Assessing the Promise and Efficacy of Digital Health Tool | IGF 2023 WS #83

Knowledge Graph of Debate

Session report

Audience

The need to enhance digital health systems in preparation for future pandemics has become increasingly evident. Accurate and reliable medical advice and treatment should be accessible without individuals having to physically visit healthcare facilities. This is crucial to ensure the safety and well-being of patients and to reduce overcrowding in healthcare facilities, especially among the elderly who are more susceptible to complications from infectious diseases.

The COVID-19 pandemic has highlighted the limitations of traditional healthcare delivery models that heavily rely on in-person consultations and hospital visits. This has caused strain on healthcare systems and increased the risk of transmission in crowded facilities. Therefore, there is an urgent call for the development and improvement of digital health solutions.

One supporting fact behind the argument for digital health improvements is the surge in healthcare demand during pandemics like COVID-19. The rapid spread of the virus has emphasized the need for scalable and efficient healthcare services that can cater to a large number of patients. By implementing digital health solutions such as telemedicine and remote monitoring, the burden on physical healthcare facilities can be alleviated, and healthcare providers can reach a wider patient population.

Another important consideration is the age and vulnerability of certain populations, particularly the elderly. Concerns have been raised about the increased risk they face when visiting crowded healthcare facilities. Digital health technologies can provide them with access to healthcare services from the safety of their own homes, reducing their exposure to potentially infectious environments.

The analysis also highlights the relevance of the United Nations’ Sustainable Development Goals (SDGs), particularly SDG 3: Good Health and Well-being, and SDG 9: Industry, Innovation and Infrastructure. Improving digital health aligns with these goals by promoting accessible and quality healthcare for all, as well as fostering innovative solutions to address healthcare challenges during crises.

In conclusion, the need for digital health improvements in anticipation of future pandemics is supported by various compelling arguments. These include the necessity for accurate and timely medical advice without physical visits to healthcare facilities, concerns about overcrowding, increased healthcare demand during pandemics, and considerations for the vulnerable and elderly populations. Embracing digital health solutions can enhance societies’ capacity to respond effectively to future health crises, ensuring comprehensive and accessible healthcare services for all.

Geralyn Miller

During a panel discussion, speakers elaborate on various facets of Microsoft’s initiatives related to health outcomes, health equity, and digital health literacy. One significant topic highlighted is the crucial understanding of social determinants of health. The speakers underscore that these non-medical factors have a substantial impact on health outcomes, accounting for 30-55% of them. It is emphasised that addressing these determinants is vital for tackling health disparities.

Another key point discussed is the importance of addressing systemic problems, including social determinants of health, to enhance health equity. Microsoft’s multidisciplinary research on issues such as carbon accounting, carbon removal, and environmental resilience is commended. The company’s involvement in humanitarian action programs to effectively respond to disasters is also highlighted. By focusing on these systemic problems, Microsoft aims to create a more equitable healthcare system.

The role of technology and data in improving health outcomes and promoting health equity is emphasised. Microsoft’s development of a health equity dashboard, which enables visualisation and understanding of the problem, is lauded. The dashboard employs public data sets to provide different perspectives on health outcomes. Additionally, Microsoft’s LinkedIn ‘Data for Impact’ program, through which professional data is made available to partner entities, aims to enhance digital health literacy by equipping students and job seekers with the necessary skills.

Responsible AI is another significant aspect underscored by the speakers. Microsoft’s commitment to principles such as fairness, transparency, accountability, reliability, privacy & security, and inclusion in its approach to AI is highlighted. The need for implementing policies and practices to ensure safety, security, and accountability in AI is stressed. Measures such as implementing safety brakes in critical scenarios, classifying high-risk systems, and monitoring to ensure human control are deemed crucial. Moreover, the licensing infrastructure for the deployment of critical systems is considered essential.

The panel also addresses the issue of potential bias in AI models and the need to understand and inspect the data guiding these models. Microsoft actively works towards understanding the distribution and composition of the data to prevent bias. The goal is to ensure fairness and reduce inequalities by ensuring that bias does not occur due to the data employed in AI models.

The value of cross-sector partnerships, especially during the pandemic, is emphasised. Collaborations between the public, private, and academic sectors in research and drug discovery are cited as successful examples. These partnerships, including government-sponsored consortia, privately-funded consortia, and community-driven groups, have been instrumental in advancing healthcare during the pandemic. The continuation of such partnerships to drive positive change is advocated.

Additionally, the panel underscores the importance of maintaining good standards work, particularly during crises such as the pandemic. The use of smart health cards to digitally represent clinical information and support emergency services is discussed. The work of the International Patient Summary Group, aiming to represent a minimum set of clinical information, is commended, and the need to continue this good standards work is stressed.

The challenge of keeping up with the accelerating pace of innovation is acknowledged. As innovation progresses rapidly, individuals and organizations must strive to stay current and adapt. The significance of dialogue and information sharing as opportunities to expand knowledge and foster collaboration is also highlighted. Panels and training sessions are seen as valuable starting points for initiating these discussions and sharing insights.

Furthermore, the panel emphasises the need for training in both tech providers and the academic system. They assert that training in digital health should be integrated into the academic curriculum to ensure that everyone in healthcare is equipped with the necessary knowledge and skills. This approach is considered essential for advancing digital health literacy and ensuring its scalability.

Lastly, responsible implementation of generative AI is discussed, advocating for open policy discussions to ensure inclusivity and address ethical concerns. The importance of discussing responsible AI is underscored for its successful and inclusive implementation.

In conclusion, the panel discussion provides an encompassing overview of Microsoft’s initiatives pertaining to health outcomes, health equity, and digital health literacy. It underscores the importance of understanding social determinants of health, addressing systemic problems, and leveraging technology and data to improve health outcomes. Microsoft’s various initiatives, such as the health equity dashboard, LinkedIn ‘Data for Impact’ program, and Microsoft Learn platform, are commended. Additionally, the panel highlights the significance of responsible AI, cross-sector partnerships, maintaining good standards work, and promoting dialogue and information sharing. The importance of training in both tech providers and the academic system, as well as responsible implementation of generative AI through open policy discussions, is emphasised.

Ravindra Gupta

Digital health has achieved technical maturity, with the necessary technology and infrastructure in place for its implementation. However, it lacks organizational maturity, as highlighted by Debbie, a panelist at an event, who pointed out the shortage of trained individuals who can effectively leverage available healthcare technology. This expertise gap poses a significant challenge to successful digital health implementation.

To address this issue, comprehensive understanding and implementation of digital health are needed. This includes educating healthcare professionals, technologists, and patients about digital health’s integration into healthcare systems. The International Patients Union is one example of an organization dedicated to training patients in effectively using digital health technology.

Another area that requires attention is government policies on digital health, which currently lack focus on capacity building. Governments should prioritize capacity building initiatives to equip healthcare professionals with the necessary skills to leverage technology effectively. Pressure should be exerted on bodies like the World Health Organization (WHO) to provide faster normative guidance for digital health policy development, facilitating effective national policies.

Private and non-profit organizations are developing innovative and affordable strategies for digital health literacy. The Digital Health Academy, for example, offers an online global course for healthcare professionals, and plans are underway to provide low-cost training courses for frontline health workers. These efforts bridge the digital health literacy gap and ensure healthcare professionals are proficient in digital tools and technologies.

Governments must play a pivotal role in funding digital health initiatives, as seen in the Indian government’s investment in the national digital health mission. This funding is crucial, especially considering the evolving business model of digital health, which has led to the withdrawal of many large companies. Government support is essential for sustaining digital health initiatives and ensuring successful implementation.

Digital health has proven its readiness during the COVID-19 pandemic. Fast-track vaccine development involved global researchers, and AI was used in repurposing drug use. Additionally, 2.2 billion doses were digitally delivered through COVID apps, highlighting the efficiency and effectiveness of technology in healthcare. This underlines the need to continue utilizing technology beyond the pandemic.

Digital health literacy is crucial for healthcare professionals and workers in the sector. Failing to adapt and learn digital health skills may render individuals professionally irrelevant. Patients’ increasing access to health information necessitates healthcare providers’ awareness of advancements to provide accurate and quality care.

Upskilling and cross-skilling in digital health are essential for scalability, as scalability relies on healthcare professionals having the necessary competencies to leverage digital tools effectively. Moreover, healthcare providers should stay ahead of patients in terms of health knowledge to provide accurate care.

In summary, digital health has achieved technical maturity but lacks organizational maturity. Comprehensive understanding and implementation, capacity building, and literacy initiatives are necessary. Government support, funding, and upskilling efforts are key to successful digital health implementation. Digital health literacy is important for both healthcare professionals and patients, and upskilling is necessary for scalability. Healthcare providers need to stay informed to provide quality care. By addressing these challenges and investing in digital health, we can achieve better healthcare outcomes for all.

Moderator

The panel speakers engaged in a comprehensive discussion on the topic of digital health literacy and equitable access to digital health resources. They acknowledged the existence of disparities in access to healthcare and emphasized the potential of digital health to advance healthcare outcomes if accessed equitably. The need to enhance digital health literacy and promote equitable access was a recurring theme throughout the discussion.

Collaboration among various stakeholders, including healthcare providers, educational institutions, and technology companies, was identified as crucial for enhancing digital health literacy. The panel highlighted the importance of developing comprehensive frameworks and assessment tools to gain a holistic understanding of individuals’ abilities in navigating digital health. This would enable tailored interventions and support for those who need it most.

The role of social determinants of health in influencing health outcomes was also emphasized. The panel noted that 30 to 55 percent of health outcomes are dependent on social determinants of health. To visualize this problem, the Microsoft AI for Good team has built a health equity dashboard. This highlights the significance of addressing social determinants, such as economic policy, social norms, racism, climate change, and political systems, to achieve health equity.

Furthermore, the speakers advocated for digital health literacy and digital skills to be viewed as part of the social determinants of health. Microsoft’s initiatives, including a multidisciplinary research initiative on climate change, partnership with humanitarian open street map team for disaster mitigation, and a free online learning platform, were highlighted as examples of addressing social determinants. Microsoft-owned LinkedIn also promotes economic development and digital skilling through their economic graph and data for impact program.

Sub-Saharan Africa was identified as a region facing high health inequality, with a high disease burden and a shortage of health workers. The panel called for focused efforts to address health inequality in this region. They highlighted the positive impact of digital technologies, especially mobile, in addressing health issues. Reach Digital Health, for example, uses mobile technology to improve health literacy and encourage healthy behaviors. The Department of Health in South Africa also implemented a maternal health program that reached around 60% of mothers who have given birth in the public health system over the past eight years.

The panel stressed the importance of incorporating a human-centered design approach in the development of digital interventions. They noted that design considerations should include an understanding of the bigger context and the needs of the end-users. This approach ensures that digital health solutions are simple, easy to use, accessible, and free, with appropriate literacy levels.

The moderators expressed their interest in hearing insights and key policy recommendations from the panel. They highlighted the importance of enhancing digital health literacy, especially among marginalized populations. The panel agreed that governments and international organizations should prioritize policy interventions and investments to achieve this goal.

Capacity building in digital health was identified as a significant ongoing challenge in the healthcare sector. The need for policymakers to focus on capacity building and provide training for healthcare professionals and frontline workers was emphasized. The speakers emphasized the importance of continuous upskilling, considering the rapid pace of technological innovation, and highlighted the need for a practical implementation focus before policy development.

The importance of equitable access to digital health resources was another key point discussed. The Digital Health Academy was highlighted as an organization focusing on affordable training, providing $1 trainings for frontline health workers to ensure affordability. The responsible development and deployment of digital health technologies were emphasized, with a focus on upholding digital rights, privacy, and security. The speakers stressed the importance of involving various stakeholders for responsible innovation.

The speakers also touched on the concept of the digital divide and its impact on health equity. They highlighted the need to bridge this divide through initiatives such as Facebook Free Basics, which provides essential information for free, improving people’s literacy and data usage. Aligning priorities between mobile network operators and health organizations was seen as crucial for improving health equity.

Youth-led initiatives and community involvement were identified as crucial for bridging the digital divide in health. The panel emphasized the need for culturally sensitive initiatives that consider the specific needs of the population. They highlighted the importance of empowering young advocates to actively shape internet governance policies to ensure equitable access to digital health resources.

Lastly, the panel discussed the role of governments in investing in digital health. The Indian government, for example, has set up a national digital health mission and provided free consultations to citizens through the e-Sanjeevani program. Implementing free telemedicine consultations through health helplines was seen as a way to bridge the digital divide and address healthcare inequities.

In conclusion, the panel highlighted the need for collaborative efforts, policy interventions, and investments to enhance digital health literacy and achieve health equity. They emphasized the importance of addressing social determinants, building digital health capacity, and promoting equitable access to digital health resources. The responsible development and deployment of digital health technologies, as well as the involvement of youth and community in shaping policies, were identified as crucial. Overall, the panel provided valuable insights and recommendations for advancing digital health literacy and equitable access to digital health resources.

Yawri Carr

The emergence of the Responsible Research and Innovation (RRI) Framework in AI healthcare is seen as a positive development in the field. This framework focuses on transparency, accountability, and ethical principles, ensuring that innovation in AI does not compromise ethical standards. It places an emphasis on safeguarding digital rights and privacy and holds AI systems accountable for their decisions.

Stakeholder involvement is highlighted as essential in the RRI process. Societal actors, innovators, scientists, business partners, research funders, and policymakers should all be involved in the responsible research and innovation process. It is important for these discussions to be open, inclusive, and timely, working towards ensuring desirable research outcomes.

Youth-led initiatives are recognized for their role in promoting responsible AI. Universities, education centres, and mentorship programs have crucial roles in inspiring young people to innovate in health technology. Community-based research projects are also highlighted as a means to promote cultural sensitivity and address specific community needs.

However, there are challenges in applying ethical considerations in profit-driven AI innovations. There is often a clash between ethical considerations and profit-driven motives. Power imbalances, particularly financial, often hinder the work of ethicists. Therefore, regulatory frameworks, certification processes, or voluntary initiatives are needed to enforce ethics in AI.

Young advocates are viewed as influential in shaping internet governance policies and ensuring equitable access to digital health resources. Their participation in policy discussions at forums like the Internet Governance Forum (IGF) and the formation of youth coalitions can amplify the collective voice for accessibility and inclusivity. Engagement with multi-stakeholder processes can ensure a diverse contribution to the policies.

Youth-led research and innovation hubs are seen as valuable in addressing digital health challenges. These hubs provide a platform for young innovators, healthcare professionals, and policymakers to collaborate and find innovative solutions.

Technologies such as telemedicine and the use of robots are praised for their usefulness in pandemic situations. Robots can restrict direct human contact, reducing the risk of virus spread. Telemedicine enables remote treatment, ensuring health services while maintaining social distance.

The importance of technology and AI in healthcare is emphasized, particularly in protecting nurses and healthcare workers. Assistive technologies like robots can help safeguard these frontline workers.

Open sharing of data and research related to the pandemic is encouraged. This open sharing can lead to greater cooperation and more effective responses to emergencies.

Digital health leaders are urged to prioritize equity and ensure that healthcare is not a privilege but a right for all. Technical skills are not the only important aspect; a commitment to equity is also vital. Healthcare and digital health care should be accessible to everyone.

The valuable role of nurses and ethicists in evolving technology is highlighted. The work of nurses remains critical in healthcare, and ethicists play a crucial role in contributing to the mission of responsible AI.

In conclusion, youth-led initiatives, stakeholder involvement, and the emergence of the RRI Framework in AI healthcare are viewed as positive developments. Challenges exist in applying ethical considerations in profit-driven AI innovations, emphasizing the need for regulatory frameworks and certification processes. The importance of technology, telemedicine, robotics, and the open sharing of data and research are recognized. Digital health leaders are urged to prioritize equity, and the crucial role of nurses and ethicists in evolving technology is emphasized. Ultimately, youth play a fundamental role in advancing digital health and ensuring its accessibility.

Deborah Rogers

The speakers in the discussion highlighted several key points about digital health in Africa and how it can potentially address health inequality and overburdened health systems. They emphasised the increased access to mobile technology in Africa, which has seen significant growth over the years. In Africa, where 10% of the world’s population represents 24% of the disease burden, access to mobile technology has the potential to bridge the gap and improve healthcare outcomes.

One of the main arguments put forth was the effectiveness of low-tech but highly scalable technology in disseminating health information and services. The speakers stressed the success of programmes that utilise SMS and WhatsApp in improving health behaviours and service access. For example, a maternal health programme in South Africa has reached 4.5 million mothers since 2014, resulting in improved health outcomes.

The discussions also highlighted the role of digital technology in improving health literacy. Through the use of digital technology, a maternal health programme in South Africa has witnessed increased uptake of breastfeeding and family planning. However, the speakers emphasised the importance of implementing digital health initiatives in a human-centred manner and being cognisant of the larger health system they are a part of.

Furthermore, the speakers addressed the issue of health equity and the digital divide. They presented an example of the Facebook Free Basics model, which provided free access to essential health information and led to increased profit for mobile network operators. This approach demonstrated that reducing message sending costs for end-users does not inhibit profit for operators, thus showing the potential for mobile network operators to improve health equity.

The discussion also delved into the importance of a human-centred approach in developing digital health interventions. The speakers emphasised that digital health should be easy to use and accessible, designed with users in mind. They also noted that access to a mobile device itself is less of a problem than the cost of data, which needs to be addressed for wider adoption of digital health services. Overall, digital health was seen as an integral part of the health infrastructure, rather than a side project.

One noteworthy aspect that was brought up in the discussions was the potential bias and lack of diversity in the development of digital health services. The speakers emphasised that the makeup of the development team often does not represent the actual users of the services, leading to the introduction of biases. This can perpetuate health inequities and hinder the effectiveness of digital health interventions. Therefore, there was a call for more diverse and inclusive development teams to ensure the services are designed to meet the needs of all users.

During the discussion, the speakers also highlighted the role of digital health in the COVID-19 pandemic. Large-scale networks were used to quickly disseminate information, and digital health platforms played a vital role in screening symptoms and gathering data. The burden on healthcare professionals was reduced, showcasing the potential of digital health to alleviate the strain on the healthcare system.

Furthermore, the importance of sharing medical knowledge and not hoarding information was emphasised. The speakers noted that the lack of knowledge during the early stages of the COVID-19 pandemic had a significant impact on everyone. Therefore, the dispersal of information on a large scale can greatly contribute to improving patient health outcomes.

The discussions also emphasised the need for investment in digital health infrastructure for future pandemics. The COVID-19 pandemic highlighted the importance of having digital health platforms in place. Building and investing in such infrastructure before the next pandemic occurs would enable a quicker response and avoid starting from scratch.

Additionally, the potential of technology to decrease health and digital literacy inequities was discussed. Technology was hailed as a great enabler in addressing these inequities and improving access to healthcare and education.

In conclusion, the discussions on digital health in Africa highlighted its potential to address health inequality and overburdened health systems. The increased access to mobile technology and the success of low-tech interventions have provided evidence of the positive impact of digital health. However, the speakers emphasised the need for a human-centred approach, diversity in development teams, and investment in infrastructure to fully capitalise on the potential of digital health. There was optimism about the future of digital health, and the involvement of youth in its evolution was seen as crucial.

Speakers