The Riyadh Declaration: the role of digital health in fighting pandemics

The Lancet
Nov 14, 2020 Volume 396 Number 10262 p1535-1606, e83-e88
https://www.thelancet.com/journals/lancet/issue/current

 

Comment
The Riyadh Declaration: the role of digital health in fighting pandemics
Bandar Al Knawy, et al.
The COVID-19 pandemic has exposed weaknesses in health and care systems and global public health responses, some of which can be addressed through data and digital science. The Riyadh Declaration on Digital Health was formulated during the Riyadh Global Digital Health Summit, Aug 11–12, 2020, a landmark forum that highlighted the importance of digital technology, data, and innovation for resilient global health and care systems.

Our panel of 13 experts articulated seven key priorities and nine recommendations (below) for data and digital health that need to be adopted by the global health community to address the challenges of the COVID-19 pandemic and future pandemics.

Recommendations from the Riyadh Global Digital Health Summit
1 Implement data-driven and evidence-based protocols for clear and effective communication with common messaging to build citizens’ trust
2 Work with global stakeholders to confront propagation of misinformation or disinformation through social media platforms and mass media
3 Implement a standard global minimum dataset for public health data reporting and a data governance structure tailored to communicable diseases
4 Ensure countries prioritise digital health, particularly, improving digital health infrastructure and reaching digital maturity
5 Enable health and care organisations by providing the necessary technology to collect high-quality data in a timely way and promote sharing to create health intelligence
6 Cultivate a health and care workforce with the knowledge, skills, and training in data and digital technologies required to address current and future public health challenges
7 Ensure surveillance systems combine an effective public health response with respect for ethical and privacy principles
8 Develop digital personal tools and services to support comprehensive health programmes (in disease prevention, testing, management, and vaccination) globally
9 Maintain, continue to fund, and innovate surveillance systems as a core component of the connected global health system for rapid preparedness and optimal global responses

The first priority is for the health and care sectors to adopt applied health intelligence (HI). HI represents a systematic approach and comprehensive methodology applied to the collection, linkage, analysis, and use of appropriate health data. HI is used for the surveillance, monitoring, and improvement of population and patient outcomes, and for assessing the efficiency and effectiveness of policies, programmes, and services.1

The second priority relates to interoperable digital technology and for this technology to be scaled up and sustainable. Digital health tools and services require a secure, trusted flow of data with scalability and interoperability support. The advent of commercial cloud computing services and distributed systems has paved the way for scalable, cost-effective service provision.

The third priority is to support the adoption of artificial intelligence (AI). Use of AI in health systems demands rapid access to various data types, often not possible in health-care settings with slow data flows.2 AI also requires vast amounts of high-quality data to achieve acceptable accuracy and validity. Health-care organisations and systems need to provide the necessary technology to collect and share high-quality data.

Effective communication about public health crises and risk is the fourth priority. Such communication requires an understanding of risk and the timely dissemination of information; seamless digital integration of case reports and deaths; and effective data visualisation tools such as map-based dashboards.3Effective communication to change knowledge, attitudes, and behaviours mandates the systematic exploration of diverse digital channels and the innovative design of digital tools for citizen engagement.4

The fifth priority concerns health data governance, quality, policy, regulation, and use. Passively generated digital location data from mobile phones and internet services provide crucial information about human mobility and interactions.5

However, ethics and privacy are essential and must be adhered to when using these ubiquitous data. Projections about disease epidemics require human mobility and interaction data that are aggregated in time and space to reconstruct population-level behaviour.6

The sixth priority relates to the quality and effectiveness of digital technology for improved patient and population outcomes. Digital technologies offer many opportunities to improve the quality and effectiveness of care, patient outcomes, and population health.7

Digital health systems should be designed and implemented to maximise data quality and access for clinicians and patients and these systems should be interoperable.
The seventh priority is research and innovation. Investing in, conducting, publishing, and promoting transparent research are foundational to digital health advances that leverage data, analytics, and AI.8

It can take an average of 17 years to translate a major medical research discovery to widespread delivery.9

The competitive, commercial culture of technology revolves around disruptive innovation, iterative discoveries, and the delivery of new technologies over months, not years. To translate life-saving innovations in digital health into widespread applications, collaboration across the best of research and innovation in health and technology is essential.

The Riyadh Declaration on Digital Health is a call to action to create the infrastructure needed to share effective digital health evidence-based practices and high-quality, real-time data locally and globally to provide actionable information to more health systems and countries. Digital and data technologies have a role in promoting the coordinated development of shared global public health policies and resilient health and care systems. These technologies can support health systems and governments to perform better in future pandemics and other global health challenges. We call on state actors to ensure that digital technology and innovation become the cornerstone of a resilient global health and care system that places individual and population health at the forefront of our future endeavours.