The promise of digital health: addressing non-communicable diseases to accelerate universal health coverage in LMICs

Nyhan, Marguerite M.

The promise of digital health: addressing non-communicable diseases to accelerate universal health coverage in LMICs

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2018-the-promise-of-digital-health-full-report.pdf(7.18 MB)

Published Version

Date

2018-09

Authors

Nyhan, Marguerite M.

Publisher

Broadband Commission for Sustainable Development

Abstract

Digital health solutions promise to change the way healthcare is provided, driving progress toward universal health coverage and transforming outcomes for patients with NCDs Worldwide, non-communicable diseases (nCDs) are responsible for more deaths than any other disease Non-communicable diseases account for approximately 70% of deaths worldwide, of which three-quarters occur in low- and middle-income countries (LMICs).1 Funding for tackling NCDs is low compared to other diseases and preventive measures in particular would have a significant impact.2 To combat nCDs, we need to transform the way healthcare is provided and expand access to all. Without properly addressing nCDs, universal health coverage (UHC), a target of sustainable Development Goal (sDG) 3, cannot be achieved Health systems must move toward universal health coverage and shift… • from facility-based care to communitybased care with a focus on increasing health system capacity and efficiency • from episodic, curative care to longterm, continuous care to institute a people-centered focus with improved access • from reactive care to proactive, preventive care featuring forwardlooking health management with improved transparency Digital health can help make these shifts possible Digital health encompasses the use of information and communications technologies (ICT) in all their forms for health. This includes electronic health records showing patients’ health histories, mobile apps designed to raise awareness about diseases and internetconnected devices such as those that allow doctors to monitor patients’ blood glucose levels remotely. What these technologies have in common is that they can fundamentally change the cost-quality equation of healthcare and empower patients, health providers, governments, and other stakeholders with the information and tools they need to manage their own health, deliver better care and strengthen the underlying health system, thereby radically expanding access and improving outcomes. Investing in digital health to strengthen entire health systems can accelerate efforts to combat NCDs, and by the same token, investing in digital health specifically to combat NCDs can have wider health system benefits. Ultimately, digital health is a catalyst in transforming how healthcare is delivered and experienced, as it allows LMICs to move from disease silos in healthcare to an integrated, resilient health system. Digital technology is driving innovation in healthcare, especially in LMICs Unmet health needs driven by a lack of health infrastructure and trained health workers, widespread mobile penetration and relatively open regulatory environments make LMICs fertile ground for innovation. And with fewer entrenched, legacy systems to overcome, countries have an opportunity to “leapfrog” and adopt newer solutions faster. Digital health should be considered an essential part of the healthcare system, just as medical equipment or hospital beds are. The results so far are encouraging A few studies have evaluated the impacts of digital health, ranging from patientlevel results like reduced blood glucose levels to system-level results such as improved access to services and cost savings. In Canada, for example, the cumulative benefits of investing in digital health were estimated at around CAD$16 billion over the course of nine years.3 The results so far are encouraging and could be used to drive further investment and scaling of digital health solutions. To maximize the impact of digital health on nCDs in order to accelerate the achievement of UHC, solutions have to be financially sustainable Many digital health solutions are launched as pilots and are often not designed for scale and sustainability. This can lead to a fragmented, uncoordinated landscape of standalone initiatives. The simplest solutions – namely those designed with the needs of the end user in mind, that use existing technologies and are integrated in the existing health system, and which are widely available in the context – have the highest chances of being scalable and sustainable. This is demonstrated, for example, by the national scaling of telemedicine services in Ghana. This report provides examples, insights and recommendations for greater sustainability in digital health.

Keywords

Non-communicable diseases , Digital health

Citation

Broadband Commission (2018) 'The Promise of Digital Health: Addressing Non-Communicable Diseases to accelerate Universal Health Coverage in LMICs'. United Nations.