A new report by a partnership involving IDS researchers on the rapid growth of digital health services since Covid-19 warns that governance systems have not kept up with the pace of change, leading to concerns over the cost, quality and accessibility of provision.
In response to the pandemic many governments removed regulatory constraints to digital health (temporarily or permanently) to quickly establish digital services, from smartphone apps to online and phone consultations, and more recently the use of AI and machine learning.
Now an industry worth US $210 billion, the global digital health sector is set to continue to grow at pace over the next few years. This has created new kinds of partnership between the public and private sectors and led to the entry of new market players, which the report identifies has also led to concerns about how this could change power relations in the health sector.
Impact on the health ecosystem
The report ‘Towards Digital Transformation for Universal Health Coverage’, looking at countries including Kenya and India, highlights that digital technologies do not just affect specific services but are part of the broader health ecosystem. Over time, they are likely to transform many aspects of how the system is organised. The kind of system that emerges and the degree to which it addresses social goals, such as equitable access to health care, will depend on action by government and other stakeholders.
The report warns that public policy cannot leave this kind of transition to market forces, and that the success of digital innovations will ultimately depend on their incorporation into the health system, the capacity of governments to manage this change and the creation of sustainable business models.
Dr Gerry Bloom, Research Fellow at IDS and co-author of the report, said:
“Governments must play a major part in how change happens. They require capacities and support to bring together different capabilities and expertise around common goals that include providing access to care, improving quality of care and lowering cost.
This strongly corresponds with the WHO Council on the Economics of Health for All’s recommendation for a collective, inclusive approach, to ensure health innovation ecosystems are governed for the common good.”
The report’s authors call for mechanisms to include the needs and perspectives of multiple stakeholders, including the most vulnerable and marginalised to ensure equitable and accountable health systems.
Equity-led approach to digital health transformation
To support the inclusion of different stakeholders in the management of complex digital health systems, the partnership, known as the Mutual Learning for Mixed Health Systems platform, is supporting and encouraging experimental learning approaches. These multi-year processes convene diverse stakeholders from health and non-health sectors to build an understanding of the opportunities and potential problems associated with digital health innovations. They also generate evidence and stimulate new thought processes on innovative ways to incorporate new technologies into strategies for improving health service performance.
The aim is to build national capacities to manage digital health transformation and create a mechanism for mutual learning between countries in the context of global digital health industry where changes in market shaping or governance arrangements in one country are likely to affect other countries.
The report is based on a multi-year consultation with over 300 senior government officials, elected representatives, leaders of private companies, technology innovators and health system analysts working in Asia, Africa and Latin America.