Environmental e-Health Impact Assessment

1. ENVIRONMENTAL e-HEALTH IMPACT ASSESSMENT
as a component of
e-HEALTH READINESS ASSESSMENT
Prof. Richard E. Scott 1,2, Leonard Mauco 1 , Prof. Maurice Mars 1
1 TeleHealth Department, University of KwaZulu-Natal, Durban, South Africa
2 CEO, NT Consulting – Global e-Health Inc., Calgary, Alberta, Canada
Photo by @mijlof 📷
ICT4Health Conference
Stellenbosch University, Tygerberg
Cape Town, South Africa
24-25th November 2015

2. What for Today
- Topics -Environmental e-Health !
2
e-Health Readiness
Environmental e-Health
Readiness !

3. ENVIRONMENTAL e-HEALTH

4. ENVIRONMENTAL e-HEALTH
The study of the impact of e-health on the environment (harms
and benefits) and means of mitigation (harms) or enhancement
(benefits) of these impacts !
Scott (2007)

5. Environmental e-Health
- The Environmental e-Health Impact Model -
http://www.ntcehc.ca/environment/

6. Environmental e-Health
- The Environmental e-Health Impact Model -

7. Environmental e-Health
- The Environmental e-Health Impact Model -

8. Environmental e-Health
- The Environmental e-Health Impact Model -
"Phonebloks open" by Dave Hakkens - Provided by email. Licensed
under CC BY-SA 3.0 via Commons -
https://commons.wikimedia.org/wiki/File:Phonebloks_open.jpg#/me
dia/File:Phonebloks_open.jpg

9. Environmental e-Health
- The Environmental e-Health Impact Model -

10. Whose To Blame ?
- WE Are -
• Twitter – a tweet ‘emits’
about 0.02g CO2
(50m/day = 1 tonne of
CO2
• Google – a search query
‘emits’ 0.2g CO2 (= 3L
water)
• e-Mail – each email
‘emits’ 0.25g CO2

11. And What Do We Do ?
- A Lot -
Medium Per SECOND Per DAY Per YEAR
Tweets 10,520 15,148,800 5,529,312,000
Instagram Photos 2,963 4,266,720 1,557,352,800
Tumblr Posts 2,356 3,392,640 1,238,313,600
Skype calls 1,927 2,774,880 1,012,831,200
Google searches 51,449 74,086,560 27,041,594,400
YouTube videos 111,132 160,030,080 58,410,979,200
e-Mails (mostly spam!) 2,441,657 3,515,986,080 1,283,334,919,200
Internet traffic 30,949 GB 44,566,560 GB 16,266,794,400 GB

12. http://www.slideshare.net/smbrown123/guide-to-social-media-outlets
Wikipedia:
Lists 212.
“This list is not
exhaustive, and
is limited to
notable, well-
known sites.”

13. e-HEALTH READINESS

14. Definition of e-Health ‘Readiness’
- Also Sometimes Called ‘Preparedness’ -
• Jennett and Bates (2003): Readiness is “the degree to which users, health care
organizations, and the health system itself are prepared to participate and succeed
in its (telehealths’) application.”
• Chattopadhyay et al. (2008): Preparedness is “a state of readiness prior to taking any
action applicable for implementing any e-health project”
• Revised (Scott et al., 2015): e-Health Readiness is “the state of being fully aware and
prepared beforehand for the anticipated changes that will occur when
implementing programmes related to use of e-Health (use of ICT for health)”

15. What Types e-Health ‘Readiness’ Are There ?
- Also Sometimes Called ‘Preparedness’ -
• Types
• Jennett et al., 2003: Core, Engagement, Structural, and Non-readiness
• Mauco et al., 2015: organisational readiness, technological / infrastructural readiness,
healthcare provider readiness, engagement readiness, societal readiness, core readiness,
government readiness, and public/patient readiness
• Groups:
• All stakeholders: System(s), Organisations, Communities, Individuals (Employees,
Practitioners, Public, Patients)

16. e-Health ‘Readiness’
- Value ~ Importance -
• ‘Readiness’ is a crucial prerequisite to the successful
implementation of (telehealth) programs.”
• ‘Readiness’ is an integral and preliminary step in the
successful implementation of (telehealth) services into
existing health systems”
• ‘Readiness’ needs to be systematically assessed and is
important for long-term success.

17. e-Health ‘Readiness’
- Frameworks, Models, and Tools -
• Gagnon et al. 2014: 26 eligible instruments described in 39
publications.
• Légaré et al. (2010): 6 questionnaires on readiness (implementing
telehealth projects).
• Weiner et al. (2008). 43 instruments for measuring organizational
readiness for change ….

18. e-HEALTH READINESS
=
e-HEALTH RESPONSIBILITY !!

19. e-HEALTH RESPONSIBILITY !!
e-HEALTH READINESS
ENVIRONMENTAL e-HEALTH IMPACT
ENVIRONMENTAL e-HEALTH
RESPONSIBILITY
=
and if
=

20. ‘Frameworks / Models’
- Some Discretion -
3 addressed ‘country’ preparedness 2 addressed e-Learning Readiness Analysis
Khatun et al.,
2015
Conceptual
Framework
for m-Health
Readiness
Kelly &
Stanley, 2014
Community
Readiness
Model (CRM)
Kagasi &
Kalema, 2014
Framework
for e-Health
Readiness
Assessment
Zapka et al.,
2013
Readiness-for-
change Model
Coleman &
Coleman,
2013
Activity Theory
Framework
Tamburis et
al., 2012
ICLI
Conceptual
Framework
Rezai-Rad et
al., 2012
e-health
Readiness
Assessment
Framework
(EHRAF)
Alshawi &
Salleh, 2011
IT/IS
Readiness
Model
Li & Ray, 2009
/ 2010
e-Health
Readiness
Assessment
Methodology
(EHRAM) and
Framework
(EHRAF)
Khoja et al,
2008
Conceptual-
Framework for e-
Health Readiness
Assessment
Chattopadhya
y et al., 2008
ICT-
preparedness-
framework
Oio et al.,
2007
Hierarchical e-
Healthcare
Readiness
Index System
del Hoyo-
Barbolla et
al., 2006
Jennett et al.,
2005
4 Readiness
Models
Jennett et al.,
2003
Core,
Engagement,
Structural, and
Non-readiness

21. What Can We Do ?
- Practice; Process; Policy -
• Practice:
• Respect: Awareness, Training,
• Rethink: Audit / LCA of e-Health equipment
• Process:
• Redesign
• Reduce / Reuse / Recycle
• Dispose
• Policy:
• Basel Convention (1992)
• Extended Producer Responsibility (EPR)
• WEEE Directive 2002/96/EC; Directive
2003/108/EC; Directive 2012/19/EU
• RoHS Directive 2002/95/EC; RoHS recast
Directive 2011/65/EU
Scott RE, Palacios M, Maturana
T. Electronic Waste – A Growing
Concern for the Health Sector.
2012.
www.telessaude.uerj.br/resourc
e/goldbook/pdf/34.pdf

22. YES
Environmental e-Health Impact Assessment
must become a component of
e-Health Readiness Assessment
A moral
imperative
and a social
responsibility
A health
imperative
–
“First, do
no harm”

23. COMMENTS – QUESTIONS !?
- Environmental e-Health Readiness Assessment -
Richard Scott: NTC.eHealthConsulting@gmail.com
Maurice Mars: mars@ukzn.ac.za
Leonard Mauco: meleomau@gmail.com