The COVID-19 pandemic became a critical inflection point for acceleration of digital health. Governments are now using mobile phones to communicate critical information directly to citizens and health workers; health workers are using their phones to connect to patients and deliver services; and patients are adopting digital health technologies for their care needs.

And yet, with greater availability and increasing adoption of digital tools, there are notable obstacles at various levels of the health system. These obstacles must be tackled to enable widespread equitable access, ensure high-quality service, and generate rapid system improvement for a resilient health system.

The third conversation in the “Resilient Health System of the Future – the case for community health” series explores the critical link between technological innovation and enabling infrastructure in addressing: What does Equitable Community Health look like in the digital age?

The future potential for digital health spans across the full spectrum of public health and healthcare. Integrated digital platforms will enable citizens to own and manage their health records, receive virtual care services, and share data with consent. Providers can use data to make better decisions and provide integrated services for patients; and governments can use aggregated data to track and manage potential health risks and outbreaks. As digital becomes fully integrated into how care is managed, delivered, and received, there are critical infrastructure gaps that will need to be addressed to prevent a growing digital divide in health.

We started exploring this question with three health system experts:

The discussion followed the structure of the Three Horizons Framework by Bill Sharpe to first explore Horizon 1: what is prevalent in the system today, next Horizon 3: what is the vision for the future, and finally Horizon 2: what are the innovations or disruptions that will help us move from Horizon 1 into Horizon 3. 

Our experts shared key opportunities and considerations for the future of integrating digital across key health systems:

• Shifting from paper record keeping to integrated digital tools
  • One of the challenges in the health system is siloed paper-based systems that create a significant lag for use of patient data at the point of care and respond to multiple health conditions for each patient. From a health system improvement perspective, this lag creates a weak signal for how the system needs to adapt moving forward and creates an overall delay in responsiveness.  
  • In response to pandemic management, there has been a critical shift accelerating the speed in digitizing health systems, and greater awareness and openness to using digital health tools at the point of care that can be expanded to other issues in public health. It is now critical to continue using this momentum to accelerate the shift to digital health.
    
• Understanding multiple pathways for patients and citizens on their digital health journey
  • It’s important to consider the different types of user groups when it comes to patients’ readiness and accessibility using digital platforms for health needs, as well as the kinds of services that patients feel comfortable accessing through a digital consultation. To fully and equitably integrate digital tools into the health system, barriers such as digital literacy, lack of access to digital devices, and data privacy issues must be addressed.
  • Taking a holistic approach that brings together multiple disciplines that centers user needs and considers the user experience and platform design is critical to account for levels of education, accessibility needs, language inclusiveness and ensuring cultural sensitivity and alignment.
    
• Empowering the community health workers through access to integrated mobile tools
  • Data that comes in a timely way allows health workers to make informed decisions at the point of care. With a predictive view on how to keep patients healthy, caregivers can take advance actions and provide timely preventative care.
  • The opportunities for digital for care workers include virtual training, supply management to proactively address shortage of devices, and integration into systems that are linking together multiple health providers and health services to align action on patient needs.
  • As community health workers onboard onto mobile platforms, it’s vital to empower and support them by setting up digital, clinical, and financial supporting infrastructures.
    
• Predictive analysis for system improvement
  • As health systems become predictive, they enable system improvements. Collected Geographic Information Systems (GIS) data can be used to track and respond to hot spots and high-risk areas and be helpful in generating critical information that health departments can use to proactively intervene and adapt to improve the system itself.
  • Tools such as IOT devices that capture biometric data into mobile application can provide low-cost accessible solution to ensure accurate data entry and accountability.  Advances in Artificial Intelligence can help with reliable data on which to train new systems and ultimately with predicting outbreaks.
    
• Setting up enabling environment for digital health technologies to scale
  • Digital innovations are ahead of policy development. Health tech companies are experimenting with different business models and iterating on design & development of the solutions. Policy development speed has been hampering the speed of innovation deployment.  To accelerate digital integration, policy makers will need to create an enabling environment for innovation scale while managing risk and ensuring quality outcomes.
  • With market forces driving massive growth in mobile technology and reducing costs of devices, there is still a gap when it comes to highly reliable and flexible cloud computing clusters that are needed by nations to manage all the health data. Scaling these services will reduce costs and accessibility to deliver technical solutions at needed scale.
  • New business models are needed to provide equitable digital technology access to patients and citizens who are not able to afford these. Funders are starting to change how they fund health innovation to ensure equity and sustainability are key components of solutions.

By continuing the dialogue, together we can identify the greatest needs and areas of opportunity to design and live into a resilient health system of the future. 

What are the key ingredients and enabling environment for equitable community health in the digital age in your community? Join the discussion

Check out the conversation page on the Futures Centre for a more detailed look at the notes from this discussion.

Explore the Signals

• How Virtual Reality Can Help Train Surgeons
• Madhya Pradesh’a DASTAK programme to tackle malnutrition gets digital tool for field monitoring
• How COVID-19 accelerated funding in Indian healthcare sector
• Telehealth and the digital divide as a social determinant of health during the COVID-19 pandemic
• Africa Emerges as Digital Health Proving Ground

Recommended Reads:

1. Digital inclusion as a social determinant of health

Check out the previous conversations

• Conversation Two: Health Systems in Pursuit of Health

• Conversation One: The Case for Community Health