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Highlighting solutions from digital health – propelling the field out of the era of “wild west” data collection, into a data use culture

By Lauren Hodsdon, Program Assistant, BID Initiative

Jul 13, 2017

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Photo: PATH/Trevor Snapp. Mothers in Tanzania’s Usa River Health Center wait to visit with a nurse. Digital strategies, such as those introduced by the BID Initiative, can create lasting, high-impact improvements to healthcare delivery.

The decade between 2000-2010 can be described as the era of the digital health pilot program. This “wild west” offered a glimpse into the untapped potential of collecting data by integrating digital tools into current health systems, where information flow was previously stagnant or non-existent. In an effort to create lasting, high-impact improvements to healthcare delivery, sharing lessons and best practices learned from implementing these pilot programs can ensure that digital health moves beyond pilots and becomes a health system mainstay.

On June 21, leaders in the field gathered for the monthly Global Digital Health Network (GDHN) meeting, hosted at PATH’s DC office, to discuss lessons from implementing data use partnerships to strengthen digital health strategies and programs. The GDHN, formally the mHealth Working Group, has been convening since 2009, with the goal of engaging and providing leadership to the global community on digital health.

During the meeting, leaders from PATH, Cooper/Smith, and Vital Wave highlighted common challenges addressed by their health system integration programs, including stakeholder engagement and country ownership, health workforce adoption, and interoperability. Dr. Henry Mwanyika, Director of the BID Initiative Tanzania, presented on lessons from Tanzania’s Data Use Partnership (DUP). PATH, in partnership with the Tanzanian Ministry of Health, conducted a landscape and gap analysis for the country’s health system and used that information to provide investment recommendations based on government priorities. The Tanzania Digital Health Investment Road Map was created as a result of this analysis to ensure program sustainability through stakeholder engagement and country ownership, by providing the government with the appropriate healthcare data to prioritize and make educated investments in digital health. Hannah J. Cooper, the co-founder and managing director of Cooper/Smith outlined the results from a study on data use and health worker system adoption on the Kuunika project, based in Malawi. The project has three main goals: improve data supply, improve data use, and improve data governance. Brooke Partridge, CEO of Vital Wave and Derek Treatman from Vital Wave, closed the conversation with a discussion on data interoperability within health systems. Vital Wave works with corporations, development organizations, and governments to scale technology solutions for a range of sectors, including health.

Below are several lessons from the GDHN presenters:

  • Identify countries and stakeholders with the political will to embrace change: Dr. Mwanyika pinpointed a few key factors to replicate Tanzania’s lessons from DUP, one of which was a “robust political will that favors strengthening health data quality and use.” Ensuring government support was central to the program’s sustainability. Working with a government that valued quality healthcare data allowed the program to be paired with policy to support it. Dr. Mwanyika also emphasized the value of collaboration with implementing partners and managers of major health information systems. Their ability to solicit input from these partners created additional support for the program, and allowed them to leverage this knowledge within the program.
  • Foster systems that are responsive to health worker needs and workflows: Kuunika project was able to develop three activities to combat the challenges they identified in Malawi. First, they developed a standard procedure to streamline paper data collection to decrease the multiple forms health workers were required to submit. To lower the burden of reporting, the Kuunika project tracked and measured this data reporting burden using health worker output factors, such as patient wait times and reporting time as indicators. Cooper also communicated the importance of incentivizing the use of digital tools, using, for instance, automated digital reports to show the impact of data decision-making to health workers.
  • Create national health data dictionaries to ensure accurate and comparative data across the entire health system: While working in Ethiopia to develop a registry of health facility records, Vital Wave discovered that many health clinics were collecting conflicting information and that health indicators were not well defined. In response to this challenge, Vital Wave, in partnership with the government of Ethiopia, created a National Health Data Dictionary, to define such indicators as early postnatal care coverage, and to ensure that data across Ethiopia was comparative and accurate. This increased data quality and the ability to use this data for decision-making, propelling the need and support for data collection throughout the country.

As digital health data use programs continue to grow, it is important to capture and share lessons learned to accelerate the field forward in the most influential way.

Amanda BenDor, co-chair of the GDHN added this insight on the program’s overarching lesson: “Sharing tools such as the Tanzania Digital Health Investment Roadmap or the Ethiopia National Health Data Dictionary emphasize the importance of strong governance and leadership needed to implement health information systems. These are complex, yet really important topics for our community to discuss.”

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