Government leadership, collaboration needed to implement digital health strategies around the world, report says

By Heather Mack

Digital approaches to healthcare may have the potential to significantly expand coverage and improve the quality and efficiency of patient care, but implementing these new technologies come with challenges of their own, including fragmented data streams, limited resources and ineffective collaboration across multiple sectors. What’s more, access to most basic requirement of digital health innovation – high-speed internet – is not equal around the world, so countries must make coordinated efforts to make technology-enabled healthcare a reality, the Broadband Commission for Sustainable Development outlined in a new report.

The agency’s Working Group on Digital Health, which includes Nokia CEO Rajeev Suri and Novartis Foundation Head Dr. Ann Aerts, authored the report in effort guide national strategies around digital health implementation.

"Despite the promise and potential of global connectivity, we cannot lose sight of the fact that nearly four billion people have no access to the Internet,” wrote Secretary General of the International Telecommunication Union Houlin Zhao. “We need to look at innovative cross-sectoral strategies that can leverage the power of high speed networks to improve education, healthcare and the delivery of basic social services to everyone, especially the poorest people, who need healthcare most urgently.”

Pointing to the World Health Organization’s observation that universal health coverage cannot be achieved without the support of technology-enabled health, the Working Group underscored the importance of coordination between multiple stakeholders.

“Cross-sectoral collaboration is not easy. Players come from different backgrounds, with different approaches and priorities, and may understand different things on the basis of the same words or phrases,” wrote Zhao. “Nowhere is this truer than in digital health, where the needs are great, the investments are significant, and lives are at risk.”

Globally, there are 7.6 million mobile connections (smartphone penetration is nearly at 50 percent and estimated to reach 90 percent by 2020) and broadband penetration has also increased in the last decade. But implementing digital solutions isn’t as simple as getting a wireless signal, the report says. Challenges include unsustainable funding, high capital expenditures and limited workforce capacity, along with a general lack of collaboration between agencies. In developing countries, this is especially exacerbated by a heavy dependence on donor funds.

To address those challenges, the report points to the WHO-ITU’s National eHealth Strategy Toolkit as a roadmap to develop a digital health implementation plan, which emphasizes government leadership (with sustained, clearly-defined and specialized roles) committed financing, and a framework with common standards around polices and regulations.

“As a first step toward national digital health implementation, a national vision for digital health should align with the country’s health priorities, as well as with the existing capacity of the country’s ICT (Information Communication Technology) infrastructure and systems,” the report states.  “A detailed action plan and a monitoring and evaluation framework can then address fundamental issues such as regulation, governance, standards and interoperability, workforce and financing. Bringing together multiple stakeholders from both the ICT and health sectors is a complex and time-consuming undertaking and yet essential if the national digital health strategy is to be effective.”

The report pointed to a few examples around the world where countries embody some of these core principles, even those with limited means. For example, Rwanda was highlighted for its national political leaders’ long-term commitment to using broadband for healthcare, whereas Norway was given accolades for its complex stakeholder management in designing and deploying nationwide electronic medical record.

"Technology is helping us move to a more human-centric approach to health care. It gives us an enhanced, sophisticated, detailed capability to track even the smallest changes in our health, allowing us to trace trends in heart rate, blood pressure, or blood sugar,” Rajeev Suri, CEO of Nokia wrote. “Today we are capable to push the frontiers of health care by using technology to reach the remotest of locations, harnessing the power of mobile devices to help health professionals bring the most efficient medical techniques and highest quality of care to every community. But the true power of technology is felt when people are empowered to protect and preserve their own health."