7 Transformative Digital Health Trends in International Development

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At the recent OpenHIE Community Meeting, I was able to meet with a wide range of digital health practitioners working for governments, donors, and implementing partners, and through my conversations, seven transformative digital health trends emerged that will be impacting international development now and in the near future.
1. Global Digital Health Goods
Adele Waugaman of USAID pointed out that there is increasing support for global goods – Open Source digital health software solutions like DHIS 2, OpenMRS, and iHRIS that can be directly adopted by government health systems – and sustainable business models to support the global goods.
This will require global goods producers and the digital health ecosystem to:

  • Evaluate digital health systems using global good maturity models.
  • Be more transparent about the true costs of developing core software.
  • Explore how countries can start supporting these costs directly.

2. Software Application Overload
Government health systems are overloaded with digital health applications. Johnathan Metzger of JSI presented on his team’s research that found over 120 software systems in Tanzania alone, with many bespoke solutions creating islands of isolated data sets, instead of extending existing systems and increasing interoperability.
Now we’ve come a long way from 2010, when Uganda instituted a mHealth Moratorium to stop digital health application proliferation. We have interoperability standards and Digital Principles to guide development, but there are still too many solutions cluttering up the digital health landscape.
3. Private Sector Solutions
Dykki Settle of PATH said that we are starting to see increases in commercial software adoption by multiple ministries of health. For example, Tableau and PowerBI are dominating data visualizations and small hospitals are turning to commercial enterprise resource planning software for back office automation.
There is still strong desire for Open Source software, yet the future will be dominated by an interoperable ecology of choice, where Open Standards and interoperability between systems is more important than specific software licenses.
4. Moving to Cloud Computing
Mike Mulbah of the Liberian Ministry of Health spoke about governments putting government-managed software services such as DHIS2 and Master Facility Lists in the cloud and buying software as a service from private sector providers to realize the cost and sustainability gains of outsourced hosting.
However, governments are concerned with allowing personally identifiable patient information to flow through Amazon Web Services and other international data centers. They are demanding stringent data privacy and client confidentiality safeguards in place before including patient PII data flows as a normal part of cloud hosted solutions.
5. Mandated Interoperability
Thomas Fogwill of CSIR Meraka Institute made the strong case for interoperability and data sharing as a cornerstone for integrated care and national health insurance. In South Africa, this was expressed as the National Health Normative Standards Framework for Interoperability (HNSF).
The HNSF is largely technology agnostic and its based on existing standards, such as HL7 and Integrating the Health Enterprise (IHE), to allow software systems to exchange data on specific health functions at scale. HNSF isn’t prescriptive to internal software systems or licensing, it only cares about data exchange at interface points.
6. Professionalization of Data Analysis
Martin Osumba of RTI International mentioned how health information systems now becoming central to managing every aspect of health facilities, from clients to hospitals – now its almost impossible to talk about health without talking about data, which means technology.
This trend is forcing a professionalization of data analysis skills across the health ecosystem. Everyone from nurses to health ministers is upgrading their skills to understand data flows, and there is now an increasing need for a professional Health Informatics Officer role too.
7. Add Your Digital Health Trend…
There are many more digital health trends that merit a mention, that were not discussed at the OpenHIE meeting. Please add your thoughts in the comments section to enlighten us all.
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