Successfully Implementing Digital Health to Ensure Future Global Health Security During Pandemics: A Consensus Statement | Emergency Medicine | JN Learning | AMA Ed Hub [Skip to Content]
[Skip to Content Landing]

Successfully Implementing Digital Health to Ensure Future Global Health Security During PandemicsA Consensus Statement

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME
Key Points

Question  What digital health recommendations should be adopted by the global health community to address the challenges of current and future pandemics?

Findings  By engaging a diverse stakeholder group of 13 leaders in the fields of public health, digital health, and health care, a consensus was reached on how to implement digital health recommendations to address the challenges of current and future pandemics across 5 main themes: team, transparency and trust, technology, techquity (the strategic development and deployment of technology in health care and health to achieve health equity), and transformation.

Meaning  This consensus statement provides a roadmap for the implementation of digital health policy by stakeholders, including governments, to prepare for and address current and future pandemics.

Abstract

Importance  COVID-19 has highlighted widespread chronic underinvestment in digital health that hampered public health responses to the pandemic. Recognizing this, the Riyadh Declaration on Digital Health, formulated by an international interdisciplinary team of medical, academic, and industry experts at the Riyadh Global Digital Health Summit in August 2020, provided a set of digital health recommendations for the global health community to address the challenges of current and future pandemics. However, guidance is needed on how to implement these recommendations in practice.

Objective  To develop guidance for stakeholders on how best to deploy digital health and data and support public health in an integrated manner to overcome the COVID-19 pandemic and future pandemics.

Evidence Review  Themes were determined by first reviewing the literature and Riyadh Global Digital Health Summit conference proceedings, with experts independently contributing ideas. Then, 2 rounds of review were conducted until all experts agreed on the themes and main issues arising using a nominal group technique to reach consensus. Prioritization was based on how useful the consensus recommendation might be to a policy maker.

Findings  A diverse stakeholder group of 13 leaders in the fields of public health, digital health, and health care were engaged to reach a consensus on how to implement digital health recommendations to address the challenges of current and future pandemics. Participants reached a consensus on high-priority issues identified within 5 themes: team, transparency and trust, technology, techquity (the strategic development and deployment of technology in health care and health to achieve health equity), and transformation. Each theme contains concrete points of consensus to guide the local, national, and international adoption of digital health to address challenges of current and future pandemics.

Conclusions and Relevance  The consensus points described for these themes provide a roadmap for the implementation of digital health policy by all stakeholders, including governments. Implementation of these recommendations could have a significant impact by reducing fatalities and uniting countries on current and future battles against pandemics.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 CME Credit™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: December 10, 2021.

Published: February 23, 2022. doi:10.1001/jamanetworkopen.2022.0214

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Al Knawy B et al. JAMA Network Open.

Corresponding Author: Bandar Al Knawy, MD, King Saud Bin Abdulaziz University for Health Sciences, PO Box 22490, Riyadh 11426, Saudi Arabia (knawyb@ngha.med.sa).

Author Contributions: Dr Al Knawy had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Crooks.

Drafting of the manuscript: Al Knawy, McKillop, Abduljawad, Tarkoma, Bates, Lee, Kozlakidis, Crooks.

Critical revision of the manuscript for important intellectual content: McKillop, Abduljawad, Tarkoma, Adil, Schaper, Chee, Bates, Klag, Kozlakidis, Crooks, Rhee.

Administrative, technical, or material support: Al Knawy, Abduljawad, Tarkoma, Lee, Crooks.

Supervision: Al Knawy, Chee, Rhee.

Conflict of Interest Disclosures: Dr Bates reported receiving grants from EarlySense; personal fees from CDI Negev; equity from ValeraHealth, CLEW, MDClone, and FeelBetter; personal fees and grants from IBM Watson; and equity and personal fees from AESOP outside the submitted work. Dr Rhee reported beng a former IBM employee and current CVS Health employee during the conduct of the study. No other disclosures were reported.

Disclaimer: Although Dr Kozlakidis is identified as personnel of the International Agency for Research on Cancer/World Health Organization (IARC/WHO), the author alone is responsible for the views expressed in this article, which do not necessarily represent the decisions, policy, or views of the IARC/WHO.

References
1.
Dixon  BE , Caine  VA , Halverson  PK .  Deficient response to COVID-19 makes the case for evolving the public health system.   Am J Prev Med. 2020;59(6):887-891. doi:10.1016/j.amepre.2020.07.024 PubMedGoogle ScholarCrossref
2.
Vandenberg  O , Kozlakidis  Z , Schrenzel  J , Struelens  MJ , Breuer  J .  Control of infectious diseases in the era of European clinical microbiology laboratory consolidation: new challenges and opportunities for the patient and for public health surveillance.   Front Med (Lausanne). 2018;5:15. doi:10.3389/fmed.2018.00015 PubMedGoogle ScholarCrossref
3.
Whitelaw  S , Mamas  MA , Topol  E , Van Spall  HGC .  Applications of digital technology in COVID-19 pandemic planning and response.   Lancet Digit Health. 2020;2(8):e435-e440. doi:10.1016/S2589-7500(20)30142-4 PubMedGoogle ScholarCrossref
4.
Blom  AG , Wenz  A , Cornesse  C ,  et al.  Barriers to the large-scale adoption of a COVID-19 contact tracing app in Germany: survey study.   J Med Internet Res. 2021;23(3):e23362. doi:10.2196/23362 PubMedGoogle Scholar
5.
Kliff  S , Sanger-Katz  M. Bottleneck for US coronavirus response: the fax machine. New York Times. July 13, 2020. Accessed December 8, 2021. https://www.nytimes.com/2020/07/13/upshot/coronavirus-response-fax-machines.html
6.
McCauley  D. “Trashed their fax machines”: Health Department scraps paper contact tracing. The Age. August 26, 2020. Accessed December 8, 2021. https://www.theage.com.au/national/victoria/trashed-their-fax-machines-health-department-scraps-paper-contact-tracing-20200826-p55pnr.html
7.
Meyer  GS , Britton  O , Gross  D .  Seven challenges and seven solutions for large-scale EHR Implementations.  NEJM Catalyst. October 12, 2018. Accessed December 8, 2021. https://catalyst.nejm.org/doi/full/10.1056/CAT.18.0073
8.
Tutty  MA , Carlasare  LE , Lloyd  S , Sinsky  CA .  The complex case of EHRs: examining the factors impacting the EHR user experience.   J Am Med Inform Assoc. 2019;26(7):673-677. doi:10.1093/jamia/ocz021 PubMedGoogle ScholarCrossref
9.
Reisman  M .  EHRs: the challenge of making electronic data usable and interoperable.   P T. 2017;42(9):572-575.PubMedGoogle Scholar
10.
Al Knawy  B .  Global data and digital public health leadership for current and future pandemic responses.   Front Digit Health. 2021;3:632568. doi:10.3389/fdgth.2021.632568 PubMedGoogle Scholar
11.
Sonnier  P . The story of digital health. Accessed December 8, 2021. https://storyofdigitalhealth.com/definition
12.
Al Knawy  B , Adil  M , Crooks  G ,  et al.  The Riyadh Declaration: the role of digital health in fighting pandemics.   Lancet. 2020;396(10262):1537-1539. doi:10.1016/S0140-6736(20)31978-4 PubMedGoogle ScholarCrossref
13.
Ogrinc  G , Davies  L , Goodman  D , Batalden  P , Davidoff  F , Stevens  D .  SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process.   BMJ Qual Saf. 2016;25(12):986-992. doi:10.1136/bmjqs-2015-004411 PubMedGoogle ScholarCrossref
14.
Oxford Centre for Evidence-Based Medicine. Levels of evidence (March 2009). Accessed January 18, 2022. https://www.cebm.ox.ac.uk/resources/levels-of-evidence/oxford-centre-for-evidence-based-medicine-levels-of-evidence-march-2009
15.
Murphy  MK , Black  NA , Lamping  DL ,  et al.  Consensus development methods, and their use in clinical guideline development.   Health Technol Assess. 1998;2(3):i-iv,1-88. doi:10.3310/hta2030 PubMedGoogle ScholarCrossref
16.
World Health Organization. Health emergency and disaster risk management framework. Accessed October 11, 2021. https://apps.who.int/iris/bitstream/handle/10665/326106/9789241516181-eng.pdf
17.
Committee on Data (CODATA) International Science Council. FAIR data for disaster risk research. Accessed October 11, 2021. https://codata.org/initiatives/task-groups/fair-data-for-disaster-risk-research/
18.
Politou E, Alepis E, Virvou M, Patsakis C. The “right to be forgotten” in the GDPR: implementation challenges and potential solutions. In: Privacy and Data Protection Challenges in the Distributed Era. Springer; 2022:41-68.
19.
Milosh  M , Painter  M , Sonin  K , Van Dijcke  D , Wright  AL . Political polarisation impedes the public policy response to COVID-19. Accessed October 11, 2021. https://european.economicblogs.org/voxeu/2020/painter-sonin-van-dijcke-wright-political-polarisation-impedes-public-policy-response-covid-19
20.
Moura  J , Serrão  C . Security and privacy issues of big data. In: Zaman N, Seliaman ME, Hassan MF, Marquez FP, eds.  Handbook of Research on Trends and Future Directions in Big Data and Web Intelligence. IGI Global; 2015:20-52. doi:10.4018/978-1-4666-8505-5.ch002
21.
Yoo  Y .  It is not about size: a further thought on big data.   J Inf Technol. 2015;30(1):63-65. doi:10.1057/jit.2014.30 Google ScholarCrossref
22.
Rhee  K , Dankwa-Mullan  I , Brennan  V , Clark  C .  What is TechQuity?   J Health Care Poor Underserved. 2021;32(2):xiii-xviii. doi:10.1353/hpu.2021.0045 Google Scholar
23.
Garattini  C , Raffle  J , Aisyah  DN , Sartain  F , Kozlakidis  Z .  Big data analytics, infectious diseases and associated ethical impacts.   Philos Technol. 2019;32(1):69-85. doi:10.1007/s13347-017-0278-y PubMedGoogle ScholarCrossref
24.
Hay  JA , Nouvellet  P , Donnelly  CA , Riley  S .  Potential inconsistencies in Zika surveillance data and our understanding of risk during pregnancy.   PLoS Negl Trop Dis. 2018;12(12):e0006991. doi:10.1371/journal.pntd.0006991 PubMedGoogle Scholar
25.
Al Manir  MS , Brenas  JH , Baker  CJ , Shaban-Nejad  A .  A surveillance infrastructure for malaria analytics: provisioning data access and preservation of interoperability.   JMIR Public Health Surveill. 2018;4(2):e10218. doi:10.2196/10218 PubMedGoogle Scholar
26.
Kluge  HHP . Statement—digital health is about empowering people. World Health Organization. June 25, 2020. Accessed December 8, 2021. https://www.euro.who.int/en/media-centre/sections/statements/2020/statement-digital-health-is-about-empowering-people
27.
Ienca  M , Vayena  E .  On the responsible use of digital data to tackle the COVID-19 pandemic.   Nat Med. 2020;26(4):463-464. doi:10.1038/s41591-020-0832-5 PubMedGoogle ScholarCrossref
28.
Silver  L , Smith  A , Johnson  C ,  et al.  Mobile Connectivity in Emerging Economies. Pew Research Center; 2019:7.
29.
Heponiemi  T , Jormanainen  V , Leemann  L , Manderbacka  K , Aalto  AM , Hyppönen  H .  Digital divide in perceived benefits of online health care and social welfare services: national cross-sectional survey study.   J Med Internet Res. 2020;22(7):e17616. doi:10.2196/17616 PubMedGoogle Scholar
30.
World Health Organization. Global strategy on digital health 2020-2025. Accessed December 8, 2021. https://www.who.int/docs/default-source/documents/gs4dhdaa2a9f352b0445bafbc79ca799dce4d.pdf
31.
Health Information Technology Advisory Committee. Final report of the Health Information Technology Advisory Committee’s Public Health Data Systems Task Force 2021. Accessed October 11, 2021. https://www.healthit.gov/sites/default/files/page/2021-08/2021-07-14_PHDS_TF_2021_HITAC Recommendations Report_Signed_508_0.pdf
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Close

Lookup An Activity

or

Close

My Saved Searches

You currently have no searches saved.

Close

My Saved Courses

You currently have no courses saved.

Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close