Digital systems support equitable healthcare

By ITU News

For the elderly, for the poor, or for people in rural communities, access to healthcare services has always presented challenges. Digital health systems promise to transform this, making medical diagnoses and advice easily available everywhere.

In the best circumstances, new health platforms have already helped to empower patients, facilitated relief for people who are vulnerable or in distress, and enabled healthcare providers to deliver better care and treatments, especially during global health emergencies.

Digital health systems, however, rely on robust infrastructure – a basic requirement that can make equitable access elusive, according to South Africa’s Minister of Communications and Digital Technologies, Khumbudzo Phophi Silence Ntshavheni.

“With many essential services now being pushed online, there is a real and present danger that those without broadband Internet access could be left even further behind,” she said in her recent keynote at the Global Standards Symposium.

Barriers to digital health adoption

Even with infrastructure in place, challenges remain to make digital health services work for everyone.

“If we want people to use digital health services and we want people to feel confident in using them, whether young or old, we need to build the trust in the services,” Petra Wilson, Senior Advisor of Personal Connected Health Alliance. “We need to have people feel that their data is safe, that their privacy will be respected, that the services delivered digitally are as good as… face‑to‑face services.”

She identifies three inter-related barriers to digital health for older persons in particular:

1) Trust: The sense of familiarity and reliability, which must be earned, nurtured, and continually reinforced.

2) Digital literacy: Patients and health-care providers need to build digital literacy and digital health literacy with an understanding of what tools are available and how these can be used.

3) Offering: Recognition by providers that there is not a one‑size‑fits‑all and that some services may need to be tailored to older people or other kinds of patients.

Wilson stresses the importance of standards, along with the interoperability they support between different disciplines and use cases. For example, environmental data systems on pollution need to interoperate smoothly with health apps to inform patients with respiratory problems when specific activities may pose a risk.

Standards to safeguard social responsibility

Healthcare technologies inherently cut across technical and social disciplines.

For Yong-Jick Lee, President of the Center for Accessible ICT (information and communication technology) in the Republic of Korea, this entails “a greater social responsibility than any other ICT application that has ever emerged.”

Lee encourages digital health developers to pay due regard to bioethical issues, the multi-faceted digital divide, and the need to secure reliable online access for persons with disabilities and older persons, who may acquire age‑related disabilities. “Technical standards related to the social responsibility of digital health care are absolutely necessary,” he says.

The need for flexible alternatives

As well as optimizing clinical care, digital health technologies can enhance ongoing health research. They offer new opportunities to address long-standing challenges, such as low doctor-patient ratios or helping patients overcome the stigma of mental disorders or certain communicable diseases.

The COVID-19 pandemic and the accompanying restrictions on daily life have made the need even more apparent for viable, scalable, and flexible alternatives to supplement traditional health treatments, said Leonidas Anthopoulos, Professor of E-business and Strategy at the University of Thessaly in Greece.

Remote monitoring and telemedicine facilities, combined with digital health records, have enabled the ongoing flow of information, limiting the need for direct contact during the pandemic of the past two years.

“However, the use of digital technologies for clinical care is not without challenges, including data quality, privacy, security as well as regulatory concerns related to digital health records”, Anthopoulos adds.

Driving digital standardization

A global shortage of medical doctors, exacerbated by COVID-19, made the need for digital technologies increasingly urgent. However, widely recognized standards were not yet in place to scale up sustainable solutions. “The inter-operational capabilities and standards − they’re absolutely critical,” said Stefan Germann, chief executive at Fondation Botnar, a Swiss philanthropic foundation.

But getting stakeholders on board to drive digital health standardization has not been easy, either within or between different national jurisdictions, he added.

“What it requires is really strong collaboration between the relevant ministries. This cannot be solved by the ministry of health itself.”

Germann called on governments to promote the necessary standards and accountability, especially among entrepreneurs in the tech sector. Key objectives for the industry can thereby contribute to socio-economic enhancements, in line with the Sustainable Development Goals (SDGs) adopted by the United Nations for 2030.

“Only in that way can we actually see that some of the adoption of the standards takes place, so that we have sustainable, scalable solutions in digital health,” he said. “Through that, hopefully, we’ll achieve the Sustainable Development Goals related to health, especially universal health coverage.”

Metrics to build trust in AI for health

The UN’s 2030 sustainability agenda, centred on the 17 SDGs, provides a framework to keep societal needs at the centre and ensure no one is left behind.

Two of the UN’s specialized agencies – the World Health Organization (WHO) and the International Telecommunication Union – see myriad opportunities to improve health services through artificial intelligence (AI).

Thomas Wiegand, Chairman of the ITU/WHO Focus Group on AI for Health and Executive Director of German research and development organization Fraunhofer HHI, noted the crucial role of technical standards developed through the broadest possible collaboration.

This occurs at the global level by way of ITU, the International Organization for Standardization (ISO), and the International Electrotechnical Commission (IEC), as well as regionally and nationally through other standards-developing organizations. The resulting standards ensure the quality, reliability, and accessibility of digital health technologies and applications in diverse markets, while helping developing economies keep up with technological advances.

The ITU/WHO Focus Group is developing a benchmarking framework for AI solutions, supporting global efforts to step up AI’s contribution to health. An open-code proof of concept for the benchmarking platform showcases the type of metrics that could help developers and health regulators certify future AI solutions, in the same way as is done for medical equipment.

Wiegand, too, stressed the need to bring health and medicine specialists together with government representatives and regulation and ethics experts, as well as engineers, technicians, and business people.

“You have to bring them all together,” he said, citing the Focus Group on AI for Health as an example.

Participants from around the world are studying AI solutions in 24 topic areas, from neurology and radiology to dermatology and outbreak detection, looking at key aspects for clinical evaluation, data, ethics, regulations, and modelling for health-care services.

Partnership tackles COVID-19 infodemic

ITU and WHO recently teamed up with the Pan American Health Organization (PAHO) and to combat misinformation and strengthen vaccine acceptance in the Eastern Caribbean. Last October, the three organizations, in partnership with regional media and advertising group Trend Media/Digicel, launched a public health education campaign to tackle the COVID-19 “infodemic” in Antigua and Barbuda, Grenada and Saint Lucia.

By sending key health messages, videos, and images via Short Message Service (SMS) and other electronic platforms, the eight-week campaign helped to spread reliable, evidence-based advice and guidance on COVID-19 vaccines to vulnerable people and communities. Topics included how vaccines are developed, how vaccines work, safety, side effects, and the benefits of vaccines.

About the Global Standards Symposium

Industry leaders and policymakers came together on 28 February to discuss how international standards supporting digital transformation can accelerate progress towards the SDGs. The symposium’s conclusions were submitted to ITU’s World Telecommunication Standardization Assembly (WTSA), which took place 1-9 March.

Download Global Standards Symposium conclusions.

About the “Artificial Intelligence for Health” Focus Group and how to get involved.