Neal Lesh presented a much-appreciated perspective on ICT for health in limited resource settings. I met Neal in June and have had several chances to hear his grounded, well informed voice-of-reason about the potential (and potential pitfalls) of focusing on ICT solutions to global health problems. “Computer and ICT innovation CAN help address efficiency, cost-effectiveness and quality of care, but let’s make sure we’re improving health as we develop tools to help do this” is a paraphrasing of one major point he shared. I think this is a really critical point to focus on. ICTs and “eHealth” have been shown to have some really interesting potential when implemented in appropriate and sustainable ways — but we’re still very early in the process of understanding how pilot projects (the majority of what’s out there) can be scaled effectively to have public health-level impacts. It’s hard to balance fostering ingenuity, innovation and creativity in ICT tool/system design with keeping the focus on targeted population health outcomes.

Neal also did a great job of pointing out that different kinds of ICT and eHealth solutions may need different kinds of business/funding models. For me, in the Public Health field, it becomes really important to then identify which support structures are appropriate for which phases of ICT development and implementation — design, piloting, implementation, monitoring and evaluation, and long term system/tool maitenance and adaptation as needed. Local capacity building for all of these phases is key to long term sustainability on the developer end of things, but ALSO on the implementer end. Health care service providers (doctors, nurses, health care facilty managers, community health workers), health advocates, policy makers, the public and private sectors, researchers and academicians, and of course patients should also be brought into the conversation about appropriate ICT for health solutions.

I’m looking forward to hearing more about how to address some of the most critical issues of knowledge sharing and transfer, sustainable support models for in-country management of ICT and eHealth systems, etc.