Change takes time, but not too much
By Kate Wilson, Former Director of Digital Health Solutions, BID Initiative
Feb 9, 2016
Posted in People, Policies & Practices, Products
Digital health has evolved beyond mobile apps and is poised to empower citizens around the globe. What needs to happen for that to occur?
Change is coming for health workers who still rely on register sheets to track and input data. Photo: PATH/Gabe Bienczycki.
We always overestimate the change that will occur in two years and underestimate the change that will occur in the next ten. Don’t let yourself be lulled into inaction.—Bill Gates.
I have always liked this quote by Bill Gates, as it reflects both my own experience in global health as well as the changing digital health landscape. A little over eight years ago, I started at PATH. Year one was quite a shock after working for 18 years in software and international trade. The business model, the acronyms—all were new to me and I knew next to nothing about global health. But I had amazing colleagues who took the time to educate me, listening to and answering my constant questions. While we came from different backgrounds, we shared a desire to change the world.
But how? I was not a scientist; but, I did know technology. In 2008, with my colleague David Lubinski (now with the Bill & Melinda Gates Foundation), I took the opportunity to start what is now PATH’s Digital Health Solutions team. In the ensuing years, we grew this from a team of 1.5 to a group of 16 based in three offices around the world.
Working directly with countries to support development of their information systems, as well as supporting direct implementations of PATH projects, we have expanded our approach to achieve better health outcomes through the use of information systems and data. We take a holistic approach that focuses not only on information system products but also on the people who use them and the policies and practices that affect that use.
The Better Immunization Data Initiative (BID) illustrates PATH’s holistic approach to digital health solutions. Working with national governments across Africa, the team is designing and refining current health products and practices that health workers need, applying them to individual country contexts, and working side by side in the field to deliver improved immunization outcomes in Tanzania, Zambia, and hopefully beyond.
PATH projects like the Better Immunization Data Initiative help us to achieve better health outcomes through the use of information systems and data use. Photo: PATH.
Since 2008, the digital health world has changed dramatically, making initiatives like BID possible. Enterprise architecture practices, our primary focus when we started the group, have become more mainstream in the global health conversation. Open software platforms (e.g., DHIS2, OpenMRS, OpenLMIS, Ihris) founded on these practices have expanded to countries. There is a growing recognition that the time for pilots is done and that all new projects must embrace the principles for digital development and be designed from the beginning to achieve national scale (or “institutionalization” as we framed it in our 2014 paper “The Journey to Scale”). Countries themselves are increasingly driving the development agenda with donors and private-sector companies actively working together to support national health systems.
Yet the barriers to achieving scale still persist; they are broader than the health sector, and more political than technical. In early February, I will start at the United Nations Foundation as the CEO of the Digital Impact Alliance. In this new role, I’ll focus on chipping away at those barriers across the development sphere and industries, exploring how we can improve deeper private-sector investment in access and services for lower-income consumers. We will also convene coalitions that can aggregate and use data to react nimbly to emerging crises.
While I do not know what the next two years will bring for digital development, I am excited to continue the journey over the next ten years, using the power of technology to empower citizens around the globe.