Digital Public Health: Interventions and Implementations

Digital public health is an emerging and rapidly growing field that utilizes technology and digital interventions to improve the health and well-being of individuals and populations. These interventions can include digital tools such as mobile apps, telehealth, and electronic health records, and can be used for a wide range of public health needs, including disease surveillance, health education, and behavior change.

In the past, public health interventions were primarily delivered in person, through face-to-face interactions between healthcare professionals and patients. However, the advent of digital technologies has allowed conventional public health to evolve. Today, digital public health is used to collect and analyze large sets of health data, to deliver health information and resources to individuals and communities, and to improve communication and collaboration among healthcare providers.

One of the key goals of digital public health is to increase the efficiency and effectiveness of healthcare delivery, which in turn can lead to better health outcomes and cost savings. This is sometimes referred to as the "new era of precision medicine" where digital health technologies are becoming more standardized and interoperable, and evidence of their utility is being developed. However, it is also important to consider potential risks and harms that may arise from these technologies and to address them accordingly.

A global strategy on digital health is crucial to promote healthy living for all people, regardless of location or age. This strategy should be robust and integrate financial, organizational, human, and technological resources. Furthermore, it should be guided by a robust strategy that integrates financial, organizational, human, and technological resources.

To ensure that digital health interventions are effective and sustainable, it is important to ensure that they are grounded in behavioral science and provide behavioral skills training, monitoring, tailored feedback, and support to guide behavior change. Furthermore, it is also important to consider the local context and to implement digital interventions in a coordinated way.

As digital health interventions become increasingly prevalent, it is important to have a clear definition and framework for classification. Some studies aim to provide the first definition of digital public health interventions and to merge leading models for public health functions by the World Health Organization, a framework for digital health technologies by the National Institute for Health and Care Excellence, and a user-centered approach to intervention development.

There are several implementation frameworks that have been developed to support the implementation of digital public health interventions. These frameworks include PARiHS, NASSS, NPT, and NOMAD IDEAS. These frameworks provide guidance on how to develop and implement digital health interventions in a way that is effective, feasible, and appropriate for the local context.

Digital health interventions have the potential to increase the performance of delivered services, increase healthcare quality, and save costs while involving users as effective partners in their own healthcare. These interventions can also support Essential Public Health Functions (EPHF). They can also make use of data sources to predict the vulnerable states of patients or healthy individuals, select the most appropriate intervention option and dose, and deliver it at the right time when the target person is in a receptive state. However, it is crucial to thoroughly implement and monitor these interventions to ensure their effectiveness.

Obviously, there are challenges. Targeted digital public health interventions can also raise ethical concerns, as data used to power these interventions are often collected in ways that disrespect data subjects' privacy, and may also target messages in ways that discriminate against marginalized groups.

Public health officials and experts (like us) have a responsibility and legal authority to make decisions about interventions and should consider certain key principles, such as selecting the appropriate intervention, facilitating implementation, and assessing effectiveness.

Another potential challenge is ensuring that digital health interventions reach those who need them most. While digital technologies have the potential to improve healthcare for all, there is a risk that they will primarily benefit those who are already well-off and well-connected. This is a particular concern in low- and middle-income countries, where many people lack access to basic healthcare services.

There are multiple organizations that are implementing digital public health solutions. The World Health Organization (WHO) has developed a Global Strategy for Digital Health to promote healthy lives and well-being for everyone, everywhere, at all ages. The strategy guides national or regional Digital Health initiatives and integrates financial, organizational, human, and technological resources. WHO also provides a practical guide for countries to develop a costed implementation plan for digital health within one or more health program areas.

The United States Department of Health and Human Services (HHS) has a Health IT Safety program that aims to improve the safety and quality of healthcare through the use of health IT. They provide guidance on how organizations should consider how new technology will handle generating new patient records, patient registration, and retrieval of information.

Deloitte, a global consulting firm, defines digital transformation in healthcare as the use of digital technologies to radically improve the performance or reach of an organization. They provide insights into how digital technologies can enable improved processes, engaged talent, and new business models in healthcare.

The American Medical Association (AMA) has a Telehealth Implementation Playbook that provides a guide for the clinical integration of digital tools in healthcare. They aim to help healthcare providers overcome the challenges and pitfalls of implementing digital health solutions in clinical studies.

Additionally, organizations such as the National Institutes of Health and the Robert Wood Johnson Foundation have invested in digital health research and implementation. They are working on developing and implementing digital solutions to improve healthcare delivery and patient outcomes.

Whereas, digital health companies provide various solutions to manage personal health and wellness, such as Oura ring, HealthVault, Butterfly Network, Nanowear, Flatiron Health, Qventus, Luma Health, Sword Health, Wildflower Health, Meru Health, and many more. These companies use technologies such as artificial intelligence, the internet of things, and virtual reality to provide next-generation solutions to patients. They aim to streamline workflow, reduce costs, and save time.

Examples of such digital health solutions include cloud-based systems that allow for demand-oriented spending and radio-frequency identification (RFID) which provides real-time visibility of health devices, telemedicine, and mobile health. These solutions are being utilized by healthcare organizations to improve patient care and satisfaction, manage the cost of care, and improve access to healthcare services.

Organizations such as Prudential in Asia (with Babylon Health), Discovery Group in Africa (the Vitality program), Manulife (with Vitality), Sun Life (BestLifeRewarded), and many more are implementing digital public health solutions such as digital therapeutics, digital health monitoring, and digital health education to improve public health outcomes.

Digital behavioral health companies are also gaining popularity and drew $2.4 billion in venture funding in 2020. However, many questions remain about how well these digital therapeutics work, how they should be regulated, their place in the healthcare system, and what impact they will have on healthcare costs.

Looking to the future, it is apparent that digital health will continue to play an increasingly important role in healthcare. With the advent of new technologies such as advanced artificial intelligence/machine learning and blockchain, we are likely to see even more innovative digital health solutions that can improve health and well-being outcomes. However, it is important to consider potential risks and harms and to ensure that digital interventions are grounded in behavioral science and are implemented in a coordinated and appropriate way. Ongoing research is needed to further understand the full public health impact and value of digital health technologies.

Sidebar: Digital health, eHealth, and mHealth are related but distinct terms that refer to different aspects of using digital technologies to improve health and healthcare.

Digital health is a broad term that encompasses the use of digital technologies to improve health and healthcare. This can include the use of data and analytics, digital tools for delivering health information and resources, and technology-enabled care delivery. Digital health can include eHealth and mHealth, as well as other forms of digital health technologies.

eHealth is a term that refers specifically to the use of digital technologies to support health and healthcare. This can include the use of electronic health records (EHRs), telemedicine, and other forms of digital healthcare delivery. eHealth also includes the use of digital technologies to support the delivery of public health services, such as the use of data and analytics to track disease outbreaks.

mHealth (mobile health) is a term that refers to the use of mobile technologies to support health and healthcare. This can include the use of mobile devices, such as smartphones and tablets, to deliver health information and resources, as well as to support remote monitoring and telemedicine. mHealth can also include the use of mobile apps to support health and wellness, such as fitness tracking and medication reminders.