Covid -19 pandemic has caused unprecedented global health crisis and weakened the countries economically. Nevertheless, it has also led to the rapid adoption of digital technology. Digital health can have transformative impact on developing countries health system.

The report, “Digital health: A health system strengthening tool for developing countries” has highlighted the examples of digital health and digital solutions which has strengthened the health system of developing countries.  Digital health should be scaled to the bottom of the pyramid and participants in the report have provided four strategies for driving adoption and scaling digital health solutions to the bottom of pyramid in developing countries. Such as,

1. Leveraging community health workers and other agent networks
2. Combining brick-and-mortar with digital technology
3. Combining business model and bundling services
4. Developing multi-stakeholder partnerships

Additionally, strategic recommendations for digital health stakeholders during and beyond the COVID-19 pandemic has been reported too

Read more: gsma.com/mobilefordevelopment/wp-content/uploads/2020/06/Digital-Health-June-2020.pdf

@ashishjoshi

Couldn't agree more. Digital health could surely be a tool for strengthening the health system. Now more than ever there is a need to have a Governing body for digital health initiatives. Data being the most powerful tool needs to be regulated and protected by all means. Prior to implementation of any Digital health initiative, more emphasis needs to be given to laying the ground work for the same. Valid and extensive research needs to be undertaken to highlight the topics of concern such as Digital divide and Evaluation of technological prowess of the health professionals, acceptance and user-centric approach which will allow to curate evidence based policy decisions. Panel discussions and experts on board for design and implementation of interventions. Amalgamation of expertise from various fields and ONE HEALTH approach will surely turn concepts into action.Innovation and ideation is required in the field of Tele-medicine given the current situation, to maximize the output and efficiency of patient care in the pandemic.

Digital health has a potential to serve a big population effectively. With the component called innovation, many health disparities can be solved by improving the healthcare delivery mechanism through time bound activities and decision and by delivering high quality services. National and regional integration, interoperability and adaptability mechanism should be established along with legal framework which guide data custodianship and data sharing with consent for effective and shared clinical decision making.

@ashishjoshi

NITI Aayog report on Health System for a New India (2019), advocates that digital initiatives are significant in efficient management of the health sector and identifies Digital health as a potent lever for improving the health system of the country. The report highlights “six pillars” of digital health initiative alternatively described as HEALTHe India. These pillars involve:

• Pillar One: Governance – improved governance of the myriad elements involved,
• Pillar Two: Health Data Dictionary (HDD) and Master Registries – creation of the necessary information standards to articulate a “common language” for interoperability,
• Pillar Three: Building a strategy for Hospital Information Systems (HIS) for ALL facilities, both public and private – new and improved information systems for health facilities,
• Pillar Four: Health Insurance Information Systems [HIIS] for health payers – A new and improved platform for health insurance payers,
• Pillar Five: Anywhere, anytime records for clinicians (Electronic Health Records [EHR]) and for patients (Personal Health Records [PHR]) – The design of a longitudinal electronic health record accessible by both providers and patients,
• Pillar Six: Facilitating the creation of the health information infrastructure – The technical infrastructure (or “exoskeleton”) as well as human capacity needed to support all this.

//niti.gov.in/node/916

Digital technologies offer new opportunities for delivering health care. And has the potential to transform healthcare services which can further contribute in several ways for health system goals. There are various factors in the ongoing process of digitalization of health services that influence the performance of the health care system. Technological change is one of the major factors. Other factors comprise quality of the process, design, the cost-effectiveness of implementation, the involved stakeholders which includes the end-users, developers, producers and government.

The proposed guidelines addresses various methods and factors affecting the effectiveness of digital health interventions and may help the governments and policymakers attain an effective way of digitalization of health services.

We also need to understand that digitalization can have both positive and negative effects. A balanced view of the effects of digitalization is needed and not all forms of digitalization may result in improved care and health system performance.

It is necessary to systematically assess and evaluate the impact of digital health services and especially the transformative aspects of healthcare delivery to understand and effectively implement new changes.

@kamalpreet

No doubt the pandemic has unraveled the myriad avenues and opportunities to uplift preventive healthcare and Public Health in India and the world. Many governments have supported stakeholders to innovate new technologies to flatten the curve. For instance, Mobile technologies  are deployed for tracking persons and notifying the authorities. Doctors and hospitals are making use of teleconsultation and tele-information which was hardly practiced prior to the pandemic. Healthcare Industries are bringing into play robotics, Artificial Intelligence, 3 Dimension (3D) printing etc., to come up with innovations that can combat the spread of the disease. 

Read More : //www.ijph.in/article.asp?issn=0019-557X;year=2020;volume=64;issue=6;spage=117;epage=124;aulast=Sarbadhikari

//www.researchgate.net/publication/345867713_A_New_Phase_of_Healthcare_COVID-19_and_Medical_Advancements

@ashishjoshi

Interesting read sir. According to European Commission- eHealth Action Plan 2012-2020 objectives of digital health services include cost-efficiency gains, improvement of the effectiveness of medical treatments, advancing the early diagnosis of illness, enhancing positive healthcare outcomes, and good governance of the public sector by enhancing transparency and accountability. Digital governance of healthcare can ensure to empower patients by improving their medical treatment in terms of quality and effectiveness, protecting their safety, privacy, and fundamental rights, and regulating their data.

According to WHO, Digital health a key building block for health-related Sustainable Development Goals, however, countries lack good governance which is required for successful implementation and sustainability of digital health throughout the health system. To coordinate stakeholders and policies digital health governance is the keystone of the foundation which is needed at all levels—local, district, and national—throughout the health information system. Good digital health governance is based on the principles of accountability, transparency, rule of law, responsiveness, equity and inclusiveness, effectiveness, efficiency, and participation, as well as confidentiality

Together with partners, the Asian Development Bank developed a health ICT governance architecture framework (HIGAF). It has three tiers that encircle the entire framework:

1. The first tier is leadership, governance, and multisector engagement- This layer ensures stakeholder coordination function of the framework. 
2. The second tier covers the governance process (legislation, policy, and compliance)- To ensure IT policies are aligned across the country, and laws are enforced.
3. The third tier is strategy and investment- which ensures that financing priorities are aligned across governments, funding agencies, and the private sector.

Read more: “Transforming Health Systems through Good Digital Health Governance”- ADB Sustainable Development Working Paper Series

//www.adb.org/sites/default/files/publication/401976/sdwp-051-transforming-health-systems.pdf

@harpreet Good read Harpreet, but still there is need to make many amendment to the NITI AYOG's 2019 reports if we compare with WHO's current guideline on mHealth.
Undoubtedly in India, there is significant caliber to leverage mHealth as a primary healthcare delivery channel. Since behavioural factors have created a need for such a channel. Indian government should intervene with other research organisation to make it effective and zero error platform.
Why there is necessary for robust mHealth platform?
According to CISCO "Globally, mobile data traffic will grow 7-fold from 2016 to 2021, a compound annual growth rate of 47%. In India, mobile data traffic will grow 7-fold from 2016 to 2021, a compound annual growth rate of 49%" mHealth applications are not crucial and being effectively used by industry.
I found this report very useful, hope you would love to read such facts.
it also includes Current challenges for mHealth adoption in India. 

The current pandemic has paralyzed the healthcare system of even those countries which were considered to be the most effective and efficient health systems in the world. It has also revealed the areas of public health preparedness which are lacking. But with this there has emerged a real understanding of how digital health could be a support structure in unprecedented times not just in addressing COVID-19 but other diseases as well. Countries with developed digital health infrastructure is leveraging its importance to contain and manage the current pandemic and simultaneously addressing the other disease burden. The overloaded healthcare systems of all the countries has got tremendously affected in its performance for achieving various layers of the Universal Health Coverage. Besides logistics, there is extreme shortage of healthcare professionals. To address the rising challenges with increasing burden of the current pandemic and also effective delivering of other health programs, there is a need of trained health workers. Usage of digital tools in medical education and capacity building would really be of much use as it would help in better decision making by the health professionals. Various evidence based digital health interventions outcomes could serve as tools for making informed decision making by policymakers which would attract contributors, donors and investors in digital health interventions thereby strengthening the health system of a country. With expansion of digital health, there would be a need of concrete governing and regulatory authorities who can take care of citizen centricity, quality of care, better access, universal health coverage, inclusiveness, data privacy, data management and interoperability within a legal structure.

I believe we have just started the journey with digital health and it will go a long way. Digital health also give an effect on our societal norms, behavioral change, national and social-economical structure, and many more. India is now embarking on the future journey for digital health. The Government of India has formulated the National Digital Health Mission (NDHM) intending to provide the necessary support for the integration of digital health infrastructure in the country. This visionary initiative, stemming from the National Health Policy, 2017 intends to digitize healthcare in India.

//www.nhp.gov.in/national-digital-health-mission-(ndhm)_pg

Although there is little evidence that examines the efficiency of mobile technology interventions with respect to healthcare systems, the existing knowledge base alludes to strengthening the individual components of healthcare systems and their relationships. 

The use of mobile technology in population health serves as a great tool to improve access, quality, coverage and safety of healthcare services. There is a growing excitement around it due to the expansion of mobile phone infrastructure, particularly in low to middle income countries. 

Plethora of evidence suggests that mHealth can help healthcare settings to work effectively, improve physician and patient communication, patient self-management approaches, support healthcare worker supervision, create a broadcast of health information, quick development of test results, reduce inaccuracies in the data collection, entry, and analysis processes and finally provide employment opportunities to workers across all skill levels.

@ritikakaur

I agree with the stated fact that mHealth has empowered users with handheld devices for a broad range of healthcare services. However, mHealth systems face significant challenges related to data security and privacy that must be addressed to increase its pervasiveness. There is an increasingly major concern regarding the security and privacy of data gathered, processed, and stored by mHealth applications. Sensitive data gathered by mobile health apps may be accessible to the patient, physicians, family members, or scientific researchers but may also be shared with third parties for advertising purposes thereby putting the confidentiality of consumer's data at risk. Secure mHealth systems can develop trust among consumers. Healthcare professionals and healthcare providers are required to adopt standard guidelines to increase security and protection of data from any Data Security breaches.

Read more about "Security and Privacy Issues Related to the Use of Mobile Health Apps"

//openrepository.aut.ac.nz/bitstream/handle/10292/8117/acis20140_submission_12.pdf?sequence=1&isAllowed=y

Digitalization is one of the newest emergings in healthcare. Covid 19 pandemic has led to the utilization of this technology in various ways like telemedicine which was unexplored & was read in textbooks only. This pandemic has not only led to accessibility but the acceptability of smartphones driven consultation which can be used as contact tracing & surveillance.   

The COVID-19 pandemic has magnified existing weaknesses and gaps in health systems especially in the developing countries. Thereafter signifying the stronger need for better healthcare system. Digital solutions have proven to be an excellent tool to address and communicate within and outside the community to provide better solutions.

Hence Digital health interventions (DHI) is the need of the hour. 

Read more about Digital Health at: 

//www.gsma.com/mobilefordevelopment/wp-content/uploads/2020/06/Digital-Health-June-2020.pdf