Access to reliable information and connectivity in the healthcare ecosystem are the crucial factors in modernising health, care and prevention delivery. To tackle global health risks and rising healthcare costs, to effectively fight health inequalities and strengthen medical research, public health is reaching for technology.
Blind decisions and wasting money
“There are, in effect, two things, to know and to believe one knows; to know is science; to believe one knows is ignorance,” said Hippocrates.
Today’s global health strategies, policies, and decisions still too often hinge on conjectures and incomplete information. The OECD report “Health at a Glance: Europe 2018” suggests that up to one-fifth of health spending is wasteful and could be eliminated without undermining health system performance. In Europe, with up to 9,7% GDP devoted to health care in 2017, billions of Euros slip through the system. At the same time, thousands of patients don’t get the necessary help because they can’t afford expensive medical procedures, or the waiting times in the underfunded public healthcare systems give them no chance of being treated when they need it.
Waste is a consequence of the lack of knowledge. The unnecessary duplication of tests and services, inappropriate or ineffective care or avoidable adverse events happen when data is missing and communication between different stakeholders in the complex ecosystem malfunctions. Modern healthcare must be an evidence-based, data-oriented, and connected healthcare. Otherwise, the translation of personalised and patient-centred care into practice won’t be possible. What’s more, we will remain stuck with episodic, hospital care instead of moving towards prevention.
Missing data leads to chaos
We learned the importance of an agile healthcare information infrastructure during the largest Ebola outbreak in history which occurred in West Africa with over 11 000 deaths reported (2014-2016). A lack of reliable data on the transmission of the disease and the number of cases showed that the strength of healthcare systems is also closely related to the effectiveness of the information and communication system. To make sure that technology is supporting public health, it is not enough to implement digital solutions, IT applications, and apps. It requires a well-designed health information strategy, political awareness, leadership, and implementation with purpose and respect for social change – not only for the sake of technology.
“Health risks can be identified and analysed faster through improved data collection and transfer, and the spread of diseases can be controlled earlier. The Vaccines Confidence Project, for example, is monitoring public confidence in immunisation programmes by using an information surveillance system for early detection of public concerns around vaccines,” says Mathias Bonk, Co-founder and Chairman of the Berlin Institute of Global Health.
Communication for research
“The concept of global health is based on a comprehensive, human rights-based, multidisciplinary, and holistic approach. Global health actors work on transnational health problems, determinants, and solutions at the interfaces between politics, science, and society, promoting interdisciplinary cooperation. This is only possible through an increasing connectiveness between researchers, scientists, decision-makers, the media, and the general public,” emphasises Mathias Bonk. The global health expert claims that an improved and secure communication of research results, scientific findings, patient data, and information on prevention, treatment, and rehabilitation is the basis for effective and efficient health systems. This also applies to the exchange between the health sector and the health-influencing sectors such as the environment, food, transport or trade.
“Although most global health challenges can only be managed successfully, if digital health solutions are available, but ethical issues need to be considered, equal rights and equality ensured and data security as well as the stability of IT platforms and networks guaranteed,” adds Mathias Bonk. And he also mentions the growing importance of digital health for addressing global health challenges: In May 2018, the 71st World Health Assembly adopted a resolution on Digital Health, recognising the potential of digital technologies to advance the Sustainable Development Goals (SDGs), and in particular to support health systems worldwide, and requesting the Director General of WHO to develop a Global Strategy on Digital health.
Transforming information into policy
“All global health challenges without exception – universal health coverage, health emergencies, etc. – need health information to take the right decisions at the right time. In this context, digital health is the right component to provide tools that allow to capture, analyse and transform health information into policy. Once policy action is in place, digital health solutions can play a key role in the transformation of the health and well-being sector. In the European Region, the WHO European Health Information Initiative is supporting countries in the enhancement of digital solutions in health information,” says Claudia Stein.
New organisational models for health
Data allows us to understand complex processes, and gives us the opportunity to prevent global risks. Artificial Intelligence could analyse social and political information to foresee forthcoming humanitarian crises. Some pilot projects in this field have already started. Monitoring micro- and macroeconomic trends could be the first step to building a global financial crisis warning system. What if we could predict the next economic collapse, epidemics or natural disasters, instead of waiting helplessly for a catastrophe? What if we could prevent actively, saving many lives and minimising the impact of global risks?
“We have not even begun to scrape the surface of what digital transformation and artificial intelligence systems will mean for global health,” says Ilona Kickbusch, the Director of the Global Health Centre at the Graduate Institute of International and Development Studies in Geneva, an international expert in areas such as political determinants of health and global health. She adds: “If the rapid development in China is anything to go by then this no longer means adapting technologies and ways of thinking from the Western countries but to drive innovation and disruption “at home” through new alliances for connectivity – like along the Belt and Road Initiative – and new organisational models for health care access based on mobile technology, be it phones or drones.”
“This is not just an issue of technology – it is also a political issue. Not only will companies compete globally for the enormous new digital health market but different digital governance models will compete in the global arena. They will determine the level of investment, the commitment to community and patient empowerment, the role of health professionals, the ethics, the type of regulation, the power of algorithms and the use of health data. WHO needs to urgently propose a global agreement on digital health governance so that the principles of fairness, equity and rights also apply to digital health initiatives,” concludes Ilona Kickbusch.