Digital-in-Health: Unlocking the Value for Everyone

Digital technology can strengthen health systems, improve health financing and public health, and increase reach to underserved populations, according to a new World Bank report launched today. The report also finds that digital technology and data are especially helpful to prevent and manage chronic diseases, care for both young and aging populations, and prepare for future health emergencies and health risks triggered by climate change.

The report, Digital-in-Health: Unlocking the Value for Everyone, was launched today during the G20 Health Ministers Meeting in Gandhinagar, India. It presents a new way of thinking from simple digitization of health data to fully integrating digital technology in health systems: Digital-in-health. This means, for example, infusing digital technologies in health financing, service delivery, diagnostics, medical education, pandemic preparedness, climate and health efforts, nutrition, and aging.

The report also underscores that the successful use of digital technologies must be inclusive of all population groups, and ensure access to digital infrastructure, modern technologies, and skills, especially for vulnerable people.

Designed with people at the center, digital technology can make health services more personal, prevent healthcare costs from increasing, reduce differences in care, and make the job easier for those who provide health services,” said Mamta Murthi, Vice President for Human Development, World Bank. “We hope that this report will give governments confidence and practical guidance, regardless of the country’s stage of digital maturity or fiscal challenges.

Improving health is getting harder, not easier. Health systems face serious and growing challenges and policy decisions are too often not based on reliable data.  It is estimated that some countries use less than 5% of health data to improve health which means that decisions are not based on data or data is not used effectively to make improvements. Within challenging fiscal environments, people-centered and evidence-based digital investments can help governments save up to 15% of health costs. The report presents pragmatic, low-cost actions to improve digital-in-health, no matter the maturity of a country’s systems or digital infrastructure. For example, better health data governance and standards to ensure systems can readily connect and exchange information are not costly but will be game changing in reducing siloed digital solutions and fragmentation.

In India, we have shown that digital innovations such as tele-consultations have reached more than 140 million people and provided accessible, affordable and efficient healthcare for everyone,” said Mansukh L Mandaviya, Minister for Health and Family Welfare, India. “We believe a digital-in-health approach can unlock the value of digital technologies and data and has the potential to prevent disease and lower healthcare costs while helping patients monitor and manage chronic conditions.” 

 

To help countries embrace a digital-in-health approach, the report proposes three essential areas to guide investments:

  1. Prioritizeevidence-based digital investments that tackle the biggest problems and focus on the needs of patients and providers.
  2. Connect the regulatory, governance, information, and infrastructure dots so that patients know that data is safe and health workers can use digital solutions transparently.
  3. Scale digital health for the long run based on trust with sustainable financing, and improved capacity and skills for digital solutions.

It will take global, regional, and country leadership to make digital-in-health a reality. The report recommends strong country leadership involving all relevant sectors and stakeholders, including civil society. Digital technology and data improvements will involve investments beyond the health sector and new partnerships with the private sector. A digital-in-health mindset needs to be a routine aspect of annual health system planning, budgeting, and implementation.

The World Bank is committed to helping low-and middle-income countries to make digital-in-health a reality to improve health for everyone. Over the past decade, the World Bank has invested almost $4 billion in digital health including in health information systems, digital governance, identification systems, and infrastructure.

For more information, including a copy of the new report, Digital-in-Health: Unlocking the Value for Everyone, please visit:

Website: www.worldbank.org/en/topic/health

Twitter: http://www.twitter.com/WBG_Health

Facebook: http://www.facebook.com/worldbank

YouTube: http://www.youtube.com/worldbank

 

Conceptualizing the Mechanisms of Social Determinants of Health: A Heuristic Framework to Inform Future Directions for Mitigation

A large body of scientific work examines the mechanisms through which social determinants of health (SDOH) shape health inequities. However, the nuances described in the literature are infrequently reflected in the applied frameworks that inform health policy and programming.

We synthesize extant SDOH research into a heuristic framework that provides policymakers, practitioners, and researchers with a customizable template for conceptualizing and operationalizing key mechanisms that represent intervention opportunities for mitigating the impact of harmful SDOH.

In light of scarce existing SDOH mitigation strategies, the framework addresses an important research-to-practice translation gap and missed opportunity for advancing health equity.

Conceptualizing the Mechanisms of Social Determinants of Health!

I. SDOH
Health inequities are most often understood as associated with the social determinants of health (SDOH)

II. Opportunity
A practical, heuristic framework for policymakers, practitioners, and researchers is needed to serves as a roadmap for conceptualizing and targeting the key mechanisms of SDOH influence

  • Unifying principles

1. SDOH are underlying causes of health inequities
-> Meaningful community engagement in data generation and interpretation for understanding and mitigating underlying health inequity drivers and multilevel resilience factors

2. SDOH shape health inequities through contextual influences
-> Development, evaluation, and scale up of multilevel interventions that address the mechanisms of SDOH at the structural, psychosocial, and clinical/biomedical levels

3. SDOH contextual disadvantage is not deterministic
-> Adoption of individualized/differentiated, decentralized, and community-based service delivery models

4. SDOH shape health over the life course
-> Proactive intervention focused on prevention and health promotion as well as restorative care to maintain and improve physical, mental, and psychosocial functioning and quality of life

5. SDOH operate through biological embedding
-> Greater prioritization of harmful SDOH mechanisms and mitigation of their biological impact in clinical education and practice, including investment in biomarkers for early detection of and intervention on emerging disease trajectories

6.SDOH operate intergenerationally
-> Prioritization of family-based approaches to restorative health care, prevention, and health promotion

7. SDOH shape clustering and synergies of health inequities
-> Greater integration of comprehensive, interdisciplinary, team-based health services delivered within a value-based framework and at the top of providers’ licenses

8. SDOH mechanisms to produce health inequities
-> Departure from vulnerability- and deficiency-focused paradigms for understanding health inequities toward multilevel resilience-focused paradigms for reducing health inequitiess

An Organizing Framework of SDOH Mechanisms

1. Underlying causal factors
-> Two distinct classes of social influence: SDOH capital and SDOH processes

2. Mediating factors
-> Two mechanisms: environmental and behavioral exposure and biological susceptibility

3. Moderating factors
-> Resilience – as collective action that supports the ability of communities to thrive when confronted with structural challenge

4. Health inequity outcomes
-> The impact of SDOH mechanisms on health inequities is dependent on the broader patterns of morbidity within the community of interest

Check out the article by Marco Thimm-KaiserAdam Benzekri and Vincent Guilamo-Ramos here:

https://lnkd.in/e57GXthQ

Empowering patients through medical technologies for a healthier future

By constantly investing in existing and future technologies, the medical technology sector contributes to a healthier Europe. The 2023 MedTech Forum looked at some key trends in legislation and business and the role that EU policymakers can play to bring medical innovations to patients in a timely manner.

Europe takes great pride in its robust social security systems and the fundamental principles of equitable healthcare access. Data indicates however that significant efforts are still required to ensure that all patients across the continent enjoy top-tier quality care and unfettered access to medical services and technologies.

Medical technologies empower early diagnoses, timely interventions, and remarkable outcomes. Medical technologies mend, revive, and improve body functions, while telemedicine and connected devices bring patient monitoring to new frontiers. Innovations speed up recovery, safeguard well-being, and equip healthcare workers with vital insights for optimal decisions and fewer complications. By relieving strain on healthcare systems, fostering social and economic vitality, averting complications, and advancing efficiency through cutting-edge data and machine learning, medical technologies are high-tech, high-value game-changers in healthcare. Diagnostic technologies also act as a first line of defence against disease outbreaks and help support their management.

Because of its innovation power, and its positive impact on patients, healthcare professionals, and health systems, the medical technology sector has developed into a key industry with an important economic and societal impact in Europe.

European leadership for the benefit of patients 

Europe’s 34,000 medical technology companies invest heavily in improving existing and innovating breakthrough technologies for the benefit of patients. These companies, 95% of which are SMEs, drive economic growth, provide employment in Europe, and boost EU exports. In doing so, the sector adheres to strict regulatory standards that ensure safe devices which live up to their performance claims. Patient health and well-being in mind, no other region in the world sets such high standards to guarantee that medical technologies are safe for patients and healthcare professionals to use.

Despite Europe’s fundamental strengths in health and medical solutions, there are growing indicationsthat new and existing products will struggle to reach European patients and health systems in a timely manner: 17% of today’s in vitro diagnostics are expected to be discontinued in Europe, particularly among SMEs and approximately 50% of medical device manufacturers are deprioritising the EU market (or will do so) as the geography of choice for first regulatory clearance of their new devices.

MedTech Europe, the leading European medical technology trade association, believes that there are persistent, system-level issues within the European regulations for medical technologies which lead to unpredictability and delays, dampen innovation, and undermine confidence in the long-term viability of the regulatory framework.

To remain a global leader in medical technologies, the EU must deliver a more patient-centred and innovation-friendly regulatory framework that addresses the system-level challenges of today while preparing for the opportunities of tomorrow.

Getting through the maze 

Beyond the medical technology industry’s sector-specific developments, fundamental changes have been brought about in the last decade by the mega trends of digitalisation and sustainability. Such trends contribute to a revolution in the way innovation in medical technologies is happening, driving the need for a more forward-looking regulatory mentality to allow innovation to thrive.

Legislative activity of the EU in this area has been, rightly, immense – and much more needs to be done to ensure that all the rules-in-development which will impact medical technologies will actually work together to deliver products to patients. The EU’s Digital Strategy, driving regulation on artificial intelligence, cybersecurity, and data, including the European Health Data Space and the European Green Deal will legislate tectonic changes, including in the area of product design, are coming with a substantial set of new or updated requirements for medical technologies.

Against this background, substantial legislations are also being revised, such as the ones on Product Liability and Corporate Sustainability Due Diligence. It is paramount to include principles that ensure patients across the EU can benefit from a high level of protection and businesses are provided with legal certainty.

These new rules will significantly impact the way and speed in which technologies can be brought to market and accessed by those who need them. Getting medical technology innovations to European patients and healthcare systems in fact can often feel like navigating a complex and ever-shifting maze.

As a result, whether for R&D investment, clinical research, manufacturing or new product launches, Europe slowly losing ground to other geographies on innovation, because the maze seems to be getting harder to navigate. The EU thus has a big task ahead to further its efforts towards driving harmonisation and creating an environment of legal certainty for businesses.

The slowly approaching end of the EU legislative cycle is a unique opportunity to reflect on what has been achieved and what is still to be done. It is not a time to rush to the finish line but to stay level-headed and look for effective solutions to ensure medical technologies reach patients on time. We need to solve existing challenges in a comprehensive, sustainable manner, setting the tone for a future environment that will allow patients to continue benefiting from first-line, quality medical technologies and more equitable access to healthcare, and health systems to build the long-term resilience they need. The medical technology industry in Europe stands ready to contribute and collaborate to make this a reality.

This article was produced in partnership with Medtech Europe. MedTech Europe is the European trade association for the medical technology industry including diagnostics, medical devices and digital health.

https://www.theparliamentmagazine.eu/news/article/empowering-patients-through-medical-technologies-for-a-healthier-future