“In the future”, predicted the Governing Health Futures 2030 Commission, “we might not even speak of digital health, as digital technologies become integral to how health is understood and delivered.” This future has not yet arrived but is getting closer.
Defined by WHO as the field of knowledge and practice associated with the development and use of digital technologies to improve health, digital health is still a relatively new topic and therefore the subject of much analysis and discussion. Digital health is becoming increasingly salient, evidenced by its growing visibility and prominence in policy discussions, funding decisions, organisational structures and conferences.
However, the global health community is moving away from what the Commission called a “narrow technical view of digital health applications and health data use” and towards thinking about the opportunities and challenges of the broader digital transformation process for health and health systems.
A new global initiative focused on digitally transforming health systems
Whilst much attention (and money) continues to be devoted to the development and implementation of individual digital solutions, it is widely understood that the full potential of digital transformations for health cannot be harnessed without adequate investment in the building blocks of digitally-enabled health systems.
Earlier this month, G20 Health Ministers highlighted the critical role of digital technologies and data for strengthening healthcare systems, improving healthcare delivery and advancing universal health coverage.
Under India’s G20 Presidency, fragmented and uncoordinated efforts to digitally transform health systems were identified as a major barrier to reducing health inequities, especially in low-resource settings. To address this challenge, the G20 have committed to support the WHO in establishing a Global Initiative on Digital Health. Under this initiative, partners will align financial resources and other forms of support behind implementation of WHO’s Global Strategy on Digital Health 2020-2025 and national digital health strategies. The initiative aims to help countries move away from a traditionally “products-focused” approach to digital health and towards a more systematic digital health transformation process.
From digital health to a digital-in-health approach
The World Bank has also made the case for embedding digital technologies and data into health systems in a new flagship report.
The report describes the evolution from e-health to m-health to digital health, reflecting changes in how the health sector was seeking to incorporate and apply digital innovations. The World Bank argues that we are now in a new phase, which it has coined ‘digital-in-health’ where the focus of policymakers and other actors must be on fully unlocking the value of digital technologies and data to strengthen health systems.
Digitally transformed health systems can expand the reach and impact of essential health services and accelerate UHC but for many people, particularly the poorest and most vulnerable communities in low and middle-income countries, the World Bank’s vision of ‘digital and health are one’ is far from reality. Renewed commitments this month from the G20, World Bank and WHO to bridge digital divides and invest in critical enablers of equitable digital health transformation such as digital literacy and data governance are therefore encouraging.
Digital transformations for health: The inevitable next stage of the journey
Harnessing digital technologies and data to improve healthcare and health service delivery for all represents only part of the digital transformations of health. The effect of digitalisation is now so pervasive, the Governing Health Futures 2030 Commission argued that it has become a dominant prism through which we understand and address health and wellbeing, including for those who are unconnected. Digital tools and environments—or lack of access to them—are impacting physical and mental health in ways that we are only just beginning to understand. Health systems must be able to respond and adapt.
Towards the end of its report, the World Bank echoes this view, writing that we have entered a period of “cultural transformation in how health is delivered and perceived”, one where our “understanding of what is necessary to live life well” is changing. Also in line with the Commission’s recommendations, the World Bank recommends that countries consider the digital determinants of health as they undertake health system reforms.
In a journey that began with e-health, the next step must be to make all digital transformations work for health. As it takes forward the work of the Commission, the Digital Transformations for Health Lab (DTH-Lab) will be encouraging policymakers, health professionals, researchers and the private sector to examine these broader questions and generate evidence on how digitalisation is changing health in both positive and negative ways.
To ensure that digitalisation leads to better health outcomes for current and future generations, efforts to digitally transform health systems must be accompanied by action to strengthen digital and governance, and tackle the digital determinants of health. Aligning with the Global Initiative on Digital Health, the DTH-Lab will work with young people and a wide range of partners from different sectors to develop governance solutions that will make health, wellbeing and public value central to the development and use of digital technologies and data.