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Table 2 Requirements for a successful implementation of a national/regional/global geo-information infrastructure. Summary of the recipes and main recommendations provided by various specialist groups and researchers from around the world for a successful implementation of a national/regional/global geo-information infrastructure that can also support real-time GIS public health applications.

From: Towards evidence-based, GIS-driven national spatial health information infrastructure and surveillance services in the United Kingdom

Developing geospatial culture and awareness/changing people and organisations
• Vision and leadership at the highest levels (e.g., departments of health)
• Official/governmental support
• Fostering a culture of data sharing and joined-up working at all levels (local to global) that considers spatial information an asset
• Raising awareness activities and campaigns; reaching out to policy and strategy makers in the health and other sectors
• Policies and practices actively promoting the exchange and reuse of geo-information, and greater public access to it
• Education, training, and capacity building
Resources and ICT infrastructures
• Appropriate human, financial and technical resources
• Providing support to organisations lacking the necessary resources to join in common, coherent national/regional/global initiatives
• Adequate information telecommunications technology infrastructures and bandwidth
• Moving to the Web and building all necessary critical connectivity/geospatial infrastructure that should not be independently recreated by all
Data security and confidentiality issues
• Developing unambiguous legal frameworks and policies, as well as suitable technical solutions to address the crucial issues of individual privacy, national security, and data confidentiality
• Adequate protection measures of networked geo-information assets against cyber terrorism
Data and standards issues
• Up-to-date and accurate core digital geo-datasets
• National data utilities/services (industry standard services that are independent of any particular user interface)
• Standardised metadata in centralised catalogues or clearinghouses
• Adopting common standards to address integration and interoperability issues (GML and other technologies; health-related standards)
• Automated geocoding
• Automated conflation of geospatial databases
Data use and applications issues
• Do not just focus on data; develop applications
• Adopting common semantics, data models (ontologies) and health indicators; the latter should also cover population demographics and socio-economic factors
• A deep understanding of data and industry; reaching a consensus on the inputs and outputs in different health and healthcare applications
• Developing increased sensitivity to and awareness of data problems and errors, as well as competency in techniques for recognising and reducing their negative impact on conclusions drawn from spatial analysis
• Appropriate and robust statistical and epidemiological methods must be used to avoid the consequences of visual bias and various data problems in GIS processes
• Seamless integration into routine workflows of intelligent software tools that are easy-to-use by mainstream public health practitioners, and which allow only valid visualisations and analyses of data from a variety of sources across space and time
• User interface accessibility requirements
Interdisciplinary collaboration and partnerships
• Development of effective partnerships (including community/academia collaboration), and involvement of and coordination between all stakeholders and users
• Community data sharing must be systematic, uniform and regular, and governed by adequate data-sharing agreements
• Building interdisciplinary teams with expertise in public health and epidemiology, medical informatics, medical statistics, health economics, computer science, law, and engineering
• Other important points: joint ownership of projects by their respective stakeholders; shared commitment; having realistic expectations
General approaches
• A combined top-down and bottom-up incremental implementation approach
• Assessing current state of geospatial readiness to respond to normal and emergency community health needs, and identifying beacon sites as examples to follow
• Fault tolerance at all levels (hardware and software)
• Full systems redundancy, and standardised database replication measures and off-site backups (these are also important aspects of data security)