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Youth-led digital first health systems: Challenges and opportunities in the age of the disruptive entrepreneur.

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This blog is part of a series of youth authored essays on Health futures: digital first health systems for and with young people. The views expressed in this blog are of the author and not of the Lancet and Financial Times Commission on Governing Health Futures 2030: Growing up in a digital world.

Introduction

Digital first health systems are about putting the patient first and creating a patient-centred care culture. They constantly look to improve the user experience and ensure that the patient’s needs guide the process. By keeping up with the latest trends and technologies, these systems can stay ahead of the curve.

Digital first healthcare helps direct and allocate resources in a direction that is most effective for each individual patient. In 2022 and beyond, this trend is expected to grow as health entrepreneurs continue to develop more innovative ways for patients to stay connected to doctors without needing to travel to a medical facility.

Disruptive innovation

According to Investopedia, disruptive innovation is defined as innovation that “transforms expensive or highly sophisticated products or services—previously accessible to a high-end or more-skilled segment of consumers—to those that are more affordable and accessible to a broader population”, thus, answering to the four essential elements of the right to health: availability, accessibility, acceptability and quality (known as the AAAQ framework).

Good examples of disruptive innovation are Amazon and Netflix launching their businesses as an online bookstore and a DVD-by-mail service respectively. Similarly, telemedicine, electronic health records, and wearable biometric data gadgets and devices are the most prominent examples in the world of healthcare. However, in this piece, I discuss the potential of disruptive innovation on the level of an entire health system.

Youth 

According to a recent study by the Copenhagen Business School, entrepreneurs in their 20s and 30s can eventually operate firms that are even more productive than those created by older entrepreneurs because they learn and invest over time. This theory is supported by the fact that many well-known entrepreneurs started their businesses in their 20s, including Mark Zuckerberg, Bill Gates, and Steve Jobs.

I believe we are past the call for youth involvement and enfranchisement and are ready for the phase of youth leadership. Youth are regarded as ‘digital natives’ where 71% of people aged 15-24 are online and more equipped with modern digital tools and are more up-to-date with the most recent technological breakthroughs. 

The vision

Disruptive innovation, applied to whole health systems, can transform healthcare and realise the right to health. The shared vision of entrepreneurs and policymakers alike must be to incorporate innovative technologies within all six building blocks of health systems worldwide as defined by the WHO:

  1. Leadership and governance
  2. Service delivery
  3. Health system financing
  4. Health workforce
  5. Medical products, vaccines, and technologies
  6. Health information systems

The challenges

The aforementioned vision statement may seem too good to be true to some healthcare leaders due to various obstacles that stand in the way of their application.

Equity:

The Governing Health Futures 2030 Commission’s work targets a digitally transformed universal health coverage to achieve health and wellbeing. However, given the current status of inequity, digital transformations will benefit developed countries the most since they have a surplus of resources to spare. On the other hand, developing countries facing a scarcity of resources will benefit the least due to significantly limited access, low rates of digital literacy, weak internet infrastructure, and a deficiency in trained professionals to run the system, thereby added to existing disparities on the local and state levels (urban/rural, demographic, and socioeconomic metrics).

The quality elements of the provided service (broadband speed, servers, hardware, support and maintenance, and cybersecurity) are another variable in the equation between developed and developing nations. In cases of unrestricted, publicly funded access, some individuals or households might dominate the service by occupying time and capacity that could be otherwise directed to more severe cases.

State actors are often in charge of the establishment and the progress of digital transformations, implementation could therefore be subject to diligence, and transparency levels will be determined by the nature of the type of governance, therefore, contributing to another tier of disparity.

All of the above will contribute to pushing the favourable circumstances of success away from young innovators in lower income countries and ultimately deepen the digital divide. Delicate monitoring and transparency measures are required to draw a precise and timely image of the transformation. International organisations and global donors such as the World Bank Group, the International Monetary Fund, and philanthropist organisations must lend a helping hand to LMICs to fulfil their digital transformation goals.

Funding:

We are discussing the design, development, and maintenance of oftentimes nation-sized gigantic platforms and systems; sustainable funding could shape a challenge for countries in the midst of economic hardships, and this will necessitate delicate budgeting for publicly, privately, or jointly financed health system models.

Additionally, emerging tech startups will require multiple rounds of funding to withstand the tests of the market. Thus local investors, venture capital firms, and innovation grants will have an essential role in helping small and medium-sized enterprises grow and expand the reach of their solutions.

Staffing:

Should this global initiative see the light, it will establish a new market and provide hundreds of thousands of jobs for young people; the new labour will require a specific skill set to run the system, and therefore there will be a need for the setting of training curricula and educational materials that will demand the collaboration of global organisations, governments, universities, and education institutions.  

Moreover, young entrepreneurs themselves will need special attention from these institutions; entrepreneurship and business leadership tools must be available to advance their skill sets and eventually boost their business operations.

The opportunities

Problem-solving:

In an imagined digital first health system, an emergency doctor can provide live instructions for critical cases via a video call to reduce mortality rates induced by transport and referral times; surgeons can utilise an alternative for follow-up and post-op care; doctors can achieve optimal privacy and comfort for their interaction with patients; and the state can minimise health spending through reducing the in-person visits which save time and resources, etc.

In the same manner, a plethora of health systems problems could be unravelled by capitalising on digital solutions led by young entrepreneurial minds. 

Public-private partnerships:

Federal and local governments, young health entrepreneurs, and healthcare business owners must join forces to attain the transformation components of digital-first health systems; seed investments by the financial authorities in preventive tech solutions startups could spare billions of dollars in the burden of disease and disability, likewise, public and private education institutions could offer scholarship opportunities for students and young professionals who are interested in digital health applications. 

Climate action:

A digital health revolution could accelerate the transition towards decarbonising health systems, offsetting numerous tons of carbon dioxide and delivering an excellent opportunity for developing countries to finance their digital transformation projects by converting them into carbon credits which developed countries can buy on the voluntary carbon markets.

Bottomline

In conclusion, tackling the challenges and leveraging the opportunities of digital first health systems will establish the ground to inspire innovation and empower young entrepreneurs. Should the vision be accomplished, we might live to witness a genuine breakthrough in healthcare, and for that, the world needs to invest in and count on the younger generations to lead the transformation.

Abdullah Rajeeb Al-Khafajy

Abdullah Rajeeb Al-Khafajy

Abdullah Rajeeb Al-Khafajy is a medical doctor with six years of experience in youth leadership and engagement advocacy on a national, regional, and international level. His work focuses on policy and advocacy and the intersection of the government, NGOs, the environment, and the private sector in producing health outcomes for the community.  Dr. Abdullah advocates for the Sustainable Development Goals: climate action, quality education, and good health and wellbeing. He played the role of a Liaison Officer at IFMSA, the world’s largest student organisation of 1.3 million medical students; where his duty was to represent and amplify their voices at global conferences and international meetings of partner organisations such as the UN and the WHO, amongst others. Dr. Abdullah is particularly interested in business and public policy, and he is in the midst of starting his own digital health startup company. 
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