HIFA colleagues
Yesterday I attended (as an online observer for HIFA) the keynote session on “Digital Transformation for Health” at the World Health Summit. [*see note below]
This was a panel session chaired by Dr Tobias Silberzahn (Global Health Network Lead at McKinsey) and featuring six speakers:
Lav Agarwal, Joint Secretary, Ministry of Health and Family Welfare, India
Prof. Dr. Awa Marie Coll Seck, Minister of State to the President, Senegal
Dr. Garth Graham, Director and Global Head of Healthcare and Public Health, Google/YouTube, United States of America
Prof. Dr. Alain Labrique, Director, Department of Digital Health and Innovation, World Health Organization
Dr. Bernd Montag, CEO, Siemens Healthineers AG , Germany
Dr. Helga Mutasingwa, Youth Representative and Medical Doctor, Global Youth Mobilization, Tanzania
Introduction.
The session started with a short scene-setting video about growth over the last two decades in use of digital in health care in Bangladesh - with benefits such as reminders for clinic appointments, identification of high-risk patients, workforce monitoring and so on; and challenges such as affordability and technical literacy.
The chair then presented a view of the aims of “Digital First Health Systems” - better health, equity, sustainabiliity, reduction in administrative burden and positive economic impact - and noted that achieving this required different strands of health care - traditional delivery, digital appproaches, prevention, personalisation - to come together. He then set out the main areas to be discussed in the panel session: future vision, benefits and risks, and public /private collaboration models.
Key points I noted from the panel discussion were:
Future vision.
“Business as usual” was not enough to meet the health Sustainable Development Goals and the Covid pandemic had served as an inflection point for innovation. We should stop thinking about digital health but think about digital transformation of the global healthcare system. For the future we can look to digital to speed up improvements particularly in access to health care, in managing non-communicable diseases, and in coping with the health workforce crisis. Progress required building an enabling environment and we needed a blueprint and foundational investments to foster this ecosystem - the WHO was there to assist member states in planning, training and so on.
The need for a patient centred ecosystem was stressed (notably by the panellist from Google/YouTube) - seeing in information as a key determinant of health and empowering citizens and patients to make healthcare decisions. People were asking for answers to health questions much faster than traditional health information systems provide. We need to take health information beyond professional journals into the living room - for instance videos are a powerful tool for making clinical information digestible.
The young were the stakeholders in the future so their perspective was crucial; their concerns about digital futures included equity, user-centredness, transparency, safety, literacy, sustainability - and fun.
Benefits and Risks.
The introduction had given an overview of these. Other risks and problems included lack of scaling-up from individual projects, lack of interoperability, and lack of public trust.
In Senegal mobile penetration (though not effective usage) was almost universal and there had been benefits for diagnostic testing, telemedicine, e-learning, and platforms for care management e.g in epidemics.
Public/private collaboration.
It was not a coincidence that there is no global company that is a “digital health giant” - it is harder to develop a digital business in the health arena than in others because there are (rightly) additional hurdles around regulation, payment and professional culture. These need to be tackled country by country, company by company.
India’s model is noteworthy - a national digital health blueprint and mission and a technical architecture on data standards and interoperability created the conditions enabling others to engage. Note the three “R”s - seet Rules, mitigate Risks and ensure realistic Rewards.=
Appropriate national development can be achieved by a blend of “top-down” and “bottom-up” - identify local good practice and help others emulate it nationally.
Ten years ago 9 principles were formulated for digital development ( see https://digitalprinciples.org/principles/ ). Since then over 300 organisations have signed up to them - we haave the makings of a shared value ecosystem for digital transformation.
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There was (unfortunately) no Q&A session following the panel discussion.
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Regards
Geoff
HIFA profile: Geoff Royston is an Independent Health Analyst and Researcher, former Head of Strategic Analysis and Operational Research in the Department of Health for England, and Past President of the UK Operational Research Society. His work has focused on informing the design, implementation and evaluation of policies and programmes in health and social care, and on fostering the capabilities of others to work in these areas. Associated activities have included modelling for understanding the performance of complex systems, analysis and communication of risk, and horizon scanning and futures thinking. He has also worked on information and communication technology in the health sector, notably in leading the design and national launch of the telephone and online health information and advice service NHS Direct. He has served on both scientific and medical UK Research Council panels, and as an impact assessor for the UK higher education Research Excellence Framework. He is a member of the editorial board for the journal Health Care Management Science and in 2012 was Guest Editor for its special issue on Global Health. He has been a consultant for the World Health Organisation, is a long standing member of the EURO Working Group on Operational Research Applied to Health Services, and is an expert adviser to the mHIFA (mobile Healthcare Information for All) programme. http://www.hifa.org/projects/mobile-hifa-mhifa He is also a member of the main HIFA Steering Group and the HIFA working group on Evaluating the Impact of Healthcare Information. http://www.hifa.org/support/members/geoff geoff.royston AT gmail.com
[*Note from NPW, moderator: Thank you Geoff for representing HIFA at this event. 'information as a key determinant of health and empowering citizens and patients to make healthcare decisions' - This is of course what we have all been saying for years (and not just citizens and patients, but health workers too) but were there any insights on *how* to move forward collectively towards universal access to reliable healthcare inforamtion?]
