If Only?! Digital Health Enablers for Pandemics: 2020 Global Digital Development Forum
On behalf the Global Digital Health Index (GDHI), we had the pleasure of convening a virtual panel discussion at the 2020 Global Digital Development Forum with four digital health experts with deep experience in epidemic and now pandemic response from around the world to discuss digital health enablers for pandemic preparedness and response. The session featured:
Ms. Nour El Arnaout (E-Health Program Coordinator at the Global Health Institute, American University of Beirut)
Mr. Jai Ganesh Udayasankaran (Senior Manager of Healthcare Information Technology and Telehealth, Sri Sathya Sai Central Trust and the Asia eHealth Information Network)
Mr. Ousmane Ly (Former General Director at the National Agency of Telehealth and Medical Informatics, Mali
Dr. Ana Riviere-Cinnamond (Regional Adviser at the Health Emergency Information & Risk Assessment Health Emergency Department, Pan American Health Organization).
The following is a synthesis of the panel. The session recording can be found here.
Throughout the panel, many of the digital health enablers presented by the panelists for more effective pandemic prevention, mitigation, and recovery aligned with those needed more broadly for digital health in general. However, pandemics force a reordering of how they are prioritized as well as how they can and should be approached in a more targeted way.
New and/or nuanced areas that emerged include policies to address privacy and data ownership concerns related to the use of mobile phone location data, Artificial Intelligence, and facial recognition to monitor physical distancing and to facilitate contact tracing; mechanisms to vet digital health tools and content for quality and safety to find the signal from the noise; standards and interoperability for data exchange; and greater integration of health, economic, and transportation data as well as cross-sectoral cross-border data sharing and exchange policies within and across countries. In addition, change management is needed to support the effective use of data in real-time with accurate and useful data visualization to inform and adapt strategies.
At the core of the discussion was the tension between the power of data and digital health tools during the COVID-19 pandemic and the need to do so in a way that is strategic, context-conscious, and has the best interest of the end beneficiaries in mind, including populations that were already vulnerable before the COVID-19 pandemic.
During the COVID-19 pandemic, it has become more apparent than ever that the collection of data - in terms of both accuracy and speed - has been critical to making informed policy decisions to curb the spread of the virus. Similarly, there are many technologies that have proven to be highly useful during the pandemic such as mobile phone location data, digitized thermometer data, and AI for facial recognition to monitor the spread of disease by location and facilitate contract tracing. However, massive-scale data collection poses serious privacy and data ownership concerns that ought to be taken seriously. Access to private health data can be wielded against owners in problematic ways. Weighing these privacy and policy considerations against the value of real-time large-scale data collection in disease identification, surveillance and response has led to different approaches to COVID-19 response around the world.
The “all hands on deck” nature of the rush of emergency response to COVID-19 has also resulted in a surge of digital health tools and content of varying degrees of safety and quality. One of the side-effects of the COVID-19 health crisis is that it has also accelerated the need and speed of digital transformation as we increasingly turn to digital connectivity for every aspect of life. Thoughtful curation and strategic deployment of a set of vetted digital health tools and content will become increasingly important as practitioners and policymakers turn to digital health tools during this battle against COVID-19. For this WHO is taking a leadership role in setting standards and vetting tools to establish a list of curated digital health tools. But, simply curating a set of standard tools is unlikely to be effective without adapting them to different country contexts. Alongside vetted tools will be the need to guide countries in how to adopt and adapt a set of strategies and tools that are best suited to their context.
While COVID-19 is forcing the global health community to reflect on the effectiveness and resilience of the current healthcare systems that are in place, it also presents an opportunity to build the foundation for a more equitable system in the longer-run. One population that has consistently been underserved by health systems across the world is the refugee population. The American University of Beirut’s Global Health Institute recently launched a COVID-19 refugee support program that leverages women in refugee communities to share knowledge about both COVID-19 and other health issues in general. The program’s success can be attributed to its user-centered approach to program design such that the program is easy to use and appealing to the beneficiaries.
Of course, underlying all these innovations and considerations are the foundational building blocks for digital health - sound strategy and policy landscape, strong leadership and governance, robust infrastructure, and well-trained workforce to name a few. Investment in these components will result in digital health ecosystems that better predict and prevent, mitigate the impact of, and recover from the current and future pandemics. We will be taking in these considerations as we refine the Global Digital Health Index to be more relevant to the current global landscape to support countries in measuring and monitoring their digital health maturity and progress.