A Report Out from the WHO-ITU Summit in Geneva

This past May, I represented Dimagi at the WHO-ITU Summit in Geneva – an event co-organized by the UN agency International Telecommunication Union (ITU) and the World Health Organization (WHO). The summit represented the first time where Ministries of Health and Ministries of IT from around the world came together to discuss digital health’s current and future landscape.

Because digital health often falls at the intersection of several ministerial jurisdictions, the primary objective of the Summit was to discuss the best ways to promote coordinated digital health initiatives in an environment where coordination can be difficult. To best support national digital health initiatives, speakers emphasized how strong cooperation among different ministries is needed to address complicated, cross-functional digital health topics – such as data privacy, cross-border data sharing, or to ensure adequate budget allocation and enforced standardization. To best address these, and to further build trust among various stakeholders, a strong policy framework is required.

To start building those policy frameworks and e-Health strategies, several countries presented how they created an independent organization or a separate department within their Ministries of Health. Speakers also laid out how their digital health policies have to face major roadblocks that currently exist in their countries:

• For many countries, IT and electric infrastructure are still lagging behind – a clear barrier for digital health.
• Healthcare budgets for digital health often do not match the WHO’s recommended budget ratio.
• Digital health system interoperability and standards harmonization is still nascent.
• Digital health services are not yet integrated enough, and need to be more centered around patients instead of around disease areas.
• Digital health strategies often don’t focus enough on bringing health practitioners onboard or building the right incentives.
• The digital health evidence base needs to be better communicated and shared.

Listening to these challenges resonated a lot with me. At Dimagi, our digital health philosophy is to not only acknowledge but also embrace structural challenges in developing digital health systems, both in the United States and abroad. It was a fun exercise to hear some of these challenges, and think about ways that our company is trying to address them on a micro-level.

• Our software platform, CommCare, is intentionally designed to function in emerging markets that have underdeveloped IT infrastructure, namely by supporting mobile apps that run offline.
• When we built CommCare, we built it as a platform so that health programs could more easily and cheaply add content to their pre-existing mobile apps. This gives them the chance to go beyond a siloed approach by disease area, and instead, build mobile applications that focus on a patient’s entire health.
• We (and our partners) have prioritized assessing CommCare’s impact, resulting in a strong evidence base of over 50 published studies.
• At the same time, we acknowledge that digital health players need to coordinate better to standardize impact metrics. It’s the only way we can move closer to best assessing its true return on investment, which will enable ministries to better understand what budget should be allocated towards digital health.
• Through the support of the Bill & Melinda Gates Foundation and our partnership with the Grameen Foundation, we have recently focused our efforts on integrating CommCare with other healthcare systems. Thorough this work, we have worked with Grameen Foundation to expand MOTECH Suite – an open source software platform that enables organizations to deploy and manage a wide range of mHealth applications.

Although cross-coordination across Ministries is often difficult, it was fascinating to see how closely these two areas and needs are rapidly converging. For example, several Ministries of IT cited healthcare as a priority to focus their digital strategies. On the other end, numerous Ministries of Health described the urgency of integrating digital strategies into their healthcare systems. While we still have many challenges ahead, I left the meeting with a sense of optimism that the integration of digital health into both health and IT policy strategies will accelerate in the coming years, leading to promising outcomes for the patients’ health.