Equi-Tech-ity: Close the gap with digital health literacy | IGF 2023

Knowledge Graph of Debate

Session report

Man Hei Connie Siu

The speakers at the discussion highlighted the persistent disparities in access to care, despite the progress made in digital health. They argued that digital health has not necessarily improved health equity and mentioned two key factors contributing to this issue: the digital divide and low digital health literacy.

The digital divide refers to the gap between those who have access to digital technology and those who do not. This divide disproportionately affects disadvantaged communities, including low-income individuals, rural populations, and marginalized groups. As digital health relies on technology, those without access are unable to benefit from its potential advantages. This creates a further divide in healthcare, perpetuating existing health inequalities.

Low digital health literacy is another barrier to achieving health equity. Many individuals lack the necessary skills and knowledge to navigate digital health information and services effectively. This can prevent them from accessing healthcare resources, making informed decisions, and actively participating in their own care. Addressing this issue requires comprehensive frameworks and assessment tools that capture and assess various dimensions of digital health literacy. By understanding individuals’ abilities and needs in this area, tailored interventions can be developed to enhance digital health literacy and bridge the gap.

Policy solutions were proposed as a means to bridge the digital divide and ensure that digital health truly advances healthcare outcomes for all. It was emphasised that these solutions should be inclusive and consider the unique needs and challenges faced by marginalized communities. By actively addressing these disparities, policymakers can promote equity and ensure that the benefits of digital health are accessible to all.

Throughout the discussion, the importance of promoting inclusivity and equitable access to digital health resources was stressed. It was highlighted that this not only requires action at the policy level but also requires advocacy for strategies that effectively address the unique needs of marginalized communities. By prioritising inclusivity and equity, digital health initiatives can contribute to reducing health disparities and improving overall healthcare outcomes.

In conclusion, while progress has been made in digital health, disparities in access to care persist. The digital divide and low digital health literacy contribute to these disparities, hindering efforts to improve health equity. Policy solutions, comprehensive frameworks, and tailored strategies are needed to bridge this divide, enhance digital health literacy, and promote equitable access to digital health resources for all individuals and communities. By addressing these issues, digital health has the potential to play a significant role in advancing healthcare outcomes and reducing health inequalities.

Audience

The current state of digital health needs to be improved in order to effectively handle future pandemics, according to experts. With the potential for another pandemic like COVID-19, it is crucial to address the shortcomings of the existing digital health infrastructure. The main concerns revolve around overcrowded healthcare facilities during pandemics, which can lead to increased transmission rates and overwhelmed healthcare systems. To mitigate these challenges, it is essential for individuals to receive accurate and timely medical advice and treatment remotely.

There is a growing need to provide accessible treatment and advice without physical visits, especially for vulnerable populations such as the elderly or those with underlying health conditions, who may face higher risks during a pandemic. The reliance on telemedicine and digital healthcare services has become necessary to ensure their safety and well-being.

The argument for improving digital healthcare in pandemic response is compelling. The current system falls short of meeting the demands and implications of a crisis like COVID-19. Enhancing virtual consultations, remote monitoring, and telehealth services would allow individuals to access medical advice, receive prescriptions, and monitor their health from the comfort of their homes.

Additionally, digital health should aim to provide consistent and accurate medical advice and treatment. The decentralization of healthcare during a pandemic can result in inconsistencies and disparities in the quality of care received by individuals in different locations. By standardizing and improving digital healthcare services, individuals can have confidence in the advice and treatment they receive, regardless of where they are located.

In conclusion, the current state of digital health needs to be improved in order to effectively handle future pandemics. The concerns over overcrowded healthcare facilities, the need for individuals to receive accurate and remote medical advice and treatment, and the importance of providing accessible healthcare for vulnerable populations all highlight the urgency of enhancing digital healthcare services. By integrating telemedicine and digital health into the healthcare system, it is possible to enhance access, ensure consistent care, and improve overall pandemic response capabilities.

Geralyn Miller

The analysis examines the perspectives of various speakers on topics related to health, technology, and social determinants. One key point is the importance of addressing social determinants of health to improve health outcomes. It is emphasized that social determinants, including economic policy, development agendas, and social policies, have a significant impact on health outcomes, contributing to around 30 to 55% of health outcomes. The argument put forward is that tackling these determinants is crucial for achieving better health outcomes.

Another important theme is the use of data and technology to understand and address health disparities. The Microsoft AI for Good team has developed a health equity dashboard that provides insights into disparities and outcomes. Partnerships between Microsoft and other organizations, such as the Humanitarian Action Program and Bing Maps, are highlighted as a way to map vulnerable areas. The argument is that data and technology play a crucial role in addressing health disparities.

The analysis also emphasizes the impact of partnerships on social determinants. LinkedIn’s Data for Impact program is mentioned as an example of a partnership that provides professional data to organizations like the World Bank Group. LinkedIn’s data has informed a $1.7 billion World Bank strategy for Argentina. The argument is that partnerships with various entities can have a significant impact on social determinants.

Additionally, the promotion of digital skilling is highlighted as a way to contribute to health equity. Microsoft’s Learn program offers free online learning resources, including role-based learning paths for AI engineers and data scientists. The argument is that digital skilling is important for advancing health equity.

Microsoft’s responsible AI initiatives are also highlighted, emphasizing their focus on fairness, transparency, accountability, reliability, privacy, security, and inclusion. It is crucial to ensure that AI systems and their outputs are understood and accountable to stakeholders, including patients and clinicians.

Furthermore, the analysis advocates for a policy of accountability in AI development, ensuring that products are safe before being released to the public. Brad Smith, Microsoft’s President, has testified in the US Senate Judiciary Subcommittee, stressing the importance of accountability and safe AI deployment. The argument is that technology creators should take responsibility for the impact of their technology.

The value of cross-sector partnerships is also highlighted, particularly during the pandemic. Different types of partnerships, including governance-sponsored consortiums, privately funded consortiums, and community-driven groups, have played a crucial role. The argument is that cross-sector partnerships are invaluable in addressing health crises.

Moreover, the analysis recognizes the importance of standards work during the pandemic. The use of smart health cards to represent vaccine status, the development of smart health links encoding minimal clinical information, and the efforts of the International Patient Summary Group in standardizing clinical information for emergency services are underscored. The argument is that the momentum around this standards work should be maintained and expanded.

The analysis also acknowledges the challenge of keeping up with the pace of innovation.

Additionally, it emphasizes the importance of gatherings and dialogue among people with similar interests for advancing in the field. It also advocates for the integration of technological training into the academic system.

In conclusion, the analysis highlights several key points relating to health, technology, and social determinants. It underscores the importance of addressing social determinants of health, utilizing data and technology to understand and address disparities, forming partnerships, promoting digital skilling, adhering to responsible AI initiatives, ensuring accountability in AI development, valuing cross-sector partnerships, acknowledging achievements in standards work during the pandemic, and addressing the challenges of innovation. It also recognizes the significance of gatherings and dialogue and the integration of technological training into the academic system.

Debbie Rogers

The analysis highlights the potential of mobile technology in Sub-Saharan Africa to improve health literacy, personal behavior change, and access to health services. In 2007, more people in Africa had access to mobile technology compared to the so-called global north or western countries. This demonstrates the widespread use and availability of mobile technology in the region. REACH’s maternal health program in South Africa has reached 4.5 million mothers, representing 60% of the mothers who have given birth in the public health system over the last eight years. The program has had several impacts, including improved uptake of breastfeeding and family planning.

Low-tech solutions, such as SMS and WhatsApp, can also empower individuals in their health. These low-tech solutions are highly scalable and can be designed with scale and context in mind. Given the ubiquitous nature of mobile technology in Africa, massive scale reach is possible, thereby increasing access to health information and services.

Additionally, designing digital health solutions with a human-centric approach and considering the larger system can enhance health literacy. By placing the human at the center and acknowledging their existence within a larger system, health literacy can be improved without widening the technology-related divide. Using appropriate language and literacy levels makes digital health services more user-friendly. Furthermore, making these services accessible for free or at a reduced cost decreases the barriers to access.

Ignoring the wider context and blindly implementing digital solutions can inadvertently increase the digital divide. It is important to understand the contextual understanding and the impact of these solutions on the existing system. Ignoring the wider context can lead to unintended consequences and exacerbate existing inequalities.

Addressing systemic issues is crucial for improving health in Sub-Saharan Africa. Currently, Sub-Saharan Africa has 10% of the world’s population, 24% of the disease burden, and only 3% of the health workers. Simply training more health workers without addressing these systemic issues will not improve the statistics and may even worsen the situation.

Telecommunication companies can play a role in promoting health equity and bridging the digital divide. The Facebook Free Basics model, for example, provides essential information that is free to access, and people who are given this free access to data then go on to use the internet more, making them more valuable customers. Collaborating with telecom companies to reduce message costs further enhances digital health access. As the reach of large-scale programs increases, the costs for telecom companies are reduced, benefiting both the companies and the access to health information for users.

Digital health solutions should work in harmony with the existing health system. Creating a digital health solution should not overburden the system, and feedback mechanisms are crucial to understand the impact of these solutions on the overall system.

Biases in creating digital health services can be reduced by having a diverse team. The biases that exist in these services are often a result of the people building them not being the ones using them. Having a team that is diverse in terms of gender and race can address these biases and ensure that digital health solutions are more inclusive and equitable.

During the COVID-19 pandemic, digital health played a crucial role in reducing the burden on healthcare professionals and empowering patients with information. Large-scale networks such as Facebook, WhatsApp, and SMS platforms provided quick and reliable information to people, proving the effectiveness and importance of digital health in times of crisis.

Long-term investment in digital health infrastructure is crucial for preparedness. Digital health platforms that served the needs during the pandemic may no longer exist and need to be maintained for future use. Another pandemic is inevitable, thus preparation is necessary to ensure a timely and effective response.

Technology can be utilized as a great enabler to decrease health inequalities and improve digital literacy. By leveraging technology, health services can reach marginalized populations and bridge the gap in access to information and services. Digital health is a mature field with the potential for large-scale implementation, as evidenced by numerous case studies of successful implementations.

There is excitement and a positive view towards the role of youth in the evolution of the digital health field. Engaging youth and integrating their perspectives can lead to innovative solutions and advancements in the field. This aligns with the broader goals of SDG 3 (Good Health and Well-being) and SDG 4 (Quality Education).

In conclusion, mobile technology, low-tech solutions, and digital health have the potential to significantly improve health outcomes in Sub-Saharan Africa. Designing solutions with a human-centric approach, addressing systemic issues, collaborating with telecommunications companies, and considering diversity can enhance the effectiveness and inclusivity of digital health services. The COVID-19 pandemic has further emphasized the importance of digital health in reducing burdens on healthcare professionals and empowering individuals with information. Long-term investment in digital health infrastructure and harnessing the potential of technology are vital for achieving health equity, reducing inequalities, and improving overall well-being.

Rajendra Gupta

The analysis highlights the importance of digital health training for various stakeholders in the healthcare sector. Firstly, it emphasises the need for policy makers to be adequately trained in digital health. The International Society of Telemedicine and E-Health, with memberships in 117 countries, is an influential body in promoting digital health training. Additionally, the World Health Organization (WHO) has established a capacity building department in 2019 to support policy makers in this area.

Moreover, it is essential for frontline health workers to receive affordable and accessible digital health training. In India, ASHA workers, who are the first responders in healthcare, will be provided with affordable £1 training in the next two months. This will enable them to effectively utilise digital health tools and technologies in their work.

Patients also need to be trained to use digital health technology effectively. They should be educated on how to open an app, use it, and understand privacy and security measures. The International Patients Union is actively involved in training patients to use digital technology, ensuring they can benefit from its potential in managing their health.

The analysis also highlights the role of governments in addressing health equity and the digital divide, particularly in low- and middle-income countries (LMICs). Governments, such as India, have launched initiatives to provide digital healthcare access to underprivileged populations. For instance, India offers free telemedicine services through 160,000 health and wellness centres across the country. Additionally, the government has rolled out 460 million health IDs with plans for 1 billion under the digital health mission. These efforts help bridge the gap in healthcare access and promote health equity.

A well-crafted policy and substantial government investment are deemed essential for the successful implementation of digital health programs. The Indian government, for instance, has established a national digital health mission and is investing in advanced systems like artificial intelligence and natural language processing to enhance telemedicine services. They are also rolling out the Ayushman Bharat Health Account number (ABHA number) to further support digital health initiatives.

Digital health is seen as a promising solution for health inequity and has the potential to bridge the gap between urban and rural healthcare service delivery. Technologies such as conversational AI and chatbots can offer basic health consultations for routine problems, while the creation of 460 million health records in India demonstrates the progress being made in digitising health information.

The analysis also acknowledges the role of technology during the COVID-19 pandemic. It highlights fast-track vaccine development through global collaborations and the use of artificial intelligence for repurposed drug use. The delivery of 2.2 billion vaccinations digitally through a COVID App further demonstrates the readiness of technology in responding to the pandemic.

The momentum of using technology in the health sector must be maintained, with government incentives and flexibility in telehealth during the pandemic playing a crucial role. Additionally, digital literacy is important for anyone in the health sector, with initiatives such as the Digital Health Academy collaborating with Google to create developers for health. Courses on robotics, artificial intelligence, and digital health are being developed to ensure that individuals at all levels of the healthcare sector possess the necessary skills.

It is further highlighted that those who do not understand digital health risk becoming professionally irrelevant. Therefore, it is crucial for healthcare professionals, including doctors, to stay updated on digital health developments to better serve informed patients.

The analysis points out that scalability is crucial in healthcare. This means that the ability to expand digital health initiatives and ensure they are accessible to all is of utmost importance in order to achieve the desired impact in improving healthcare delivery.

Overall, the analysis underscores the importance of digital health training for policymakers, frontline health workers, patients, and the broader healthcare sector. It highlights the role of various stakeholders, including private organisations, civil society, and governments, in promoting digital health literacy, addressing health equity, and bridging the digital divide. The analysis also highlights the potential of technology in managing healthcare, particularly during the COVID-19 pandemic. Moreover, it emphasises the need for digital literacy and scalability in order to maximise the benefits of digital health in the healthcare sector.

Yawri Carr

The analysis delves into several key topics related to digital health and technology. One of the main focuses is the Responsible Research and Innovation (RRI) Framework, which aims to harmonise technological progress with ethical principles. The framework advocates for policies that preserve digital rights and establish mechanisms of accountability. This is seen as crucial in guiding the development of digital health technologies, ensuring that they are ethically sound and aligned with societal values.

Ethical considerations in the development of digital health technologies are explored further. It is argued that in competitive environments, where efficiency, speed, and profit are prioritised, ethical concerns can be compromised. This tension between ethics and industry objectives highlights the need for a careful balance between technological advancements and ethical principles, ensuring that technology is developed in a responsible and sustainable manner.

The involvement of youth in digital health is highlighted as a significant factor in bridging the digital divide and enhancing digital health literacy. Youths can play a crucial role in the research process, ensuring that interventions are culturally sensitive and address the specific needs of their communities. Innovation challenges and mentorship programmes are seen as powerful tools for guiding youth in the development of their ideas. Additionally, digital health literacy programmes can be initiated to equip young individuals with the necessary skills and knowledge to navigate the digital health landscape effectively.

The analysis also emphasises the importance of youth participation in internet governance policies. By actively engaging in discussions and decision-making processes, young advocates can ensure equitable access to digital health resources. It is argued that youth coalitions can amplify their collective voice on topics such as digital health equity, ultimately driving positive change and promoting inclusivity in healthcare.

Innovation hubs are suggested as a collaborative platform where young innovators, healthcare professionals, and policymakers can come together to create solutions for digital health challenges. The involvement of supportive companies and resources can aid in filling innovation gaps and promoting meaningful advancements in the field.

During a pandemic, telemedicine and the implementation of robots are highlighted as crucial. Telemedicine enables the delivery of remote healthcare, minimising contact and reducing the risk of contagion for healthcare workers. Robots, on the other hand, can perform tasks considered dangerous or dirty, thus protecting the health of patients and medical professionals.

The analysis also supports the initiative of Open Science, emphasising the importance of open access to data and research. Costa Rica’s proposal for an open science initiative to the World Health Organization (WHO) is highlighted as a positive step towards facilitating collaboration and partnerships for the advancement of digital health technologies.

The role of technology in emergency situations is underscored in the analysis. It is argued that technology can help protect healthcare professionals and patients during emergencies, providing essential support and resources to mitigate risks and ensure effective healthcare delivery.

Finally, the analysis recognises the value of ethicists’ work and emphasises the importance of their active involvement in discussions about responsible AI. Ethicists are seen as vital in ensuring that the development and deployment of AI technologies align with ethical considerations and respect for human values.

In conclusion, the analysis provides a comprehensive examination of various aspects of digital health and technology. It highlights the importance of ethical considerations, youth engagement, innovation hubs, and the role of robots and telemedicine. The insights gained from this analysis further emphasise the need for responsible and inclusive development of digital health technologies, while recognising the value of collaboration, inclusivity, and ethics in driving positive advancements in the field.

Speakers