Apps, telemedicine, vaccination passports: WHO warns of digital divide in healthcare
The digitalization of the healthcare system has made great progress in Europe in recent years – especially due to the corona pandemic. This applies especially to health apps and telemedicine, writes the World Health Organization (WHO). She presented a report focusing on the European region at a symposium on the future of the healthcare system in the digital age in Porto on Tuesday. The authors emphasize that “there is still a lot to do” and make suggestions for improvements.
“The Covid-19 pandemic has clearly brought the crucial role of digital technology into focus,” says the analysis, which is over 100 pages long. Digital vaccination certificates are particularly helpful: “They have been our allies in maintaining essential health services and in emergency preparedness and response.”
In particular, 2022 – marked by the after-effects of the pandemic – will be remembered as a “significant milestone on the path to comprehensive digital health,” writes the European director of the UN institution, Hans Kluge, in the foreword. Last year it became clear that it was “not just about technology”. The aim is also to “strengthen health systems, improve accessibility and promote cultural change towards sustainable care and public health”.
“A key risk is that a digital health divide will emerge due to uneven delivery (…),” warns the WHO. Millions of people across the region may not yet benefit from digital health technology. European countries urgently need to address this inequality through targeted investments and expanding the skills and capacities of healthcare providers.
Supply in rural areas
“It is a sad irony that people with limited (…) digital skills are often the ones who benefit most from digital health tools,” Kluge points out. He refers to older people or residents of rural areas as examples. With its digital health program, the WHO wants to ensure that “everyone benefits and no one is left behind.”
The report shows that the vast majority of countries in the region – 44 out of 53 WHO member states in the Old Continent – have a national digital health strategy. All of them also have laws to protect privacy and personal data. However, only 19 countries have developed guidelines for evaluating digital health interventions, despite this being “critically important” for safety and effectiveness.
Impetus for laws due to the corona crisis
Just over half of the countries in the region have implemented digital health literacy policies and a digital inclusion plan. Thirty have passed laws to support telemedicine applications during the Corona crisis. Slightly more than half of the countries have a data strategy that regulates the use of big data and analyzes using artificial intelligence (AI) in the health sector. The German federal government renewed its relevant agenda last week.
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According to the WHO, the pandemic has “highlighted the costs of inadequate investment in data and digital health.” Member states must make more efforts “to develop sustainable financing strategies for the further development and implementation of digital health.” In addition to maintaining public funding for digital health programs, they should strengthen public-private collaboration to overcome any monetary problems.
Contact tracing and more
The WHO is specifically looking at apps such as digital health applications (DiGA). Due to the pandemic emergency, “personal contact between health workers and patients has been impaired”. There has been “a significant shift towards virtual remote consultations”. A large part of this was communicated via mobile applications, also known as mHealth. Above all, states have had their hands full quickly setting up nationwide coronavirus testing and vaccination services, introducing contact tracing to contain the spread of the disease and monitoring quarantines.
According to a WHO survey, two thirds of European member countries developed apps for contact tracing such as the Corona Warning App (CWA), and 55 percent developed digital proof of vaccination. The latter have become “the new passes for public venues and travel”. Surprisingly, 72 percent of member states lack a dedicated body responsible for the regulatory oversight of apps in terms of quality, security and reliability. Only 15 percent reported evaluating government-funded mHealth programs.
Broadband for data flow
The WHO advises member states to provide “every household and community access to reliable, affordable broadband.” In order to build trust in digital health tools, the data flowing in must be “safe and secure”. Another crucial factor is the interoperability of electronic patient files in particular, for which the EU is pushing forward the controversial European Health Data Space.
The EU Commission just confirmed that the WHO’s global digital network for health certifications plans to digitize all of the organization’s yellow vaccination cards. To this end, the WHO should adopt the system behind the EU vaccination or rehabilitation certificate, including its principles and techniques, according to a response to a question from EU MP Peter Liese (CDU). This supports the project because the WHO-compliant evidence on the cell phone makes the annoying search for the yellow booklets unnecessary. Previously, it was only possible to show proof of corona vaccination digitally via the CovPass app or the CWA.
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