Nepal | September 29, 2020

OPINION: Shaping the future of digital health

Jhabindra Bhandari
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In recent years, digital technologies are showing remarkable values for health. Common technologies such as the Internet, smartphones, tablets and laptop computers have been very helpful in better managing health services and monitoring the impact of population health policies around the world. Thus, they provide a wealth of opportunities in shaping the future of health policies to improve the health and well-being of all populations.

More significantly, digital technologies are being used to improve the health information system at all levels. This has been instrumental in strengthening both the effectiveness and efficiency in data collection, reporting and monitoring the performance of the health sector at large. However, there are critical needs of building the capacity of the health workers at the community level to ensure that the technologies they adopt are better supported, managed and effectively used.

On the other side, effective use of digital technologies can also support self-care, provide ways to address the health needs and enable access to health services. In this case, digital health provides important tools to reach individuals and the public with health messages that can be acted on, such as targeted health campaigns or text reminders via the mobile phone to take medication or attend clinic visits. Improving digital health literacy can help to educate, inform, motivate and empower individuals and families for desired behaviour change.

At the community level, health facility managers should also be able to share data with national systems, which requires alignment with a national plan as well as with existing regulation and policies for data privacy and protection. Of course, appropriate use of digital technologies empowers the health workers in improving the quality of services.

In many developing countries, the impressive trend of investing resources on digital health has shown strong commitment to use digital technologies for advancing universal health coverage and meet the Sustainable Development Goals (SDGs). Using and scaling up of digital health solutions can revolutionise how people achieve higher standards of health, and access services to promote and protect their health and well-being.

In the context of globalisation, there are critical needs of harnessing the potential of information and communications technologies to accelerate progress across the health-related SDGs. That is why there is a pressing need to enhance the governance of digital health for strengthened health systems across the developing countries.

In Nepal, an integrated health information management system has been there since 1993. Over the years, significant efforts have been made at enhancing the capacity of the health workers and managers to collect, analyse and exchange data and information in all areas of health. The increasing use of digital technologies is central to strengthening the health system for rapid and coordinated response in public health emergencies.

Nepal’s health sector information strategy -2007 aims at obtaining disaggregated data by gender,  caste and ethnicity from health facilities and optimise the use of health information in decision-making processes. More importantly, a web-based data entry system has been functional for online reporting across health facilities.

In recent years, District Health Information System -2 (DHIS-2), which is the largest health management information system (HMIS) platform, has been widely used in many low and middle-income countries. This is typically used as a national health information system for data management, analysis as well as monitoring and evaluation of health services. With DHIS-2, we can capture data on any type of device, including desktops, laptops, tablets, smart phones and feature phones.

In this context, the Integrated Health Information Management Section (IHIMS) at the Department of Health Services is primarily responsible for timely updating health information for effective use in planning and management of health services. This also facilitates the Ministry of Health and Population (MoHP) in developing relevant policies, guidelines and protocols related to an integrated health information system.

Despite remarkable progress, there are emerging needs to ensure institutional support for the development and consolidation of national e-health strategies and their effective implementation in the federal context. The local governments might need comprehensive health information to further improve participatory planning and management of health services. Therefore, provision of comprehensive digital health training and guidelines is urgently needed to enhance the capacity of health facility managers and relevant stakeholders at the local level.

At the same time, concerted efforts are needed to promote the standards for safety, security, privacy, interoperability, and the ethical use of data within and outside the health sector. To sum up, a road map is needed to advance effective cross-sectoral partnerships at the national level for aligning resources and investments as well as ensuring the sustainability and growth of digital health in the broader domain of the health information system. After all, the purpose is to improve health for all by accelerating the development and adoption of appropriate digital health solutions.

Bhandari is a senior doctoral research fellow in global health systems

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