Towards Equitable and Resilient Digital Primary Care Systems: An International Comparison and Insight for Moving Forward

Abstract

Objective: While the COVID-19 pandemic provided a global stimulus for digital health capacity, its development has often been inequitable, short-term in planning, and lacking in health system coherence. Inclusive digital health and the development of resilient health systems are broad outcomes that require a systematic approach to achieving them. This paper from the IMIA Primary Care Informatics Working Group (WG) provides necessary first steps for the design of a digital primary care system that can support system equity and resilience. Methods: We report on digital capability and growth in maturity in four key areas: (1) Vaccination/Prevention, (2) Disease management, (3) Surveillance, and (4) Pandemic preparedness for Australia, Canada, and the United Kingdom (data from England). Our comparison looks at seasonal influenza management prior to COVID-19 (2019-20) compared to COVID-19 (winter 2020 onwards). Results: All three countries showed growth in digital maturity from the 2019-20 management of influenza to the 2020-21 year and the management of the COVID-19 pandemic. However, the degree of progress was sporadic and uneven and has led to issues of system inequity across populations. Conclusion: The opportunity to use the lessons learned from COVID-19 should not be wasted. A digital health infrastructure is not enough on its own to drive health system transformation and to achieve desired outcomes such as system equity and resilience. We must define specific measures to track the growth of digital maturity, including standardized and fit-for-context data that is shared accurately across the health and socioeconomic sectors.

Thrombocytopenic, thromboembolic and haemorrhagic events following second dose with BNT162b2 and ChAdOx1: self-controlled case series analysis of the English national sentinel cohort

“…Internationally, we need to maintain the higher levels of digital maturity achieved during the pandemic and ensure these datasets are of the highest data quality. 31 We should learn to work with entire national datasets, or with international data, especially to detect rare events. A limited primary care dataset of entire English national health data are available for research, with studies based on 46 million adults published, though not yet on second dose safety.…”

Medicina en la era digital: alcances y perspectivas

“…La integración de soluciones tecnológicas en este nivel de atención es fundamental para garantizar una respuesta ágil, coordinada y eficiente ante cualquier eventualidad, que permita la atención continua y personalizada de los pacientes (Kuziemsky et al, 2022).…”

Primary Care Informatics: Vitalizing the Bedrock of Health Care (Preprint)

“…Primary care informatics professionals rapidly deployed and scaled virtual health visits and identified and addressed inequities in the digital divide (such as those due to internet access) [12]. In response to the COVID-19 pandemic, additional opportunities were highlighted to further strengthen systems, including vaccination and disease prevention, disease management, public health surveillance, and pandemic preparedness [13].…”