Digitalisation of Health Must Be Approached in A Holistic Manner Digital Health 08/12/2022 • Megha Kaveri Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to print (Opens in new window) Panelists at a digital health session at this week’s UNITE Global Summit in Lisbon. Digitalization of health services and systems needs to be approached holistically, and take a rights-based approach to services that makes access more equitable, not less so. These were two themes that emerged at a session on ditigal health as an enabler of universal health coverage at the UNITE Global Summit 2022, In Lisbon, Portugal this week. The Summit, from 5-7 December brought health-focused parliamentarians from countries around the world together to see how they might use their legislative clout more effectively to advance global health goals. Achieving universal health coverage by 2030 is part of the global SDG agenda and digitalisation could play a key role that goal, Dr Christoph Benn, the director for global health diplomacy at the Joep Lange Institute, Amsterdam, said at the panel session. But digital health trends could also increase inequalities, he warned. And that is something legislators need to be mindful of when initiating and reviewing digital health investments in their own countries. “There is a fast paced digital transformation that can increase the digital divide and leave more people behind. And I think our discussion is about how we turn that around to make sure that this really serves all people in need.” Dr Christoph Benn Benn added that a global framework on data privacy, ownership and security is another issue that would be important for parliamentarians to tackle at national level and multilaterally. Such frameworks are critical to build confidence in digital health systems that politicians support and people will actively use. “If you are asking me one issue where I feel, you know, parliamentarians can really make a difference, I think it is about legislating data governance principles in your various countries,” he said. In countries with federal systems of government, ensuring consistency in digital health platforms can be particularly complex because health systems, as well as related digital systems and regulations, may not be harmonized across different states or provinces, added Gisela Scaglia, a former member of parliament from Argentina. This is yet another issue for parliamentarians to address. Political will is a main component in transformation of health systems in any country. However, it is equally crucial that civil servants and politicians approach and overcome technical challenges, step by step, said Luis Goes Pinheiro, a senior Portuguese Health Ministry official. He described, for instance, how Portugal has used European Union funding to strengthen telecom infrastructure that would be critical for digital health interactions with the nation’s health centres via peoples’ smart-phones and computers. Infrastructure in about half of the 3,000 health services targeted have been improved over the past few years, he said, but many barriers have had to be overcome. Luis Goes Pinheiro “This is very challenging even for someone who’s been involved in the government,” he said, of the nuts-and-bolts issues that came up around strengthening health systems’ digital capacities. “In Portugal, we have 300 million Euros that we need to use by 2024,” he said. “So this is a major thrust there, but there are also headwinds all over the world. These are trying times when it comes to access to human resources, not just in the field of digital work. We need qualified people which are lacking and we need material resources. There’s been a breakdown in supply chains by the pandemic and made worse by the war in Ukraine.” In addition, political will is not always as strong as it should be, he pointed out, and this is something that legislators can be mindful about: “Creating projects whose results will come in the long term is always very unsettling for the government. Sometimes politicians think short term, but these projects need to have short, medium, and long term perspectives. Legislation is needed to institutionalize digital practices established during pandemic Dr Marisa Aizenberg, a lawyer and researcher in public health at the University of Buenos Aires also flagged the need for new legislation to drive digital transformation in health in the post COVID era, to make improvised telemedicine systems established during the pandemic more permanent. “We have had many emergency laws to validate digital tools like distance care or remote care and others. So I think this is a true challenge, digital transformation. It does not have just to do with public policies, but it’s legal. Legal instruments are necessary for this transformation to take place.” Dr Mariza Aizenberg And while formulating rules and norms around digitalisation is important, it must all be based on a human rights perspective, she added. “Otherwise, legislation may even be widening the inequalities, widening the gap. And when I talk about reasonable costs, I’m thinking about what happens to people with disabilities that won’t have access to these health technologies. I’m also talking about gender perspectives and vulnerabilities (like children and senior citizens) and how these adjustments are so important to include all these groups.” Stressing the need to have proper legislation in place for data protection and citizens’ privacy, Dr Aizenberg said. “Any new legislation must be able to be adapted quickly to the changes that take place and create a single digital health system.” Digitalization often in the Communications Ministry – not Health Digital health is, however, a multisectoral issue, Neema Lugangira, a member of parliament from Tanzania said. And she underlined that many countries place this portfolio under the Information and Communication Technology ministry and not in the health ministry. That can, however, create barriers for fit-for-purpose digital health systems to flourish. “When we’re talking about digital health, there needs to be some sort of alignment between the ICT ministry and the Health Ministry. So one of the first things that can enhance our role as parliamentarians is to have this multi-sector approach.” Neema Lugangira Along with a multi-sectoral approach from the government, Lugangira stressed the importance of viewing digitalisation of health on a continuum. In low- and middle-income countries in particular, this must begin with digital literacy, access to electricity and mobile connectivity. “We need to also look at their entire digital infrastructure. There’s access to electricity, access to just simple mobile connectivity and access to the knowledge and the skills (needed to use devices)…So if it’s digital health, how will that work? So we need to look at all of those things.” Multilateralism on the agenda To bridge the digital divide in developing countries like Mexico, developed countries must come forward to invest resources, said Sarai Nuñez Ceron, a member of parliament from Mexico, stressing the importance of multilateralism in digitalization of health systems. “Digital health should be a priority for the development of health systems everywhere in the world. This requires up to date dynamic regulations that can be a solid basis for the protection of people and also investment in innovation,” Ceron said. Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to print (Opens in new window) Combat the infodemic in health information and support health policy reporting from the global South. 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