Novartis Foundation, Switzerland.
Telecommunication Development Bureau of the International Telecommunication Union, Switzerland; Broadband Commission for Sustainable Development, Switzerland.
Int J Med Inform. 2021 Jun;150:104456. doi: 10.1016/j.ijmedinf.2021.104456. Epub 2021 Apr 10.
Rising rates of NCDs threaten fragile healthcare systems in low- and middle-income countries. Fortunately, new digital technology provides tools to more effectively address the growing dual burden of disease. Two-thirds of the world's population subscribed to mobile services by the end of 2018, while the falling price of connectivity and the 5G networks rollout promise to accelerate the use of digital technology. Properly leveraged, we can employ digital solutions and applications to transform health systems from reactive to proactive and even preventive, helping people stay healthy. With artificial intelligence (AI), health systems can be made more predictive by detecting risk factors and helping health professionals respond faster to prevent disease. Yet this rapid pace of growth has also complicated the digital health landscape. Myriad digital health apps compete and overlap in the public and private sectors, and significant gaps in the collection and analysis of digital data threaten to leave some behind. Established in 2010, the Broadband Commission for Sustainable Development is led by ITU and UNESCO and advocates for the transformational impact of broadband technologies for development. Its working group on digital and AI in health, co-chaired by the Novartis Foundation and at different times Nokia, Intel and Microsoft, identifies best practices for countries to realize the potential of digital technology in health and care. Interviewing more than 100 key stakeholders and reviewing over 200 documents, the Working Group set out to identify common challenges that countries face in implementing digital health solutions, and to develop a framework that countries can use to build systems for supporting digital health solutions. Common challenges include a lack of coordination leading to fragmented digital health solutions; lack of systems and workforce capacity to manage data and digital technology, and inadequate financing to support digital health. The working group proposes six building blocks for digital health systems: formulate and execute a national digital health strategy; create policy and regulatory frameworks that support innovation while protecting security and privacy; ensure access to digital infrastructure; ensure interoperability of digital health system components; establish effective partnerships; and sustain adequate financing.
不断上升的非传染性疾病发病率威胁着中低收入国家脆弱的医疗体系。幸运的是，新的数字技术提供了更有效地应对日益增长的双重疾病负担的工具。截至 2018 年底，世界上三分之二的人口已经订阅了移动服务，而连接成本的下降和 5G 网络的推出有望加速数字技术的使用。如果得到适当利用，我们可以利用数字解决方案和应用程序，将卫生系统从被动转变为主动，甚至是预防性的，帮助人们保持健康。通过人工智能 (AI)，健康系统可以通过检测风险因素并帮助医疗保健专业人员更快地做出反应来预防疾病，从而变得更具预测性。然而，这种快速的增长速度也使数字健康领域变得更加复杂。众多的数字健康应用程序在公共和私营部门中竞争和重叠，而在数字数据的收集和分析方面存在的巨大差距，有可能使一些人掉队。成立于 2010 年的可持续发展宽带委员会由国际电联和教科文组织领导，倡导宽带技术对发展的变革性影响。其数字和人工智能工作组由诺华基金会共同主持，诺基亚、英特尔和微软也曾担任不同时期的共同主席，为各国确定了在卫生和保健领域实现数字技术潜力的最佳做法。该工作组采访了 100 多名主要利益攸关方，并审查了 200 多份文件，旨在确定各国在实施数字卫生解决方案方面面临的共同挑战，并制定一个框架，供各国用于建立支持数字卫生解决方案的系统。共同的挑战包括缺乏协调导致数字卫生解决方案碎片化；缺乏管理数据和数字技术的系统和劳动力能力；以及支持数字卫生的资金不足。工作组提出了数字卫生系统的六个构建模块：制定和执行国家数字卫生战略；创建支持创新同时保护安全和隐私的政策和监管框架；确保数字基础设施的获取；确保数字卫生系统组件的互操作性；建立有效的伙伴关系；以及维持充足的资金。
