National eHealth Strategies Simplified

Lincoln A. Mouraa, Beatriz de Faria Leãob

aAssis Moura eHealth, Porto Alegre, RS, Brazil

bBLeão Informática em Saúde, Porto Alegre, RS, Brazil


This tutorial approaches the steps for preparing a robust National eHealth Strategy that will guide the creation of a suitable eHealth environment and the deployment of a consistent, reusable, flexible and long-lasting eHealth platform and its applications. The tutorial covers aspects of Organizational Resources – including Governance, Leadership, Legislation, Regulation and Policies – Investment and Financing, Human Resources, Infrastructure, Interoperability and Standards – or eHealth Architecture, and Systems and Services. The methods presented and discussed in this tutorial are largely based on the National eHealth Strategy Toolkit, proposed by WHO and ITU and ISO TR 14.639 Capacity-based Roadmap for an eHealth Architecture. The tutorial also relies on the experience of the authors, from conceiving to deploying large-scale Health Information Systems in complex environments.

There has been a growing interest in eHealth as a tool for improving the delivery of health care around the world today, and also in how it can make health systems more efficient and more responsive to people’s needs and expectations. Evidences that eHealth can indeed improve Health and Health Care are still being collected although it is clear to many countries that eHealth is an essential part of Health and deserves due attention. Such countries have proposed diverse strategies and policies for approaching eHealth with a variety of outcomes. The need for a robust approach to creating a robust eHealth Strategy, adherent to a country’s needs and compatible with its maturity and capacity levels, has been widely recognized and addressed . Some of the soundest methods and frameworks for developing IT strategies start by developing an Enterprise Architecture which is a complex and time consuming process. There are, however, at least two methods proposed explicitly for eHealth that combine thoroughness with an understanding of the complexity of the Domain, thus leading to a flexible, step-by-step approach to creating eHealth Strategies. These methods are the National eHealth Strategy Toolkit, proposed by WHO and ITU and ISO TR 14.639 Capacity-based Roadmap for an eHealth Architecture .

Using these methods requires some knowledge of Health Informatics and its complexity, but they are best developed by a combination of top-level public health systems managers, health informaticians and health care workers.

This tutorial describes these two methods, navigates through their blocks and discusses how to apply them in example situations, given from the participants. The methods are very flexible and can be adapted to almost any eHealth maturity level, from the simple exchange of text messages using mobile phones, to full fledge distributed EHRs.


Learning objectives

Participants will be exposed to robust tools that can be applied to almost any environment with reasonable financial investment and effort. They will be guided through the steps to be taken towards creating a National, or even wide – regional, eHealth Strategy, with examples from the real world.


Target audience

Health systems managers, eHealth professionals, HI standards experts. No special background requirements are needed but an interest in the organization of the eHealth environment is advisable.