Impact of Digital Health on Universal Health Coverage

Digital health, or digital healthcare, is a broad, multidisciplinary notion that draws on concepts from an intersection between technology and healthcare. Digital health applies the technological transformation to the healthcare field, incorporating software, hardware, and services. It includes mobile health (mHealth) apps, electronic health records (EHRs), electronic medical records (EMRs), wearable devices, telehealth, and telemedicine, as well as personalized medicine. Digital health can be extremely beneficial to its stakeholders, such as patients, practitioners, researchers, application developers, and medical device manufacturers and distributors.

?An estimated 400 million people around the world lack access to basic health services. Each year, close to 100 million people are pushed into extreme poverty because they have to cover their own health costs. These numbers have increased with COVID-19 and will continue to increase as people lose jobs, and health insurance and health expenditures rise due to COVID-19-related spending on testing, treatment, and vaccines.

?With the global burden of health problems on the rise, digital health plays an increasingly important role in healthcare today. The COVID-19 pandemic accelerated the shift to digital health and enabled online medical support through services like online symptom checkers, patient portals, remote patient monitoring tools, and telehealth.

?The shift to value-based healthcare (VBHC) is fundamental to achieving Universal Health Coverage (UHC) objectives of quality healthcare, financial protection and equitable access to healthcare. These systems are already stretched, riddled with chronic diseases and complex morbidities that have been further exacerbated by COVID-19. It is crucial to optimize the efficiency of health systems through digitization and deliver patient-centric care.

Digital health innovations are designed to help save time, boost accuracy and efficiency, and combine technologies in ways that are new to healthcare. A pressing need to enable remote healthcare delivery quickly overcame the inherent rigidity of traditional healthcare systems, sparking a digital health boom. For example, telemedicine has made it possible for doctors and patients to interact more frequently, regardless of where they are, greatly expanding the geographic reach of healthcare workers. E-learning and mobile learning tools are other features of digital health that promote preventative and health-seeking behaviors in line with UHC.

?Apart from telemedicine technology to improve communication between patients and doctors, digital health interventions can help decrease the potential for exposure to contagious diseases and to various intelligent sensor technologies that can collect data at the user level. An example is the ability to design a smartphone-connected pacemaker device using a mobile app to securely and wirelessly transmit data to a patient's network, giving patients better insight into the health data from the pacemakers and sharing the health information to their physicians.

Digital health also includes mobile technology that monitors health data and provides support in managing long-term chronic conditions. For example, wearables like Fitbits, smartwatches, etc, help monitor parameters like blood oxygen levels, heart rate, number of steps taken, calories burnt, etc. The pandemic boosted sales of such devices.

?UHC is driven by digital health and data-driven care, and we must make sure that these technologies include methodical collection and analysis of detailed health-outcome data. This helps quantify the impact of health interventions independent of access by carefully monitoring health outcomes for appropriately segregated groups.

?The significance of the data obtained by these components highlights the "digital gap," emphasizing how disadvantaged individuals lack the resources to engage in healthy behaviour. For patients who live in rural areas without access to the internet, this enables customized approaches to care delivery, enabling them to obtain care through alternate models like mobile clinics. The Rockefeller Foundation has collaborated on one such new mobile health pilot program, to reach underserved populations.

?Gumla District and the Jharkhand Government recently announced the opening of Mobile Health and Wellness Centers in an effort to broaden the impact and reach of the Government of India's Ayushman Bharat Health and Wellness Centers program. This unique mobile van-based concept, also known as "Swasthya Sawari," was created in collaboration with the government, the U.S. Agency for International Development (USAID), Jivika Healthcare, and Boston Consulting Group (BCG). This specialized mobile van-based model will advance the main goals of the program, namely, providing universal access to free primary health care, strengthening accountability at the last mile, and shifting the focus of the health ecosystem from curative to preventive healthcare for all, by bringing a skilled medical team, equipment, and medicines closer to the doorstep of the underserved population in the Gumla District.

?The application of Artificial Intelligence (AI) in healthcare has the potential to revolutionize digital and universal health coverage. AI is currently being used for medical imaging, genetics testing, diagnostic codes analysis, and in infectious disease outbreak predictions and disease modeling. In addition to supporting and informing medics, epidemiologists, and policymakers on the most effective methods to promote health at the population and individual levels, AI can offer strong tools to automate jobs and accelerate previously time-consuming procedures.

While digital health has the potential to prevent disease and reduce healthcare expenditures, due to the massive amounts of data collected from a variety of systems that store and code data differently, data interoperability is a major challenge to digital healthcare. Accessibility and literacy about these digital innovations are other obstacles in the way of digital health. Owing to the sensitive nature of the information collected and stored for medical purposes, there are concerns about the safety and security of data and the possibility of data leaks.

?In conclusion, while a digital transformation in healthcare is ongoing, there are many challenges that arise with each step. COVID-19 has accelerated this digital transition. We must harness the power of data to identify key pain points and blind spots in our healthcare delivery models, and expand coverage to more of the world’s population.