Office of Research Services and the School of Business, MacEwan University, Edmonton, Alberta, Canada.
WHO Collaborating Centre on eHealth, School of Population Health, UNSW Sydney, Kensington, NSW, Australia.
Yearb Med Inform. 2022 Aug;31(1):47-59. doi: 10.1055/s-0042-1742502. Epub 2022 Jun 2.
While the COVID-19 pandemic provided a global stimulus for digital health capacity, its development has often been inequitable, short-term in planning, and lacking in health system coherence. Inclusive digital health and the development of resilient health systems are broad outcomes that require a systematic approach to achieving them. This paper from the IMIA Primary Care Informatics Working Group (WG) provides necessary first steps for the design of a digital primary care system that can support system equity and resilience.
We report on digital capability and growth in maturity in four key areas: (1) Vaccination/Prevention, (2) Disease management, (3) Surveillance, and (4) Pandemic preparedness for Australia, Canada, and the United Kingdom (data from England). Our comparison looks at seasonal influenza management prior to COVID-19 (2019-20) compared to COVID-19 (winter 2020 onwards).
All three countries showed growth in digital maturity from the 2019-20 management of influenza to the 2020-21 year and the management of the COVID-19 pandemic. However, the degree of progress was sporadic and uneven and has led to issues of system inequity across populations.
The opportunity to use the lessons learned from COVID-19 should not be wasted. A digital health infrastructure is not enough on its own to drive health system transformation and to achieve desired outcomes such as system equity and resilience. We must define specific measures to track the growth of digital maturity, including standardized and fit-for-context data that is shared accurately across the health and socioeconomic sectors.
虽然 COVID-19 大流行为数字卫生能力提供了全球性的刺激，但它的发展往往是不平等的，规划是短期的，缺乏卫生系统的一致性。包容性数字卫生和弹性卫生系统的发展是广泛的结果，需要系统的方法来实现这些结果。本文来自国际医学信息学协会（IMIA）初级保健信息学工作组（WG），为设计能够支持系统公平性和弹性的数字初级保健系统提供了必要的初步步骤。
我们报告了澳大利亚、加拿大和英国（来自英格兰的数据）在四个关键领域的数字能力和成熟度增长：（1）疫苗接种/预防，（2）疾病管理，（3）监测，（4）大流行准备。我们的比较着眼于 COVID-19 之前（2019-20 年）与 COVID-19 （2020 年冬季以来）期间季节性流感的管理。
所有三个国家在从 2019-20 年流感管理到 2020-21 年以及 COVID-19 大流行管理的过程中，数字成熟度都有所提高。然而，进展的程度是零星的和不平衡的，导致了人群中系统不公平的问题。
从 COVID-19 中吸取的教训不应被浪费。数字卫生基础设施本身不足以推动卫生系统转型，也无法实现系统公平性和弹性等预期结果。我们必须定义具体措施来跟踪数字成熟度的增长，包括在卫生和社会经济部门之间准确共享的标准化和适合背景的数据。
