Higa Christina, Okamura Jessica, Okamoto Sean, Okamura Norman
University of Hawai'i at Mānoa, Honolulu, HI, United States of America.
Stud Health Technol Inform. 2018;254:33-42.
Small island developing states (SIDS) have much to gain from the use of Health Information Technology (HIT) and telehealth to improve care, improve population health, increase access to care, and lessen costs. At the same time, planning, implementing, and operationalizing HIT is costly and requires significant technical, human, financial and planning resource infrastructure to support implementation and operations. This paper provides a broad overview of how HIT and telehealth has evolved in the U.S. Affiliated Pacific Islands (USAPI) SIDS, the progress that has been achieved, the role of political affiliations and international assistance, and the many challenges that remain. The paper highlights the differences in treatment between the territories and the nations affiliated with the United States through the Compacts of Free Association (COFA), and the important roles of other donor countries, regional, and international organizations. The paper also raises questions of how advances in HIT and telehealth can be further achieved and sustained in the USAPIs. Finally, the paper identifies the need for the building of knowledge and skills to develop careful plans so pitfalls of silos, proprietary systems, and inadequate technical support can be lessened or avoided in the grand challenge of adoption and maturing of HIT and telehealth.
小岛屿发展中国家（SIDS）可从利用健康信息技术（HIT）和远程医疗中获得诸多益处，包括改善医疗服务、提升民众健康水平、增加医疗服务可及性以及降低成本。与此同时，规划、实施和运营健康信息技术成本高昂，需要大量技术、人力、资金和规划资源基础设施来支持实施与运营。本文全面概述了健康信息技术和远程医疗在美国附属太平洋岛屿（USAPI）小岛屿发展中国家的发展历程、已取得的进展、政治关系和国际援助的作用以及仍存在的诸多挑战。本文强调了通过《自由联合协定》（COFA）与美国相关的各领土和国家在治疗方面的差异，以及其他捐助国、区域和国际组织的重要作用。本文还提出了如何在美国附属太平洋岛屿进一步实现并维持健康信息技术和远程医疗进步的问题。最后，本文指出需要积累知识和技能以制定周密计划，从而在健康信息技术和远程医疗的采用与成熟这一重大挑战中减少或避免出现孤岛现象、专有系统和技术支持不足等问题。
