New digital approaches to healthcare services are tackling inequities, data gaps, and silos between animal, human, and environmental health to reshape the future of healthcare and crisis preparedness.
Thursday, 7 March marked 74 years since the founding of the World Health Organization (WHO). Since 1948, efforts to strengthen health and medical preparedness across the globe have made leaps forward. But these efforts continue to contend with many of the same challenges: inequities, insufficient community engagement, damaging economic structures, data gaps, to name a few.
Climate change is amplifying some of these issues. Inequities are also deepening, as digitalisation of healthcare services thrive in some parts of the world and remain absent in others.
A new generation of digital tools and services are emerging to make healthcare more accessible, democratic, and conscious of the overlaps between animal, human, and environmental health.
In Geneva and other Swiss cities, several digital health hubs are positioning themselves to enable projects around the world – from devices for remote medical examinations to data collection tools that draw on unusual sources.
Improving accessibility and engagement
One young globally-minded initiative is the International Digital Health and AI Research Collaborative (I-DAIR), based in Geneva, that works to democratise digital and artificial intelligence for health.
It collaborates with forty partners from around the world and engages with local communities and patients to understand the specific needs that virtual healthcare tools and services can meet.
One of its projects, for example, is to use patients’ experiences to develop new benchmarks to check whether a digital healthcare service, like an app for online mental health consultations, really works, Amandeep Singh Gill, I-DAIR’s chief executive and project director, told Geneva Solutions.
“We are working with hospitals in two countries to develop a platform for patient-reported outcome metrics, which you can use to actually take the patient's voice into the assessments. This is human-centred benchmarking of technology,” he explained, which is being developed over the next twelve to eighteen months.
I-DAIR emerged from discussions in 2018 and 2019 on the impact of digital technologies across the UN’s areas of work. Its funders include Fondation Botnar and the Wellcome Trust. It is currently hosted by Geneva’s Graduate Institute of International and Development Studies (IHEID) with plans of launching as its own foundation in the coming year.
I-DAIR also has an open telemedicine platform in the works. This platform would offer group appointments for patients facing similar illnesses, disabilities, and trauma. The project aims to connect as many people as possible with healthcare advice, particularly in areas where specialists are few.
The technology will undergo on-the-ground testing in India, where there are just over seven doctors for every 10,000 people, and in Kenya, where there are less than two doctors for every 10,000, according to data from the WHO.
Breaking data silos
Another I-DAIR project is to develop devices for remote medical examinations that can transfer data easily to healthcare practitioners and into the databases of regular healthcare systems. These devices include ones for taking temperature and examining ear, nose, and throat health, says Gill.
Feeding data from these devices into the regular healthcare system will break barriers between similar proprietary devices that are often expensive and operate only within their own data networks.
“[These open hardware diagnostic devices] could be used by humanitarian workers on the ground, by school teachers, by community health workers to do rapid assessments, and then help public health authorities to come out with better informed decisions,” says Gill.
The data from these devices can also be pooled to help practitioners, epidemiologists and crisis centres develop a better understanding of health at different geographic levels and thereby preempt outbreaks or catch them in their early stages.
Other Swiss-based initiatives are also helping to prepare governments and healthcare professionals for the next major outbreak. One is the Geneva Hub for Global Digital Health (GDHub), whose partners include Université de Gèneve, the WHO, the Swiss Agency for Development and Cooperation, and the Geneva Health Forum.
The hub offers healthcare providers, researchers, funders, and policy-makers tools a platform to share knowledge, develop governance, and stay up-to-date on relevant policies. It also keeps track of innovation and generates maps of digital health projects.
Another initiative across the border in the canton of Vaud is the Integrated e-Diagnostic Approach (I-eDA), launched by the Lausanne-based children’s aid organisation, Terre des Hommes, in 2010. The app takes healthcare practitioners through questions to ask and assessments to conduct when giving children a medical screening.
It also includes video and audio examples of symptoms to help practitioners identify them. Close to 86 per cent of Burkina Faso’s healthcare centres use I-eDA as of late 2020, and its use is growing in Mali, Niger, and India.
Terre des Hommes uses artificial intelligence systems to combined data from I-eDA and other sources, like weather stations, to anticipate the different factors that can generate crises, Riccardo Lampariello, head of Terre des Hommes’ health programme, said at the International Cooperation Forum’s working session on digital health for resilience that was held in Geneva last Friday.
“There is a responsibility by all actors to converge towards a coordinated approach,” Lampariello said. The NGO’s future plans include tailoring alerts based on the capacity of individual facilities to handle certain caseloads and case types, he added.
Pursuing the unusual
Understanding overlaps between animal, human, and environmental health also requires seeking out unusual data sources, says Gill.
I-DAIR is making it a point to draw on the unconventional—like studying sewage water for signs of certain Covid-19 variants. The collaborative is developing the digital infrastructure for a pandemic surveillance and response scheme that will draw on unusual data and can be launched in places low in resources.
Speaking with locals is crucial. “The shepherds that cross borders in Africa often have more information on how diseases are spreading than our usual sources of data. So you need to work with the communities on the ground when you are developing these types of technologies.”
I-DAIR’s vision of the future of digital healthcare is one that integrates unusual data sources and engagement with local communities. “That’s the kind of technology development that’s needed today,” says Gill.