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All too often, however, it remained just talk – until the advent of Covid-19 left countries with no other option but to provide safe, affordable, and accessible health care digitally.
The need for rapid implementation and scale-up of digital health made it clear that no one stakeholder – government, private sector, foundations, or other – can make it happen on their own. Rather, it requires the involvement of all parties, including that of the end users. The question then becomes: how can and should countries leverage cross-stakeholder collaboration to move from the hype and hope of digital health to hands-on, evidence-based solutions that help countries achieve universal health coverage?
This question was at the heart of discussions at the 2021 Digital Health Week, which was themed Collaborating for digital health and better care. The week included a series of three closely connected sessions which were co-sponsored by the UHC2030 Private Sector Constituency and the Digital Connected Care Coalition (DCCC). The sessions examined the challenges and opportunities for scaling digital health tools and how to better align public and private sectors to deliver health services.
What are the different tasks or roles that organizations, governments, the private sector, and the World Bank, for example, should take? And how should the various stakeholders collaborate to address the multiple aspects of digital transformation such as: improving the digital infrastructure and regulatory ecosystem; data and privacy issues; improving the health workforce’s capacity to use digital tools; the digital literacy of end users; and ensuring equity, value, and trust in digital health?
One key factor that was mentioned by participants in both this panel and the second session, A deep dive into the private sector’s involvement in digital care, which looked at three concrete digital health interventions, was the need for government to take a leading role in ensuring good governance and in establishing the regulatory and policy environment that will enable digital innovations and private sector initiatives to thrive. As Dr. Anthony Adofo Ofosu, of the Ghana Health Service, said, “Governments need to provide […] the basic infrastructure and implement policies and legal frameworks in a way that is inclusive of all players. Because if you don’t put in the right policies, then people won’t get what they really need.”
Jan-Willem Scheijgrond, of Royal Philips, spoke of the need to work in co-creation, bringing together the various competencies needed while ensuring that the sector remains competitive, striking a balance between large-scale solutions that might be politically sensitive and small-scale solutions that would be essentially meaningless. Beyond the policy and infrastructure issues, there are also the challenges of developing a business model that will ensure a sustainable solution and avoid the fragmentation that characterized digitization pre-Covid.
From the implementation side, another issue mentioned by many private sector entities is the difficulty of interacting with governments and of knowing which of multiple government representatives or departments they should collaborate with, at what level they should engage, and how to work in proximity with government infrastructure at every level. “Had we understood how to engage with the Ministry [of Health] more meaningfully from the beginning, we would have been more successful,” said Ms. Anne Stake, of the Medtronics Lab Padayon project in the Philippines. Dr. Ofosu emphasized that from a government perspective, innovative solutions are needed to deal with identified problems, and not merely solutions looking for problems, as sometimes happens.
When asked what lessons have been learned as a result of the pandemic, Marelize Gorgens of the World Bank said that Covid-19 has been revelatory as to the scale and volume that was possible for telemedicine, and that one of the biggest revelations was how quickly it is possible to create a telemedicine service.
As Dr. Rodrigo Saucedo of the Carlos Slim Foundation in Mexico pointed out, “Digital health evolved from being a luxury good to being a basic good in this pandemic, and this has been demonstrated to decision-makers around the world.”
What sort of transformations have been seen in the delivery of health services? Some concrete examples discussed at the Digital Health Week included the work being done by Babyl in Rwanda, where they operate a call center staffed by part-time doctors and nurses handling some 4,500 phone consultations per day, all accessible through the national health insurance scheme, according to Dr. Shivon Byamukama.
In Mexico, says Dr. Saucedo, where the biggest health problem is non-communicable diseases such as diabetes and hypertension, digital solutions are being used for active prevention and evidence-based disease management; it is seen as an enabler of personalized public health.
Dr Niti Pall, of AXA, explained her company has bundled insurance and digital health services via platforms such as telecom, retail, banking and rideshare service providers in countries such as Bangladesh, Thailand, Indonesia, Egypt and Spain. She emphasized the consumer perspective, stating that what customers are looking for is trust, empathy, expertise, and information. Ms. Gorgens pointed out that there is now an expectation on the part of consumers and health care professionals alike that there are and should be different ways to deliver health care. Dr. Pall aptly called it new “click and brick” models.
Several panelists pointed out the importance of remembering that health care must be seen as an ecosystem and to not allow the fragmentation of service delivery. Ms. Stake said that Padayon sees digital health as only one of their strategies; whereas it is a key solution for both patients and health workers, it has to be paired with hyperlocal field solutions and implementation-focused partnerships.
Also mentioned was the risk that countries, particularly low- and middle-income countries (LMICs), will be unable to scale up their investment in digital transformation as the pandemic recedes, which might lead to a widening “digital divide” between LMICs and high-income countries.
All participants emphasized technology as an enabler; a tool that will help build a solid body of evidence of feasibility and scalability, and that data and privacy concerns must remain paramount. There was general agreement that the pandemic has clearly demonstrated the need for action. As Jan-Willem Scheijgrond, of Philips, stated, “We are at a pivotal point in the digital transformation of health care. Now – in three years’ time it will be too late.” To take the agenda forward, we will need new kinds of partnerships.
#digitalhealth #privatesector #DCCC
The speakers participating in the three panel sessions are listed below. The sessions can be viewed on the UHC2030 website
Webinar 1: Collaborating for digital health and better care
- Marelize Gorgens Prestidge, World Bank
- Dr. Anthony Adofo Ofosu, Ghana Health Service
- Jan-Willem Scheijgrond, Royal Philips
- Niti Pall, AXA
Moderator: Desta Lakew, Amref Health Africa
Webinar 2: A deep dive into the private sector’s involvement in digital care
- Dr. Shivon Byamukama, Babyl, Rwanda
- Rodrigo Saucedo, Carlos Slim Foundation, Mexico
- Anne Stake, Medtronics LABS Padayon, Philippines
Moderator: Dr. Muthoni Ntonjira, Philips Kenya
Webinar #3: DCCC projects and collaborating with the private sector in digital health
- Dr Ademola Serrano, PharmAccess
- Neeraj Jain, PATH India
Moderator: Dr. Shivon Byamukama, Babyl Health Rwanda & Digital Connected Care Coalition