Health Digital Transformation

Program for Municipalities and Governments

ACHA – Americas Continental Health Alliance, with the support of European partners and experts with vast experience in digitalization processes of the health sector, helps and provides support to municipalities, provincial, state and national governments of different Latin American countries in their digital transformation processes.

Diagnosis and evaluation

Survey on the current state of digitalization

Prior to the digitizalization process, a survey is needed to know the current level of digitalization and possible willingness and adaptation to the digital transformation of the Health Sector.

The survey should address the following areas:

  • Demographics and Socioeconomics

  • Factors Related to Technology Acceptance and current technology  use

  • Motivations to Participate and Reasons for Concern

  • Access Control Preferences
  • Willingness to Share Data

  • Enablers for Acceptance

  • Barriers for Acceptance

Guiding principles

Four guiding principles aim our strategy towards the appropriate and sustainable adoption of digital health technologies within the context of the national health sector and health strategies.

Our strategy acknowledges that each country owns its digital health action plan built on the strategy, within its own national context. Along their path towards the health-related Sustainable Development Goals, countries will adopt digital health in a way that is sustainable, respects their sovereignty, and best suits their culture and values, national health policy, vision, goals, health and well-being needs, and available resources.

Digital technologies are an essential component and an enabler of sustainable health systems and universal health coverage. To realize their potential, digital health initiatives must be part of the wider health needs and the digital health ecosystem and guided by a robust strategy that integrates leadership, financial, organizational, human and technological resources and is used as the basis for an action plan which enables coordination among multiple stakeholders. These

initiatives should be led through strong governance structures. The strategy should address an approach that will work across multiple health priorities underpinned by standards and an architecture that enables this integration.Historical review shows that ill-coordinated or disjoined digital health initiatives lead to vertical or stand- alone information and communications technology solutions that, although well-intended,often result in information fragmentation and, consequently, poor delivery of services.

Our strategy promotes the appropriate use of digital technologies as digital public goods which are adaptable to different countries and contexts to help address key health system challenges to support equity in access to digital resources so that no one is left behind. It promotes the protection of people, populations, health care professionals and systems against misinformation and the misuse of information, malicious cyber activities, fraud and exploitation, inappropriate use of health data, racism and human rights violations within the framework established by international treaties.

The “digital determinants of health”, such as literacy in information and communication technologies and access to equipment, broadband and the internet, become more important as digital health becomes more prevalent. The strategy underscores the need to ground digital foundations within national strategies and emphasizes the need to work with different sectors and stakeholders at all levels.

The strategy promotes syntactic and semantic interoperability with standards as a cornerstone of health information to enable sharing of information in a connected world.

The appropriate use of digital health takes the following dimensions into consideration: health promotion and disease prevention, patient safety, ethics, interoperability, intellectual property, data security(confidentiality, integrity, and availability), privacy, cost-effectiveness,patient engagement, and affordability. It should be people-centred, trust-based, evidence-based, effective, efficient, sustainable, inclusive, equitable and contextualized. The growing global challenge of digital waste on health and the environment must also be appropriately managed.

There is a pressing need to invest in efforts to overcome the major impediments that developing countries face in engaging with and accessing new digital health technologies, such as an appropriate enabling environment, sufficient resources, infrastructure to support the digital transformation, education, human capacity, financial investment and internet connectivity, as well as issues related to legacy infrastructure, technology ownership, privacy, security, and adapting and implementing global standards and technology flows.

Overview of the WHO National e-Health Strategy Toolkit

Part 1
National eHealth vision
  • Manage the process
  • Engage with stakeholders
  • Establish the strategic context
  • Learn from trends and experience
  • Draft an inicial Vision
  • Identify required components
  • Gather information on the eHelth environment
  • Assess opportunities and gaps
  • Refine vision and develop recommendations
National eHelth action plan
  • Manage the process
  • Engage with stakeholders
  • Develop eHelth action lines
  • Develop an integrated action plan
  • Determine high-level resource requirements
  • Apply funding constraints to refine plan
  • Define implementation phases
National eHelth monitoring and evaluation
  • Manage the process
  • Engage with stakeholders
  • Develop eHelth action lines
  • Develop an integrated action plan
  • Determine high-level resource requirements
  • Apply funding constraints to refine plan
  • Define implementation phases

Health Sector digital transformation in Latin America

The digitalization of healthcare services implies important cultural changes both for healthcare professionals and for the rest of the population.

Despite the considerable progress made by some countries, many still need support for the development and consolidation of national e-health or digital health strategies and for the deployment of their plans.

Digital health should be at the core of healthcare priorities and benefit people in an ethical, safe, reliable, equitable and sustainable way.
It should stick to the principles of transparency, accessibility, scalability, replicability, interoperability, privacy, security, and confidentiality.

Our Vision

The vision of our strategy is to improve health for everyone,everywhere by accelerating the development and adoption of appropriate, accessible, affordable, scalable and sustainable person centric digital health solutions to prevent, detect and respond to epidemics and pandemics, developing infrastructure and applications that enable countries to use health data to promote health and well-being, and to achieve the health-related Sustainable Development Goals

To start or continue with health digitalization process, it is necessary to:

Recognize that Digital Health institutionalization in national health systems requires countries to make decisions and commit to them.

Recognize that, for Digital Health initiatives to be effective, an integrated strategy is needed. Identify the main stakeholders of the health and non-health sector who will develop the vision and national plan for Digital Health, for its subsequent deployment.

Establish governance mechanisms to provide better visibility, coordination and control of Digital Health deployment.

Set the strategic context for Digital Health, which provides the grounds for the national vision and plan, and enables the government to assess and make informed decisions about opportunities that arise from the ICT industry and other stakeholders. Promote the proper use of digital health technologies.

Assess the current Digital Health environment in terms of the existing eHealth components, as well as the ongoing programs or projects.

A possible national plan for the Health Sector digitalization should focus on:

  • Ensuring interoperability and standards adoption
  • Providing incentives for innovation and Digital Health integration in basic services
  • Identifying funding for short and long-term deployment
  • Meeting citizens’ expectations in terms of access and use of healthcare services
  • Using data and information for public health planning, privacy policies and information security
  • Carrying out monitoring and assessment to ensure that the plan is executed according to priorities.

Digital health will be valued and adopted if it :...

 It is accessible and supports equitable and universal access to quality health services.

Enhances the efficiency and sustainability of health systems in delivering quality, affordable and equitable care, strengthens and scales up health promotion, disease prevention, diagnosis, management, rehabilitation and palliative care including before, during and after an epidemic or pandemic, in a system that respects the privacy and security of patient health information.

Digital health can radically change health outcomes if it is supported by sufficient investment in governance, institutional and workforce capacity to enable the changes in digital systems and data use training, planning, and management that are required as health systems and services are increasingly digitized.

The implementation of appropriate digital health technologies is a key component of a national strategy. Exploring the potential of global solutions and shared services should be considered as part of the national health strategy, at the same time as generating evidence on the implications for access, cost, quality, safety and sustainability of applying these global solutions in health systems within vastly different country contexts.

The purpose of our strategy is to strengthen health systems through the application of digital health technologies for consumers, health professionals, health care providers and industry towards empowering patients and achieving the vision of health for all.

In the context of this strategy, digital health is understood to mean “the field of knowledge and practice associated with the development and use of digital technologies to improve health”. This definition encompasses eHealth.

Digital health expands the concept of eHealth to include digital consumers, with a wider range of smart and connected devices. It also encompasses other uses of digital technologies for health such as the Internet of Things, advanced computing, big data analytics, artificial intelligence including machine learning,and robotics.

The digital strategy emphasizes that health data are to be classified as sensitive personal data, or personally identifiable information, that require a high safety and security standard.
Therefore, it stresses the need for a strong legal and regulatory base to protect privacy, confidentiality, integrity and availability of data and the processing of personal health data, and to deal with cybersecurity, trust building, accountability and governance, ethics, equity, capacity building and literacy, ensuring that good quality data are collected and subsequently shared to support planning, commissioning and transformation of services. It is important to maintain transparency and effectively communicate about data security strategies.

The strategy aims to create a shared understanding among all Stakeholders  regarding the importance of digital health solutions, and an approach towards creating an interoperable digital health ecosystem which is to be understood as a digital interoperable information technology infrastructure that is primarily used by the health care community across all care settings, in particular by health care providers, health service providers and patients as well as by public health authorities, universities and research institutions.

An interoperable digital health ecosystem should enable the seamless and secure exchange of health data by and between users, health care providers, health systems managers, and health data services.
Health data are predominantly generated by and processed between health care providers and the health care community.

Sharing health data in the context of a person-centric digital health ecosystem and for the purpose of public interest should be encouraged with the patient’s consent, when undertaken in a manner that is built on trust, protects patient privacy, secures digital systems, and protects against malign or inappropriate use. Such sharing is vital as it can contribute to the enhancement of quality of processes, the outcomes of health services and the continuity of care for patients (primary use of health data). It may also lead to the building of a knowledge base, which should be able to interact with other data systems including for example data on social determinants of health and registries.

The secondary use of health data is important to improve the quality of healthcare and research effectiveness. It could enable testing, validating and benchmarking artificial intelligence solutions and big data analyses across various parameters and settings, and the continuity of care of patients (primary use of health data). It also leads to the building of a knowledge base, which should be able to interact with other data systems, registries, etc.

The secondary use of health data with appropriate deanonymization of datasets would enable ethically managed testing, validating and benchmarking artificial intelligence solutions and big data analyses across various parameters settings and ethics.

Important information

Global strategy on digital health 2020-2025
Estrategia mundial sobre salud digital 2020–2025
WHO guideline recommendations on digital interventions for health system strengthening
8 principios rectores de la transformación digital del sector de la salud
8 Princípios Orientadores da Transformação Digital do Setor da Saúde
8 Guiding Principles for Digital Transformation of the Health Sector