Bridging the Global Digital Health Gap
Recently, Zoom announced a partnership with Suki Health to use artificial intelligence to help transform telemedicine visits. This innovation will likely transform healthcare. Zoom’s move is just one in a long line of disruptive technologies that not only change the way industries function but also give people new tools to improve their lives.
Photo credit: Unsplash (Chris Montgomery)
While the work of Zoom and other companies is admirable, as with many innovations, some people get left behind. The healthcare industry is no exception. Before entering the healthcare space, there were already concerns that technologies such as Zoom might be inequitable for individuals who lacked access to the connectivity needed to access such technologies that the company offered.
Digital inclusion disparities are stark, with socioeconomic factors such as age, race, and class status playing a critical role in determining who can benefit from these tools. For instance, those with limited English proficiency may struggle to navigate digital health platforms, further exacerbating health inequities. In addition, we must ensure innovations are also translatable to countries in the Global South, where such technologies can be invaluable to advancing health care. Health systems can adopt several strategies to ensure digital health solutions are inclusive and beneficial to everyone.
For one, these systems have to prioritize accessibility and affordability. There must be an investment in solid infrastructure, cost-effective solutions, and adaptable payment options. Solutions must also be culturally relevant, accessible in multiple languages, and developed with community input. They should be user-friendly for all age groups, accessible to individuals with disabilities, and continuously refined based on user feedback.
This must be done while protecting patient information and ensuring ethical data practices. As health equity leaders in our respective industries and organizations, we provide examples of how such principles have been implemented in our countries, Pakistan, Ghana, Ethiopia, and India. These examples can serve as valuable lessons for other systems seeking to expand healthcare technology strategies.
Expanding Access to Health Facilities
Telemedicine and collaborations between healthcare and technology organizations can bridge the physician-patient ratio gap between urban and rural areas by connecting patients in rural areas with doctors in urban centers, improving access to quality healthcare services.
In Pakistan, approximately 64% of people live in rural areas with limited access to health facilities. A collaboration between microinsurance provider Milvik BIMA and telecommunication organization Mobilink Jazz has eliminated the need for many physical visits to healthcare facilities by providing telemedicine services for individuals in the country who lack other sources of healthcare. This service is available for featured phone users, including 57 million people who do not have smartphones or broadband availability.
BIMA and Mobilink Jazz have also conducted health education plans to raise awareness about disease prevention through SMS, interactive voice response messaging and mobile app push messages.
The Authors are Atlantic Fellows for Health Equity: Dr. Zaki Abate, Samuel Akuffo, Dr. Hina Ghole and Jasmine Maringmei | Photo Credit: Abby Greenawalt.
Delivering Critical Supplies to Those in Need
Drone technology can provide logistics services for critical healthcare commodities, especially in hard-to-reach rural areas in Africa. Zipline, a Silicon Valley startup, has been making inroads in Africa since its launch in Rwanda.
Inaccessible locations, such as mountainous areas, islands, or even places with security risks, limit the movement of people and critical life-saving commodities like food, medicines and information.
Zipline drones have also delivered emergency interventions such as blood and provide preventative tools such as PPEs and vaccines.
Zipline CEO Keller Rinaudo leading the tour of the medical drone facility | Muhanga, 14 October 2016 | Photo Credit: Paul Kagame (Flickr)
During the initial COVID-19 outbreak, when there was a high demand for tests and testing services, the Ghana Ministry of Health collaborated with Zipline to use drones to provide COVID testing in local communities. The samples were delivered to Zipline distribution centers and sent to testing centers in the larger cities via drones, eliminating the need to drive for hours to testing centers in central cities. Zipline would send these samples to the testing centers in the main cities. Zipline also supported the government in distributing more than 3 million doses of COVID-19 vaccines to rural communities.
Addressing Other Pandemic Challenges
COVID-19 also exposed other limitations to many global health systems. To serve its population, which had the highest number of COVID-19 cases in Eastern Africa, Ethiopia had to leverage several digital health innovations to support its pandemic response, showing value in enhancing existing digital systems.
Two platforms — Vitas and mBrana — were customized to support end-to-end visibility of COVID-19 vaccine distribution. Vitas, a platform that supports warehouse management, inventory control, and logistics management information for the Ethiopian Pharmaceutical Supply Service, was customized to protect commodities required for the national COVID-19 response, quantify national demand, and support procurement and distribution operations.
mBrana, an open-source mobile platform, was integrated with Vitas to manage vaccine inventory at the district and zonal levels. This provided real-time access to vaccine availability, receipts, and issues, allowing users to quickly generate and send orders to hubs while tracking order progress.
India also uses digital tools to support the response to the ongoing COVID-19 pandemic. States like Kerala have further enhanced these efforts by introducing region-specific digital solutions, showcasing the potential for sub-national innovation. Within the first year of the COVID-19 pandemic, Kerala adopted digital solutions to manage the crisis and keep the public informed. One of the early initiatives was the “Break the Chain” awareness campaign, which utilized television, print media and social media platforms to educate citizens on preventive measures.
Photo Credit: Flickr
Collaborating with the CoronaSafe Network, a crowd-sourced resource for information about COVID-19, the state also launched online quizzes to enhance public understanding of the disease. As the severity of the pandemic became evident, Kerala developed more targeted digital tools, including the COVID-19 Jagratha portal and the GoK-Direct mobile application which became a trusted source of information, with over 500,000 downloads and a 4.5/5 rating on the Google Play Store.
“Innovation should be directed at solving a need for the patient, the service provider, or the system.”
Kerala’s innovative use of digital platforms extended beyond information dissemination to include creative methods for engaging the public and addressing healthcare gaps during lockdowns.
There is a great need for more investments in innovative technologies in the Global South to enhance health further. Our examples demonstrate just a small amount of the potential that such innovations have for improving health and service delivery to normally inaccessible regions.
Innovation should be directed at solving a need for the patient, the service provider, or the system. This means digital interventions must begin by identifying the pain points of the customer or patient and must also have beneficial linkages to other parts of the health system. As new and innovative technologies continue to emerge, it is critical that these approaches also be made available to diverse global communities.
