nto be mitigated\n\t\nˆ Identify the feedback frequency that is feasible to allow for rapid \nidentification of potential issues.\n\t\nˆ Find the appropriate balance between rigorous and rapid methodologies \nfor feedback. Frequency and rapid feedback need to be balanced with \nunderstanding the burden of collecting, analysing and reporting back those \ndata.", "truncated": true, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-179", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 179", "pageStart": 179, "pageEnd": 179, "target": "../sections/page-179.md", "narrative": null, "content": "167\nAnnexes\nAlso see the following additional resources:\n\t» Guidelines for adaptive management: outcome of the OzAM 2003 workshop, Brisbane. University of Queensland \nSchool of Natural and Rural Systems Management; 2004 (https://espace.library.uq.edu.au/view/UQ:84380). \n\t» PIMPAC adaptive management guidance. Pacific Islands Managed and Protected Area Community; 2018 \n(https://data.nodc.noaa.gov/coris/library/NOAA/CRCP/NMFS/PIRO/Projects/427/PIMPAC2018_Adaptive_\nManagement_Guidance.pdf).", "truncated": false, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-180", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 180", "pageStart": 180, "pageEnd": 180, "target": "../sections/page-180.md", "narrative": null, "content": "168\nDigital implementation investment guide\nAnnex 8.2 \t Logic model template\nLogic models link inputs (programme resources), with processes (activities undertaken in the delivery of services), outputs (products of processes), outcomes (intermediate \nchanges) and impact. You can use the template below to map out the different inputs, processes, outputs and outcomes, including the specific indicators you will use to \nmeasure your outputs and outcomes. \nIMPACT\nOUTPUTS\nOUTCOMES\nPROCESSES\nINPUTS", "truncated": false, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/prose-page-181", "types": [ "folio-assistant-core:Prose", "doco:Section" ], "kind": "prose", "title": "Page 181", "pageStart": 181, "pageEnd": 181, "target": "../sections/page-181.md", "narrative": null, "content": "169\nDigital Implementation Investment Guide (DIIG)", "truncated": false, "provenance": "ingested", "summary": { "status": "not-summarised" } }, { "id": "library/9789240010567-eng/blocks/figure-img-p182-1", "types": [ "folio-assistant-core:Figure", "doco:Figure" ], "kind": "figure", "title": "", "pageStart": 182, "pageEnd": 182, "target": "../images/img-p182-1.png", "narrative": "draft", "content": "A standard ISBN barcode (EAN-13) reading 9789240010567, printed with the number both above the bars and split beneath them ('9', '789240', '010567'). 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