What Is Digital Health?

Digital health is an umbrella term that encompasses an array of information and communications technologies used in health care, including mobile health (mHealth), telehealth/telemedicine, eHealth, health information technology (IT), health management information systems, use of blockchain technology, and artificial intelligence. These digital health technologies can support individuals, health providers, and health systems managers to make informed decisions and engage individuals to improve demand, access, coverage, quality, and affordability of health care for everyone.

Digital health interventions can be used for a wide variety of purposes. The World Health Organization (WHO) classifies digital health interventions based on four categories of intended users: clients, including current and future users of health services and their caregivers; health care providers; health system or resource managers; and data services, or service providers that help manage data for users. Examples of the activities under each target user category include:

  • Interventions for clients: Targeted client communication, personal health tracking, on-demand information services, clients’ financial transactions.
  • Interventions for health care providers: Client health records and identification registration, telemedicine, referral coordination, prescription management, and health care provider training.
  • Interventions for health system managers: Health financing and management of human resources, supply chains, facilities, and equipment.
  • Interventions for providers of data services: Data collection, management, use, and exchange.

Learn more about WHO’s Classification of Digital Health Interventions and Draft Global Health Strategy on Digital Health 2020-2024.

 

Digital Health Enabling Environment

Building an environment that promotes widespread use of digital health technologies is critical to the success of investments in digital health. The digital health enabling environment consists of interrelated building blocks that support a robust national digital health ecosystem and the individual applications and systems that work within it. To help countries adopt, employ, and scale up use of these technologies, WHO and the International Telecommunications Union (ITU) developed the National eHealth Strategy Toolkit to provide a standard framework and best practices for building a strong enabling environment. The building blocks for this enabling environment include:

  • Leadership and governance: Manage national-level coordination of digital health investments and strategic planning activities. Learn more about the Country Health Information Systems Data Use (CHISU) project to strengthen host country capacity and leadership to manage and use high quality health information systems to improve evidence-based decisionmaking.
  • Strategy and investment: Organize and prioritize long-term investments and plan for the country’s digital health environment. Learn more about the Digital Health Investment Review Tool and the Principles for Digital Development to support strategic investments in the use of digital technologies to support public and global health.
  • Legislation, policy, and compliance: Enact policies and legislation that support and align with the digital health strategy as well as advance the broader digital health enabling environment.
  • Services and applications: Build a national portfolio of digital health services and applications. Learn more about current country digital health investments in the Digital Health Atlas. The Digital Square project also helps bring together partners to improve how the global community designs, uses, and pays for the digital health tools and approaches. In addition, the Data.FI project brings together leaders across the digital health and analytics landscape to harness the power of data to end the HIV pandemic.
  • Standards and interoperability: Develop standards needed to advance standardized collection and exchange of accurate data and information across digital health systems, platforms, and organizations. The use of standards (for example, vocabulary, format, transport, and process) in digital health systems advances the interoperability of data across unaffiliated systems, enables reuse of data and reduces fragmentation. Learn more about the Health Information Systems Interoperability Maturity Toolkit that countries are using to assess their level of maturity and opportunities for improvement.
  • Infrastructure: Invest in physical infrastructure (for example, networks and servers), equipment (for example, phones and computers) as well as an integrated set of common and reusable software components (for example, identity management) needed to support a cohesive portfolio of digital health systems. Learn more about developing a country digital health infrastructure in the WHO and ITU Digital Health Platform Handbook: Building a Digital Information Infrastructure for Health.
  • Workforce: Build the digital literacy and capacity of the health workforce to apply digital tools and inform digital health system design and workflows to improve service delivery, health system management, and patient outcomes.
  • Integration and sustainability: Identify and promote sustainable financing models to inform future products and services, including integration and maintenance. Learn more about this building block in the WHO Draft Global Strategy on Digital Health 2020-2025.

When these building blocks are addressed in a coordinated way, they improve health system performance and outcomes, as well as influence the scalability of digital health interventions to strengthen family planning and reproductive health programs. Stakeholders are working to better understand countries digital health enabling environments and align digital health investments to address a clear set of requirements and use cases(s) to move towards more sustainable and scalable systems.

To assess their digital health enabling environment and monitor progress towards implementing digital solutions at scale, countries can use the interactive Digital Health Index. This tool can help decisionmakers address the policy environment for digital health and make informed decisions about resource allocation.

Few countries have robust policies or strategies in place to be able to take full advantage of the benefits of digital health. The success of digital health in a country also requires relevant government agencies across multiple sectors to collaborate, including health, information and communications technology (ICT), economic, science, innovation, and data privacy and protection agencies. Governments, development partners, and other stakeholders must coordinate investments in the digital health enabling environment to reduce fragmentation of digital health technologies and ensure that different ICT platforms and applications can connect and exchange health information with each other. While this may seem like a daunting challenge, emerging country lessons and successes are paving the way for stronger country digital health enabling environments. Examples of how countries are addressing the digital health enabling environment include:

  • Leadership and Governance: In Ethiopia, the federal Ministry of Health is working to advance health sector transformation priorities to improve quality and equity of health care services. This work is supported by the Information Revolution Roadmap that focuses on improving health data collection, analysis, sharing, and use to improve decisionmaking. To accelerate the efforts, the Ministry of Health established a health information system governance framework to lead and coordinate investments across stakeholders. Through the Ministry of Health leadership and coordination of stakeholders in governance bodies, Ethiopia has been able to advance the Information Revolution Roadmap priorities. This model of cross-agency collaboration demonstrates how country leadership and good governance can more effectively manage national-level coordination of digital health investments.
  • Strategy and Investment: The Government of Tanzania has shown commitment to health sector transformation by developing and endorsing a National eHealth Strategy and a companion Digital Health Investment Roadmap. Together the strategy and the financial investment roadmap provide clarity on the existing digital health IT infrastructure, and the government’s priorities for future investments and activities. The government-led Digital Health National Steering Committee and technical working group utilize the documents to coordinate activities and investments with government leaders, implementers, and donors to help reduce data and IT silos in the health sector and advance health sector transformation priorities. This approach shows how a national vision and strategy can provide a framework for stakeholders and governance bodies to organize and prioritize investments.
  • Standards and Interoperability: In South Africa, the Department of Health developed the National Health Normative Standards Framework for Interoperability in eHealth to enable health information to be shared electronically across disparate IT systems to improve care coordination and improve health outcomes. The Framework references international and national digital health standards so that digital health implementers can align their IT solutions to enable exchange and use of health information by health system managers, providers, and individuals across disparate organizations and IT systems. Curating and publishing national digital health standards and guidelines supports health sector data sharing, data aggregation, systems integration, and advances interoperability of health sector data.

The U.S. Agency for International Development’s Digital Health Vision presents a roadmap for how USAID can support its partner countries as they strengthen the digital transformation of their health sectors, by encouraging strategic planning, strong governance, interoperability of data and digital systems and a data use culture to enable long-term sustainability. It calls for the Agency and its partners to support four strategic priorities:

  1. Country-level capacity in digital health: invest in the digital health enabling environment, including leadership, governance, and workforce capacity to enable investments in digital tools to succeed.
  2. National digital health strategies: align with and support national digital health strategies and costed implementation roadmaps as an organizing framework for funders’ investments in digital tools.
  3. National digital health architectures: invest in and support country digital health architectures that establish a blueprint for country information needs, interoperability plans, and software and hardware requirements.
  4. Global goods: support development and use of adaptable and reusable knowledge products (e.g., reference guides, toolkits) and software tools (often, but not always open source) that are adaptable and reusable.

Through mechanisms, such as, Digital Square, Data.FI and the Country Health Information Systems Data Use (CHISU), USAID is supporting these strategic priorities to bolster low and middle-income countries digital health enabling environments.

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