Digital Technologies for Public Health: Lessons from the Covid Era!

The year 2020 was supposed to be a watershed moment in public health history, where several goals and targets were set forth. The Global Burden of Diseases list was continually fluctuating, with the non-communicable diseases competing with infectious diseases for supremacy in terms of mortality and morbidity. The sudden deluge of the COVID19 pandemic disrupted the health ecology in the global arena.

Over the last few decades, technology has been a leveler touching almost all facets of human existence. However, the piecemeal technology solutions often do not yield tangible results. They may be excellent islands of excellence, but unless they are merged into a single harmonious system with inbuilt logic and process optimization, they remain as useless and, at times, frustrating technologies.

Technologies have proven beyond reasonable doubt their abilities to provide optimal solutions. However, their adoption across the spectrum and scaling up to meet the public health challenges are plagued by technical, administrative, and human resources issues. There is an acute shortage of human resources across different components of health care services that impair the effective use of technology solutions. The availability of trained human resources such as nurses and physicians is not readily available to meet the spectrum's requirements.

Today, there is a disconnect between the academic, research, and industry with the implementation stakeholders. The fundamental question is, "who is defining the problem and how are the research questions framed?" Most of the time, solutions are developed for the perceived problem through cross-domain experience. The challenges posed through this approach are one the implementer will find it challenging to adapt the solution as the workflow and activities do not align with the solution offered, leading to redundancy. Secondly, the proposed solution by itself adds to the problem as it would bring in one more layer of unwanted activity to the ground level personnel. For example, it was proposed to capture pictures of people in home isolation. Several apps provide geo-tagged pictures that can verify the exact location of an individual. We expect the individuals to upload their photos from the confines of their bedrooms to a public domain without knowing the outcome or utility beyond the statutory requirement! Apart from the fundamental questions of trust and privacy, unless the images are verified and used for a specified purpose, it remains a futile activity. So is the case of collecting myriad data regarding home isolated C+ patients. If the information is captured in an app and lies unanalysed, the whole exercise is redundant. So, we need to arrive at need-based technologies rather than technology defined needs!

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