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Updated On: Thursday, 17 January 2019

Q&A: Privacy ‘not keeping pace’ with digital health

The pace of technological advancement in digital health – where smartphones and the internet are being used to personalise health services – is moving faster than policies to ensure people’s data is being protected, according to Patricia Mechael, co-founder of the non-profit organisation HealthEnabled.

“The technology is moving faster than policies to ensure that data ownership is clear,” says Mechael, who while at the Bellagio Center in 2015 worked on the Global Digital Health Index, an interactive tool designed to monitor and evaluate digital health at a country level. The Index was launched during the World Health Assembly in May this year. As part of the Bellagio Residency 2018 series, Mechael tells SciDev.Net about the shift towards integrating electronic health systems and mobile health applications, and using them at scale safely and sustainably.

What can we expect to see in how digital health tools are used by community health workers in the next 10-20 years?

What we've seen traditionally has been a real focus on health system strengthening and using technology for health information systems, disease surveillance. Increasingly, because of universal health coverage, it's being used for health insurance. Then in parallel, there have been a number of support tools for health professionals and health workers. We've had tools to support everything from decision support for community health workers, mobile telemedicine, and community case management – so registering and tracking of individuals, and then linking them to health services in a clinic. But a lot of that work has largely happened in isolation of the larger health system. Now what we're seeing are some really exciting developments of bringing those two pieces together.

What’s an example of this?

A really good example is the MomConnect programme in South Africa, which started as a resource to provide messages to women during their pregnancies, as well as through to the first year of [the baby’s] life. People were largely happy with the services they were receiving. But then there was this request by the nurses to say, is there a set of support tools for the nursing staff providing the services ‒ and is there a way to connect these women into services and track them more systematically? There's now a suite of tools developed that are highly integrated with each other. So what used to be highly centralized is moving more towards decentralization, and it's being connected. We're also starting to see individuals accessing different tools to support their own health as well as interact with the system.

How widely is that happening beyond MomConnect, which your organisation is involved in?

Is that integration promoted on the policy level, or is it driven by technology developers?

What's the motivation for countries to require that integration?

Do you see a downside to setting up these systems?

Does the responsibility to look at these issues rest with governments themselves?

Are there other areas that need attention?

This interview has been edited for brevity and clarity.

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