THE DIGITAL TRANSFORMATION IN
HEALTH UNDER COVID-19
Policies for the Development of Data Infrastructure, Sharing and Use
Francesca Colombo, Head of Health Division
Directorate for Employment, Labour and Social Affairs
The 3rd WASS Digital Health Panel Discussion, 12 October 2020

Digital health has potential to be transformational…
Clinical practice improvement (quality)

System management

Faster access to critical information
More analytical precision
Improved clinical decision making (A.I. & Machinelearning)

Surveillance

Evaluate public health interventions
Inform good policy
Faster detection of outbreaks & hotspots
Faster response to public health emergency

Predictive public health

Monitor performance
Ensure better access to care
Reduce waste

Empowering people to self-careConnected patients and doctors
Better patient experience and satisfaction
Greater patient voice, choice andcoproduction of healthMore precise identification of at-risk populations
More targeted strategies and interventions to improvehealth promotion and disease prevention

Research & innovation

Statistical power
Vast and varied datasets‘Real world evidence’ for improving
medical technologies

…but sector is failing to harness full potential

Despite rapid digitalisation and immense opportunities in anindustry where information and communication are so
intrinsic to success and failure,

the health sector remains ‘data rich but information poor’Investment is lower in the health sector
Investment

Institutions

Investment in software and databases
as a % of non-residential GFCF

Data use

Infrastructure

Purchases of intermediate ICT
services as a % of output

Note: Note: Gross fixed capital formation (GFCF) is a measure of spending on fixed assets. Source: OECD 2019, Health in the 21st Century

Digital skills

Numerous & significant institutional barriers
InvestmentInstitutions

Data use

Infrastructure

Digital skills

Barriers and enablers of telemedicine use highlighted by experts, by number of reporting countries
Privacy and security legislation, information governanceConnectivity, access to broadband, and coverage in rural areas

Enablers

Suitable qualification/accreditation/training of staff

Barriers

Interoperability and ICT infrastructure
Clear reimbursement mechanisms
Specific legislation on telemedicine (e.g. on liablity)
A single coherent governance, management, funding strategy
Culture of change and adoption of new technologies
012345678Note: x-axis is number of countries; Source: OECD 2020, Bringing health care to the patient: an overview of the use of telemedicine in OECD countries910

Missed opportunities in linking & using data
Investment

Institutions

Technical, operational andgovernance readiness to use
electronic health record data, 2016

Source: OECD 2019, Health in the 21st Century.

Data use

Infrastructure

Digital skills

Geographical digital divides remain
Investment

Institutions

Data use

Infrastructure

Digital skills

Households in areas where fixed broadband with a contracted speed of 30 Mbps or more is available, 2017Source: OECD 2019, Measuring the Digital Transformation: A Roadmap for the FuturePatients and professionals need more support
Investment

Institutions

Workforce skills(Digital) health literacy

Lack of involvement

Data use

Infrastructure

Digital skills• 30 to 70% of health professionals report knowledge andskills shortages relating to digital tools and data analytics• More than half of people in most OECD countries are
considered to have a poor level of health literacy• A digital tool is often a “black box” to a health worker or is
not informed by workers’ and their patients’ needsA true digital transformation in health requires
political leadership, will and bold policy reform
Strategy• Overarching, cross-sector digital (health) strategy with aconsolidated vision, plan and policy-framework

Governance• A governance framework that enables data use and sharing for
agreed purposes but ensures privacy and data security

Capacity• Human (workforce and the public to make the most fromdigital technology) and institutional (data can be put to workto generate knowledge and action) capacity

Artificial intelligence and COVID-19: a new impetus?
Drug discovery
Machine learning used in the UK
and Hong Kong (China) to identify
molecules to halt viral replication

Faster diagnosis & prognosis
SARS-CoV-2

AI models developed in Chinalearn from CT scans to support
faster interpretation of images

Responsive people-centred care
In Spain, automated chatbots
that can both enquire about
symptoms and give advice

Early warning & surveillance
Canada and US searching big data
within and outside health sector tospot infections and target policy

Safer care & work environments
Danish self-driving robots with ultraviolet light to disinfect health care units moving
autonomously from room to room, taking the elevator and opening doors automatically
Image of coronavirus: Alissa Eckert, Dan Higgins/CDC

Exponential growth in telehealth but will it last?
See http://www.oecd.org/health/COVID19-OECD-Health-System-Response-Tracker.xlsx for more
Expanded provider payment

SARS-CoV-2

e.g. Estonia, Slovak Republic, Poland, Japan,Belgium, US, Ireland, France, Australia

New services and platforms
e.g. Slovak Republic, Greece, Israel,Turkey, Luxembourg, Brazil, Chile, Spain

New guidelines and regulations
e.g. Belgium, France, US, Japan, Korea

New legislation allowing usee.g. Costa Rica, Peru, Estonia, Poland

High-level political encouragement
e.g. Switzerland, UK, France, US
Image of coronavirus: Alissa Eckert, Dan Higgins/CDC

COVID-19 gives new momentum to real-time data
Before the pandemic hit only a few countries had real-time data on:• Real-time data about clinical visits at the national level.
• National international traveller information linked to patient data.
• National laboratory testing regarding influenza test results.
Now, according to informal poll of OECD country delegations:• 83% noted COVID-19 had led to more timely data collection• 74% that it had led to new person-generated data
• 61% that it had led to new or improved data linkage

Key takeaways

A digital transformation can help address
emerging health & policy challenges but…
a digital transformation relies on policy
reform, not just digitising existing processes

Strategy, governance and capacity can set
the reform process in motion &Smart investment will lead to ahealthy economic return

Read more @ www.oecd.org/health & www.oecd.org/coronavirus

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Francesca.COLOMBO@oecd.org