Digital transformation as a new determinant of health

Elena Torrente
 

The Spanish Ministry of Health has recently published the Digital Health Strategy of the National Health System. The document, closely aligned with the WHO and European Union strategy on this matter, presents three main lines of action:

1. Development of digital health services aimed at people, organizations and processes that make up the health protection system, with an equity approach.
2. Generalization to the maximum of the interoperability of health information.
3. Promotion of the analysis of data related to health, its determinants and the health system.

The three lines seem very appropriate given the new context of the digital health boom that COVID-19 has brought with it.

The first point appeals to the accessibility that technology allows. The pandemic has meant a before and after in the use of telemedicine throughout the world and new channels of access to health services have been generated, both in the public and private sectors. In many cases with a reasonable degree of satisfaction on the part of professionals, according to recent articles like this one, and also on the part of citizens whose expectations to continue using virtual care when the pandemic ends are high, according to this study.

The second point deals with interoperability, that is, the need to adapt computer systems to guarantee the exchange of clinical information between health systems on a national and international scale. Finally, the reinforcement of data analysis is promoted as a means to optimize clinical decision-making, planning and management, something that will be essential in the future as Cristina Adroher magnificently analyzes in her recent post.

Another element that appears in the strategy and that I would like to point out is the participation of people in managing their health, emphasizing lifestyles and prevention.

The contribution of digital technology to health

There are many opportunities that technology offers to promote healthy lifestyles, from the creation and dissemination of content on a global scale to the numerous devices, wearables and health apps that are created daily. Technology should be used as one more tool at the service of health promotion and disease prevention interventions, given the potential for personalization that it entails.

We know that individual behaviour and lifestyle habits make up an important determinant of health along with factors such as genetics, the environment and the socio-economic context, among others. Recently, The Lancet and Financial Times Commission has published an interesting report (see here) where the need to consider digital transformations as a new determinant of health is raised.

The article states that social determinants of health, such as age or socioeconomic background, have a direct influence on how technologies are used for issues related to health and well-being. In this sense, the usefulness of digital health depends on the level of digital health literacy that each person has. On the other hand, we know that access to technology and proven and reliable sources of information are essential for making decisions that promote healthy lifestyles. During the pandemic, it has been clearly shown how technology influences trust in health systems, both in a positive sense (dissemination of contagion prevention campaigns on social networks) and negative (anti-vaccine movements, dissemination of hoaxes...).

The report concludes with four areas for action to shape the future of health in a digital world:

1. Consideration of digital technologies as increasingly important determinants of health.
2. Construction of a governance architecture that generates trust in digital health by granting rights to patients and vulnerable groups.
3. Collection and use of health data based on the concept of data solidarity to simultaneously protect individual rights, promote the public good potential of such data, and build a culture of data and capital justice.
4. Definition of digital health strategies and clear investment roadmaps in all countries, which help prioritize those technologies that are most necessary at the different levels of digital health maturity.

It seems that on the last point the homework has already been done in Spain, another thing will be its start-up and implementation by the competent bodies in the territory. For all this, the activation of European Next Generation funds through the Strategic Project for Economic Recovery and Transformation (PERTE) for Vanguard Health to mitigate the determinants of health of digital origin will be essential.

Bibliography

• Accenture Patient Survey May 2020. How COVID 19 will permanently alter patient behavior.
• Prof. Ilona Kickbusch, PhD; Dario Piselli, MSc; Prof. Anurag Agrawal, PhD; Prof. Ran Balicer, PhD; Prof. Olivia Banner, PhD; Michael Adelhardt, MD, et al. The Lancet and Financial Times Commission on governing health futures 2030: growing up in a digital world. October 24, 2021.
• Ministerio de Sanidad. Estrategia de salud digital del Sistema Nacional de Salud. 
• Vidal-Alaball J. et al. (2020). Primary Care Professionals’ Acceptance of Medical Record-Based, Store and Forward Provider-to-Provider Telemedicine in Catalonia: Results of a Web-Based Survey. Int. J. Environ. Res. Public Health, 17, 4092 2 of 13.