Data-driven solutions to strengthen health systems in a post-COVID-19 world

Digital transformation is needed to create data-driven health ecosystems 

The panel was in agreement with Marcelo D'Agostino, who has discussed strategies to strengthen health systems post-COVID with Ministries of Health, and put forward that creating data-driven ecosystems is the most relevant solution to strengthen the first line of care as systems re-open.

Incentivising the public to share data
For that to be possible, however, the panel agreed that aggregated, anonymised patient data are essential:  this will enable improved health system decision-making and medical innovation. While public resistance to sharing data with government and health systems has lessened during the COVID-19 pandemic (as exemplified by the willingness to participate in contact tracing programmes) Joanne Hackett pointed out that once the crisis has passed the public may require incentives to share their data, such as increased access to diagnostics.

Maintaining trust, transparency, and data security are key
While there are privacy and security concerns surrounding the collection of non-anonymised, non-aggregated data (i.e. data for specific individuals), Marcelo D’Agostino made the point that it is hugely valuable as it allows health systems to identify people who are vulnerable or at risk.

Panellists reinforced the need for trust and transparency; citizens must believe data are securely held and concerns about data breaches must be addressed. The need for clear data governance strategies with guiding principles and data-sharing agreements – at national and transnational levels – was universally agreed. Tõnu Esko suggested the use of Blockchain for trustful data-sharing, highlighting its use in Estonia to maintain nationwide electronic health records. 

John Lim put forward that there are three governance and regulatory areas that need to be addressed in order to facilitate digital health; interoperability, confidentiality of data, and equity. While John acknowledged that countries need to start by assessing their own infrastructure, regional and global approaches can also help in this regard.

It was agreed that health systems cannot work in isolation and must embrace new concepts for public health, including partnerships with other sectors such as finance, education, and technology. 

Smart partnerships can strengthen the ability of health systems to deliver data-based solutions

Effective ecosystems which integrate the public and private sectors as well as academia can support health systems in managing the transformation to deliver data-based solutions. Tony Estrella made the point that public-private innovation activities, such as sandboxes, also democratise data by providing immediate visibility on findings and outputs, to help people and improve health outcomes.

Collaboration supports innovation
Joanne Hackett felt that unfair demands are placed on health systems to innovate, incentivise partnerships, and deliver quality health care. Her view is that external expertise can be used to enhance the abilities of both the health system provider and the supplier.  Joanne pointed to those initiated during the current COVID crisis between health systems and pharmaceutical companies to develop a vaccine.

Tõnu Esko suggested that many of the solutions required to rapidly tackle the pandemic have come from the private sector, as it has resources and the freedom to operate. Conversely, a lack of action and limited services are typically seen when there is a disconnect between public and private. To reinforce his point, Tõnu mentioned his collaboration with academia and tech starts ups to develop a digitalised COVID-19 Immunity Passport. 

An integrated, multinational approach 
Steve Guise reinforced the crucial role the private sector can play. Multinational companies working with health ecosystems across the globe can be an integrating force – reducing fragmented, national or even local approaches. He shared his experience from within Roche, where real-world data are used to drive R&D productivity and bring medicines and diagnostics to patients faster. 

Working together to reduce misinformation
The panel discussed strategies to manage the “infodemic” – the abundance of information, misinformation, and data – which can build up, particularly during crises such as COVID-19 or Zika. Public-Private partnerships were offered as a solution, with John Lim stating that they reinforce understanding and trust in information. He made the point that partnerships are critical because information – even if accurate – raises more suspicion if it is only from one source and not coordinated from, or validated by, others. 

It was agreed that enormous amounts of effort and money are spent in health systems which can be optimised and maybe even eliminated through the use of technology. Technology also has the potential to reduce health inequities and disparities in access. 

Countries must leverage technology to increase health coverage

COVID-19 has accelerated the adoption of telemedicine, and Tony Estrella made the point that countries without an existing healthcare legacy have seen especially rapid adoption rates. With the “mobile first” mindset already established in many parts of Asia, apps such as MyDoc, which offers online consultations, electronic prescriptions and medical certificates, has seen 60% plus adoption rates in Singapore and Hong Kong. 

Tõnu Esko emphasised the need for health systems to uniformly increase digitalisation and standardisation, stating that you “can’t have telemedicine if you’re still using paper forms” and pointing to Estonia’s widespread adoption of online prescriptions (99.9%). 

Overcoming inequity of access
Marcelo D’Agostino highlighted that hundreds of millions of people live without internet, and as such data-driven solutions cannot be seen as a panacea for access. He urged the consideration of strategies to connect the disconnected. The panel considered ways of reducing these inequities, with John Lim offering that telemedicine can achieve democratisation of data and access, and ensure similar health models are accessible for all. With smartphones individuals have power and diagnostic capacity at their fingertips.

Delivery of data-driven solutions supports society’s broader health goals

The panel agreed that an effective ecosystem is one in which the public and private sectors and academia work together to implement something that is digitalised, secure, and draws from private sector experience to serve the public good. By implementing data-driven solutions and democratising data and access, health systems can come closer to achieving the broader health goals wanted by all – reduced health inequities and delivery of universal health care. 

However, this cannot be achieved without citizens sharing their data. Public outreach and education will be required to maintain trust in the security of data, address misinformation, and support the adoption of data-driven solutions.

Watch the full discussion here:

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