In recent years, universal health coverage has emerged as a central imperative of the World Health Organization, the United Nations, and most of its member states. Leaders from across the world came together from Sept. 17-30 in New York during the U.N. General Assembly to discuss this pressing issue, among many other things.
According to a report published in 2017 by WHO and the World Bank, up to 3.5 billion people — almost half the world’s population — still don’t receive the health services they need.
“Let’s start utilizing all of this potential through a committed ecosystem of strong collaborators. I firmly believe that this is key to addressing the complex challenges in expanding access to care.”
—And there is an important fact that is often overlooked: while lack of access to care is obviously most pressing in low- and middle-income countries and we should focus on improvements in these areas, it is also a matter of concern in the industrialized world. That is possibly even more unforgivable — how can it be that countries that actually have all the elements needed to solve this problem, are not capable of doing so? Is it the system? The unwillingness to work together? The challenges that come with transformation?
Access to care and social determinants of health
It is increasingly being understood that social determinants — the conditions in which people are born, grow, work, live, and age, and the political, social, and economic forces and systems shaping these conditions — have a huge impact on health.
We tend to underestimate these social determinants of health, but research shows that around 70% of health outcomes are driven by factors beyond health care. In countries at all levels of income, health, and illness follow a social gradient: if you are in a lower socioeconomic position, your health is likely to be worse as well.
The idea of taking social determinants of health into account, as part of individual care management, as well as population health strategies, is driving an approach to health that is focused on improving the environmental and community factors — taking away barriers to make it possible for individuals to live a healthier life, with better access to care.
Exploring the impact of digital health technology on health care professionals and patients
It is promising to see that the 2019 future health index report — based on a survey of 15,000 individuals and more than 3,100 health care professionals across 15 countries, exploring the impact of digital health technology on health care professionals and patients — shows that digital technology is increasingly being used and appreciated. Health care professionals who use digital health records in their practice report that technology has a positive impact on the quality of care provided, on satisfaction for themselves, and on outcomes for patients.
Another encouraging finding from the report is that when it comes to adopting digital health technologies, industrialized economies can learn from forerunner countries including China, Saudi Arabia, India, and the Russian Federation. In these countries, the percentage of health care professionals that currently use some form of digital health technology or mobile health app is relatively high in comparison to countries with a longer health care legacy — for example, 96% in China, 88% in India, and 85% in Saudi Arabia, versus 76% in the U.S.
Digital health technology — helping to reach beyond hospital walls
The key to realizing improved access to care, while taking social determinants of health into account, is not building more hospitals. With digital health technology, monitoring or treating a patient doesn’t have to begin or end in a hospital: remote patient monitoring and virtual care, beyond the walls of the hospital, are now real options.
In May 2018, the World Health Assembly agreed on a digital health resolution that urges member states to prioritize the “development, evaluation, implementation, scale up and greater utilization of digital technologies as a means of promoting equitable, affordable and universal access to health for all.”
Digital health technology can play a key role in engaging patients in their personal health, and in collecting both clinical and social data to investigate and monitor the influence of social determinants of health and disease. Capturing the data gives analysts and care providers the opportunity to know which patients are most at risk and how and when to intervene, and to work together with social services to ensure access to high-quality care, improve outcomes, and effectively manage costs.
How can digital health technology be most effective in providing access to care?
As pointed out in a recent Devex special report on“Digital health solutions: Lessons and best practices from implementers” — produced in partnership with Philips and based on interviews with implementers of digital health solutions — for digital health technology to be effective, it needs to be easy to use, low-cost, and locally relevant.
According to interviewees, the most impactful solutions are based on local needs and aspirations, take work practices into account, align to local skill levels, and build in incentives for the individual to use the system.
Smartphones and mobile devices, for example, are widely adopted and used daily, across all socioeconomic levels and ages. This supports the collection of a broad range of reliable patient information through dedicated apps, offering a seamless experience that will also help to lower the barriers to use.
Likewise, telehealth services enable the sharing of data and digital health records across sectors and organizations, and can also help to break down the social barriers that deter some people from seeing a doctor. Artificial intelligence can help to detect social determinants of health in the data, which could lead to a prediction of the likelihood that a patient is at risk, and even immediate intervention if needed.
Stop talking, start acting
Nowadays, we have digital health technologies at our disposal that support data sharing and analysis, and enable more effective, integrated health solutions at a lower cost, right across the health continuum — from healthy living and prevention to diagnosis, treatment, and home care — while taking social determinants of health into account.
But it’s not about technology only — partnership and collaboration are also central to the efficient and effective delivery of care.
So let’s start utilizing all of this potential through a committed ecosystem of strong collaborators. I firmly believe that this is key to addressing the complex challenges in expanding access to care.
Therefore, I hope that everyone who attended the U.N. General Assembly, myself included, is willing to truly open their eyes, think differently, change and collaborate. It’s time to stop talking and start acting.
For a closer look at the innovative solutions designed to push for progress on universal health coverage around the globe, visit the Healthy Access series.
