In 2005, the World Health Assembly urged member states “to consider drawing up a long-term strategic plan for developing and implementing eHealth services … to promote equitable, affordable and universal access to their benefits.”
This edict was reiterated in 2013, and in 2018, a guideline was released containing 10 evidence-based recommendations on digital interventions for health system strengthening. Two years later and a pandemic emergency has brought an urgency to our doorstep. The potential and necessity for digital, transformative, global health care has never been clearer.
Prior to the COVID-19 pandemic, British Columbia demonstrated costs savings and increased accessibility through strategic investments made by government, non-profits and industry. Starling Minds and Alavida Health are both B.C.-based companies in the digital health space that benefited from early investments. Starling Minds developed a workplace mental health platform for organizations as an on-demand, 100% digital cognitive behavioural therapy solution for employees to access evidence-based support. Alavida offers an alternative treatment to 12-step programs through a mobile platform, allowing clients to track their drinking, triggers and medication use, and share them with their care team in real time.
The use of digital health services has grown exponentially during COVID-19. Health authorities quickly developed toolkits for diagnostic and care support, enabling more people to hold virtual appointments with their primary care physician. Telus Health expanded its Home Health Monitoring service to better support vulnerable populations. While reactive, this demonstrates that B.C. has the capability to pivot and make digital health work.
Canada’s Digital Technology Supercluster has also invested heavily in digital health. The Dermatology Point-of-Care Intelligent Network uses an artificial intelligence-powered medical imaging network to connect all points of care for patients who may be dealing with skin cancer. The project will expedite urgent cases faster through e-referral and e-triage, and train artificial intelligence models on real-life clinical data to create algorithms for clinical decision support and medical education.
The COVID Cloud is another project aimed at securely sharing data and knowledge about the genetics of the COVID-19 virus over a global network, which is critical to the rapid development of treatments and therapies. This platform is a model of how health data can be made accessible across multiple jurisdictions.
Digital innovation is transforming health care by offering enormous promise to improve quality of life while decreasing expenses. We need to move forward in making it normative, but not without rigour and a healthy dose of caution. Health data is personal by nature and needs to be secured to prevent theft and inappropriate use. There are additional challenges around accessibility for patients and informed consent. We also need a thorough plan for protecting patients and practitioners. These are solvable challenges.
A provincial and national platform for health data has the potential to enable a much broader representation of diverse populations, where patients are empowered and access to specialist care is democratized. The technological solutions to collect and interpret data at scale using federated access are being developed. Privacy jurisdiction and policies are the real barrier and we need to find solutions for those now more than ever. •
Pascal Spothelfer is president and CEO of Genome British Columbia.
