Sustainable Translation of Digital Health Technologies
Creators: name: Haines, Nicola
name: Trust, The Wellcome
Publisher: name: F1000 Research Limited
Year: 2024

description: <b>Executive Summary</b><br>
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In an era characterised by unprecedented advances in technology, the potential to transform healthcare through the integration of digital health technologies (DHTs) has captured the imaginations of researchers, innovators, and healthcare practitioners around the world. These DHTs encompass a spectrum of digital medical devices, predictive modelling tools, and more, promising to revolutionise healthcare delivery, address mental health challenges, combat infectious diseases, and confront the complex intersection of climate change and health.<br>
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However, DHTs developed in academia often fail to translate effectively into tangible real-world health impacts.<br>
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Translation is affected by a wide range of factors, which include the DHT type, the commercialisation route, the intended customer, and the end-user. We have identified <b>7 high level barriers </b>which exist across the translation pathway and hinder sustainable translation:<br>
 

 <b>Academics struggle to find funding </b>for translation activities
 <b>Academics tend to focus on knowledge generation </b>rather than commercialisation
 <b>Poor data collection </b>and poor adherence to standards impairs of DHTs form academia
 <b>Misconceptions around open-source </b>commercial viability, security, and maintenance costs limit successful translation
 Academics have limited knowledge to draw on for creating <b>sustainable nonprofit organisations </b>
 <b>Poor understanding of local context </b>often hinders implementation
 <b>Gaps in digital skills across stakeholders </b>at all levels hinders sustainable translation

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The substantially different enabling environments for digital health between high-income countries (HICs) and low- and middle-income countries (LMICs) results in different challenges and opportunities for each and warrants different requirements for sustainable translation. Funders should be aware of these barriers, and the wider context surrounding translation of DHTs to employ interventions and techniques to ensure successful translation to achieve real world health impacts. Funders have a crucial role to play in supporting the translation pathway directly through providing grant funding and by advocating for policies which promote translation sustainability. Donors must balance funding between basic research that contributes to scientific discovery and leads to academic publications, and challenge-led research that has immediate practical implications leading to economically sustainable market-ready products.<br>
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In LMICs it is <b>important for academics and funders to form partnerships </b>with national and regional level government, local NGOs and local technology providers who understand the local health and technology context and are therefore more likely to understand the requirements that will lead to sustained uptake. Funders should advocate for <b>expansion of open data initiatives and uptake open data standards, </b>whilst appreciating that the benefits of such initiatives can only be fully realised if <b>sustainable nonprofit business models </b>for digital health technologies can be consistently established. Funders should <b>consider open-source technologies as key enablers </b>of human and technological capacity, particularly for foundational technology platforms or technologies with multiple use cases. Universities should be encouraged and <b>upskilled to spin-out social enterprises </b>that are focused on delivering health value in LMICs.<br>
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In HICs, academics could be encouraged to <b>engage with end-users and customers </b>much earlier in the design and prototyping phase of the DHT development; and where possible, adhere to other industry standard digital development principles. Academics do not necessarily have the training or skills to develop, commercialise, and embed technologies. Therefore, they should be incentivised to <b>partner with organisations and individuals to scale and commercialise innovation</b>. Academics should also be incentivised through equity provision, rewards for achieving impact, or flexible involvement in implementation. Funders should <b>explore alternative translation models </b>that are not so reliant on the academic researcher playing multiple roles across the translation pathway.<br>
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To effectively tackle the obstacles that prevent DHTs from being sustainably translated, funders are key players in acting and pushing for change. However, the most powerful results will come from <b>cross-sectoral collaboration </b>across governments, universities, healthcare providers, funders, nonprofits, and international bodies – joining forces to make sure innovations are sustainably translated for health impacts.<br>
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<b>Context and Introduction</b><br>
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The global digital health landscape is dynamic and evolving at rapid pace. The COVID-19 pandemic further accelerated the demand for digital health technologies (DHTs), and 2020 marked a record-breaking year for funding and investments into the sector, with a 66% increase in venture funding from 20191. The proliferation of technologies provides an exciting opportunity for developers and researchers to make positive health impacts – at both patient and system level. Within the academic sphere, research teams continuously generate pioneering DHTs, driven by the pursuit of enhanced health outcomes, improved patient care, and the broader societal objective of achieving sustainable health impacts. The potential of these innovations is not being realised. A substantial divide exists between the academic genesis of these technologies and their realisation as sustained, accessible, and impactful solutions.<br>
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This report explores the multifaceted landscape that surrounds the translation of DHTs from academia into real-world applications. We pay particular attention to Wellcome’s strategic domains of Mental Health, Infectious Disease, and the intersection of Climate Change and Health, but many of our findings are generalisable across health domains. We delve into the pathways, barriers, and dynamics that shape the translation of promising innovations into practical technologies capable of enhancing healthcare delivery, improving public health, and contributing to a resilient and sustainable healthcare infrastructure.<br>
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We seek to empower funders with a set of actionable recommendations intended to stimulate positive change and enhance the success rate of translating DHTs, ultimately realising their potential for sustainable impact on health and wellbeing.