In December 2014, PATH released Journey to Scale, a reflection on the challenges global health organizations and funders had faced in accelerating the use of digital tools to improve health service delivery and health outcomes. Our conclusion at that time was that while access to digital technology was spreading quickly, political and other ecosystem barriers persisted, including the lack of shared goals and efforts among digital health stakeholders, resulting in many small-scale pilots and systems that had limited impact.
In the decade since, PATH had focused on actualizing the recommendations in Journey to Scale. This includes working to ensure digital tools and investments are designed according to the needs of local health system stakeholders, aligned to the vision and priorities of the government, and built around realistic funding models.
We recently reflected on these subsequent efforts, now captured in “Ten Years of Digital Transformation and Data Use: How Far We Have Come and the Road Ahead.”
In this paper, we highlight key trends and shifts in global digital health practice over the last 10 years. This includes the alignment of stakeholders around shared principles and frameworks, such as the Principles for Digital Development and the SMART guidelines, and the acceleration of investment in digital health systems, such as disease surveillance and telemedicine platforms, as a result of the COVID-19 pandemic.
What has changed over the last decade in global digital health?
To further our reflection on what we have achieved and where we are going, I asked PATH’s digital health experts about major trends in global digital health over the last 10 years. Below are some of their reflections.
Better collection, availability, and use of health data
Our digital health experts noted that, over the last decade, countries have made significant progress in building the infrastructure, systems, and skills necessary to introduce electronic medical record (EMR) systems. EMRs lead to better care for all patients as health professionals can access an individual's health history, vaccine record, lab results, and other key information that helps with making accurate diagnoses and effective treatment plans. Digitized health records also help health care providers to quickly identify patients who are due for follow-up visits and to share data on disease trends with public health professionals who can use the data to direct resources most appropriately. This improvement in data access and use is also thanks to the improved use of standards and building interoperable systems.
“Today, when talking about health data and data exchange, we talk about interoperability standards, such as FHIR, much more than we used to 10 years ago,” said Carl Fourie, Deputy Director of Digital Services in PATH’s Center of Digital and Data Excellence (CoDE).
“We are all settling in on a universal ‘language’ and stopping the arguments of how to integrate and store data and moving toward how to use the data to improve health service delivery and achieve the promise of digital health.”
“We are...stopping the arguments of how to integrate and store data and moving toward how to use the data to improve health service delivery and achieve the promise of digital health.”— Carl Fourie, Deputy Director of Digital Services, PATH
Movement toward localization
Over the last decade, national governments, supported by the global health community, have taken greater ownership of digital health systems and tools. Local technologists are developing more tools, and investments are directed to improving infrastructure and human capacity to support the sustained use of these tools.
“There has been a notable change in how programs are designed and implemented. Localization has become a central theme, prompting donors to prioritize locally driven implementation strategies and align with needs identified by local governments,” said Nina Getachew, a Senior Project Administrator in CoDE.
The localization movement has also supported programs that develop local digital health leaders, as well as a skilled workforce that can effectively use and sustain digital health systems and tools. For example, PATH’s Digital Health Applied Leadership Program (DHALP) has supported ministries of health to increase their capacity to design and implement digital health initiatives and shape training programs that are needed to effectively staff and sustain these initiatives.
“Localization has become a central theme, prompting donors to prioritize locally driven implementation strategies and align with needs identified by local governments.”— Nina Getachew, Senior Project Administrator, PATH
What’s next?
PATH digital health experts also reflected on upcoming shifts. With the recent changes in global health funding, countries and implementing partners face a period of uncertainty alongside an opportunity to innovate and drive digital health solutions that are sensitive to financial adjustments, the rapid advancement of digital technology, and emerging health risks.
Rise of artificial intelligence
Artificial intelligence (AI) is already playing an increasing role in health care worldwide, supporting health care workers to interpret test results, make diagnoses, and access expert-level guidance when they encounter complex or unfamiliar cases. AI provides immense potential for increasing access to health information, but there is also work to do to ensure AI-enabled tools are free of bias and accessible to all.
PATH is at the forefront of advancing research and evidence on how to safely and effectively use large language models to support frontline health care workers with clinical decisions. In a recent commentary, PATH and its partners advocated for investing time and resources in AI-focused research and evidence generation. This will help ensure that in 10 years we can look back and see that governments and implementing partners rolled out AI innovations in a purposeful way that was backed by evidence and contributed meaningfully to the goal of universal, high-quality health care access.
“Climate services for health will be a growing area of importance, especially related to mitigation and response to extreme weather events and pandemic response.”— Linda Taylor, Technical Program Manager, PATH
More integration between climate and health
Climate change is a growing and urgent health challenge, particularly for populations already facing health and economic disparities.
“Climate services for health will be a growing area of importance, especially related to mitigation and response to extreme weather events and pandemic response,” said Linda Taylor, Technical Program Manager in CoDE.
PATH experts are supporting these efforts by promoting Digital Public Infrastructure (DPI) as essential for integrating climate and health data, allowing policymakers and health leaders to make informed decisions as they build climate-resilient health systems. As we look ahead to the next decade, we know countries will need to combine satellite data, weather information, and health sector insights to better predict disease outbreaks, respond to changing health needs, and mitigate the impact of extreme weather events.
Cross-sectoral partnerships, DPI, and digital public goods will be critical to enhancing climate- and health-informed data systems.
PATH is committed to advancing the recommendations shared in our most recent reflection paper to accelerate progress toward equitable digital transformation.
We invite our partners, funders, and the wider digital health community to join us in looking ahead to the next 10 years with optimism, recognizing progress and building on this momentum to help everyone, everywhere, live healthier lives.
