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BridgingGapsinHealth Manual 2022-2023
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Word from our NPO
Dear SCOPHeroes,
It's my pleasure to have the Bridging Gaps in Health manual published, to be a guiding document for all our members and anyone interested in working on this vast focus area.
BGH has not always been the easiest focus area to explain, and members have always needed guidance and explanations to bring them closer to the topics at hand. Thus, this is a much needed publication that aims to bridge all the knowledge gaps that might be present.
With “bridging the gap” being the umbrella guiding our discussions, we tackle topics like climate change, health systems, antimicrobial resistance, and more, keeping in mind how to ensure universal access to well-integrated care, and how to reduce health problems originating from health inequities.
Have a read through this manual, prepared by a wonderful cohort of passionate members, led by Nada Mahmoud (SWG Coordinator), with the guidance of Omar Elmowafi (National BGH Coordinator). We hope it serves its purpose well and guides all our beloved members in their SCOPH journeys.
It's time to bridge the gaps!
With LoPH,
Samira Yasser
IFMSA-Egypt National Public Health Officer (NPO)
22-23
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“Bridging Gaps in Health” is one of the most versatile focus areas within IFMSA-Egypt. It leaves a lot of space for innovation and enables public health advocates to identify their own gaps within healthcare systems and allows them to work on bridging them.
Whether it’s climate change, antimicrobial resistance or universal health coverage, BGH directs us in working towards these ideas as they are the main pillars of the focus area. However, it does not know any boundaries and its goal is to provide a blank canva for SCOPH members so their creative energy is not restricted and they can be independently creative.
Sadly, there is a lot of confusion around as members struggle to comprehend how to work within it due to lack of resources since the focus area is relatively new. This manual aims to bridge the knowledge gap we have and actively contribute to the focus area through enabling meaningful and impactful activities within our scope.
We hope this manual will prove to be “The Missing Piece” in your journey as a public health advocate, as there are valuable resources and guidelines to be discovered. We tried our best to provide you with a timeless manual that can guide you well in this “confusing” focus area, hopefully not anymore thanks to this manual!
Yours sincerely, “The Missing Piece” SWG, Nada, Layla, Omyma, Ayah, Salma and Omar
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Amessagefrom ourFAC
When it comes to health, it's no secret that there are gaps. These gaps can be seen in different aspects of health, such as access to healthcare, health outcomes, and disparities among different populations. These gaps in health can have serious consequences and affect the quality of life for many people.
Bridging gaps in health means working towards reducing or eliminating these gaps. It's about making healthcare accessible and equitable for all people, regardless of their background, socioeconomic status, or geographic location. Bridging gaps in health means working towards creating a healthcare system that is inclusive and meets the needs of all individuals.
The Bridging Gaps In Health Manual is a comprehensive guide that aims to help future healthcare professionals, policymakers, activity coordinators and advocates bridge gaps in health. It provides an overview of the different types of gaps in health, the factors that contribute to these gaps, and the strategies that can be used to address them. The manual also includes case studies and examples of successful initiatives that have been implemented to bridge gaps in health.
By working together and using the tools provided in this manual, we can make progress towards bridging gaps in health. We can create a more equitable and just healthcare system that meets the needs of all individuals, regardless of their background or circumstances.
"Perfection is achieved, not when there is nothing more to add, but when there is nothing left to take away"
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Meet Meet Tea Tea
NadaMahmoud SWGCoordinator
AyaAyman SWGMember
LaylaEl-Sallab SWGMember
OmymaAyman SWGMember
SalmaMagdy SWGMember
Our t Our am am
MohamedHany DesignTeamMember
HamsaMahmoud DesignTeamMember
MomenHassan DesignTeamMember
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Ahmed Abdelaziz DesignTeamMember
RawanAdel DesignTeamMember
FirstPiece
UNIVERSALHEALTH COVERAGE
-Health equity VS Health equality
-Social determinants of health
-Health system
-Health system models
-UHC in Egypt
-Gaps in health system
-The Doctor–Patient Relationship
-Health literacy & UHC
-Health literacy
Health Equity VS Health Equality
What Is Health Equality?
In healthcare, equality means treating all patients the same way. For example, a hospice nurse may spend equal amounts of time with every patient, or a dermatologist may offer the same information about sun exposure and skin cancer risks to each of theirs.
What Is Health Equity?
Health equity prioritizes social justice in healthcare. Unlike health equality, which calls for equal treatment for all patients, health equity prioritizes treatment and care based on need.
Equality does not always work in practice because some people need more support or a different kind of support than others.
For example, the APHA has noted that while online and telehealth options may work well for patients with access to the internet, online platforms may exclude patients who do not have internet access. No matter how well an organization designs a website or web platform, if some patients cannot gain access to it due to living in a rural area, being unhoused, or lacking the income to purchase an electronic device, these efforts will not enable health equity.
An equity approach, according to the APHA, strives to give everyone the “opportunity to attain their highest level of health” which means giving extra attention and resources to people with ill health because of a lack of access.
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Social Determinants of Health
What are social determinants of health?
As defined by the World Health Organization (WHO), SDOH are the nonmedical factors that influence health outcomes.They are the conditions in which people are born, grow, live, work and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.These circumstances are shaped by the distribution of money, power and resources at global, national and local levels.
The SDOH have an important influence on health inequities the unfair and avoidable differences in health status seen within and between countries. In countries at all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse the health.
The following list provides examples of the social determinants of health, which can influence health equity in positive and negative ways:
Income and social protection
Education
Unemployment and job insecurity
Working life conditions
Food insecurity
Housing, basic amenities and the environment
Early childhood development
Social inclusion and non-discrimination
Structural conflict
Access to affordable health services of decent quality.
The social determinants of health also determine access and quality of medical care terminants of health.
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What about Education Access and Quality?
People with higher levels of education are more likely to be healthier and live longer.
Healthy People 2030 focuses on providing high-quality educational opportunities for children and adolescents and on helping them do well in school.
Children from low-income families, children with disabilities, and children who routinely experience forms of social discrimination like bullying are more likely to struggle with math and reading. They’re also less likely to graduate from high school or go to college. This means they’re less likely to get safe, high-paying jobs and more likely to have health problems like heart disease, diabetes, and depression.
In addition, some children live in places with poorly performing schools, and many families can’t afford to send their children to college. The stress of living in poverty can also affect children’s brain development, making it harder for them to do well in school. Interventions to help children and adolescents do well in school and help families pay for college can have long-term health benefits
What about Health Care Access and Quality?
Healthy People 2030 focuses on improving health by helping people get timely, high-quality health care services.
About 1 in 10 people in the United States don’t have health insurance. 1 People without insurance are less likely to have a primary care provider, and they may not be able to afford the health care services and medications they need. Strategies to increase insurance coverage rates are critical for making sure more people get important health care services, like preventive care and treatment for chronic illnesses. Sometimes people don’t get recommended health care services, like cancer screenings, because they don’t have a primary care provider. Other times, it’s because they live too far away from health care providers who offer them. Interventions to increase access to health care professionals and improve communication in person or remotely can help more people get the care they need.
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Neighborhood and Built Environment
People live in have a major impact on their health and wellbeing. Healthy People 2030 focuses on improving health and safety in the places where people live, work, learn, and play.
Many people in the United States live in neighborhoods with high rates of violence, unsafe air or water, and other health and safety risks. Racial/ethnic minorities and people with low incomes are more likely to live in places with these risks. In addition, some people are exposed to things at work that can harm their health, like secondhand smoke or loud noises. Interventions and policy changes at the local, state, and federal level can help reduce these health and safety risks and promote health. For example, providing opportunities for people to walk and bike in their communities like by adding sidewalks and bike lanes can increase safety and help improve health and quality of life.
Social and Community Context
Public health infrastructure provides the necessary foundation for all public health services from vaccinations to chronic disease prevention programs to emergency preparedness efforts. Healthy People 2030 focuses on creating a strong public health infrastructure. The Public Health Infrastructure objectives address high-performing health departments, workforce development and training, data and information systems, planning, and partnerships.
A strong public health infrastructure includes a capable and qualified workforce, up-to-date data and information systems, and agencies that can assess and respond to public health needs. While a strong infrastructure depends on many organizations working together, public health departments play a central role in the nation’s public health system. Federal agencies rely on a solid public health infrastructure in state, tribal, local, and territorial jurisdictions.
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Health inequities
are avoidable inequalities in health between groups of people within countries and between countries. These inequities arise from inequalities within and between societies. Social and economic conditions and their effects on people’s lives determine their risk of illness and the actions taken to prevent them becoming ill or treat illness when it occurs.
Examples of health inequities between countries:
The infant mortality rate (the risk of a baby dying between birth and one year of age) is 2 per 1000 live births in Iceland and over 120 per 1000 live births in Mozambique;
The lifetime risk of maternal death during or shortly after pregnancy is only 1 in 17 400 in Sweden but it is 1 in 8 in Afghanistan.
Social gradient
The poorest of the poor, around the world, have the worst health. Within countries, the evidence shows that in general the lower an individual’s socioeconomic position the worse their health. There is a social gradient in health that runs from top to bottom of the socioeconomic spectrum. This is a global phenomenon, seen in low-, middle- and high-income countries. The social gradient in health means that health inequities affect everyone.
For example, if you look at under-5 mortality rates by levels of household wealth you see that within counties the relation between socioeconomic level and health is graded. The poorest have the highest under-5 mortality rates, and people in the second highest quintile of household wealth have higher mortality in their offspring than those in the highest quintile. This is the social gradient in health.
Why do we need SdoH ?
Social determinants have a major impact on health outcomes—especially for the most vulnerable populations. Factors such as a patient’s education, income level and environment must be considered when providing treatment and care.
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As the Kaiser Family Foundation noted in recent research: “Based on a meta-analysis of nearly 50 studies, researchers found that social factors, including education, racial segregation, social supports, and poverty accounted for over a third of total deaths in the United States in a year.”
It Is therefore essential for primary care providers such as nurse practitioners educated in FNP programs to consider social determinants of health to enable more holistic, comprehensive healthcare for the patients and families they serve.
Closing the gap in a generation [Final Report of the Commission on the Social Determinants of Health]:
The development of a society, rich or poor, can be judged by the quality of its population’s health, how fairly health is distributed across the social spectrum, and the degree of protection provided from disadvantage as a result of ill-health. In the spirit of social justice, the Commission on Social Determinants of Health was set up by the World Health Organization (WHO) in 2005 to marshal the evidence on what can be done to promote health equity, and to foster a global movement to achieve it.
As the Commission has done its work, several countries and agencies have become partners seeking to frame policies and programmes, across the whole of society, that influence the social determinants of health and improve health equity. These countries and partners are in the forefront of a global movement.
The Commission calls on the WHO and all governments to lead global action on the social determinants of health with the aim of achieving health equity. It is essential that governments, civil society, WHO, and other global organizations now come together in taking action to improve the lives of the world’s citizens. Achieving health equity within a generation is achievable, it is the right thing to do, and now is the right time to do it.
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A p i i c h h s r t S e L t o a W W A m i e S r c h w s 2 1 18
3. Health system financing
Health financing is fundamental to the ability of health systems to improve human welfare sustainably. However, financing is more complex than a simple Generation of funds. To understand the nature of indicators that can be used to monitor and Evaluate health systems financing requires explicit assessment of the expected goals.
It is defined as the “function of a health system concerned with the mobilization, Accumulation and allocation of money to cover the health needs of the people, individually and Collectively, in the health system… the purpose of health financing is to make funding available, as Well as to set the right financial incentives to providers, to ensure that all individuals have access to effective public health and personal health care”.
4. Health workforce
The ability of a country to meet its health goals depends largely on the people responsible for organizing and delivering health services. Evidence of a direct and positive link between the numbers of health workers and population health outcomes has been demonstrated by studies. Many countries, however, lack the adequate human resources needed in healthcare. This may be due to; limited production capacity, migration of health workers, poor mix of skills and demographic imbalances. The formulation of national policies in pursuit of human resources for the development of the country’s health system requires sound information. Additionally, building knowledge and databases on the health Workforce requires coordination across sectors. WHO is working with countries and partners to strengthen the Global evidence base on the health workforce — including gaining consensus on a core set of indicators for monitoring the stock, distribution and production of health workers.
5. Medical products, vaccines and technologies
According to the WHO framework for health systems , a well-functioning health system ensures equitable Access to essential medical products, vaccines and technologies of assured quality, safety, efficacy and costEffectiveness.
To achieve these objectives, the following are Needed:
National policies, standards, guidelines and regulations that support policy.
Information on prices, the status of international trade agreements and the capacity to set and negotiate Prices.
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Reliable manufacturing practices when they exist in-country and quality assessment of priority products; Procurement, supply and storage, and distribution systems that minimize leakage and other waste; and Support for rational use of medicines, commodities and equipment, through guidelines and strategies to Assure adherence, reduce resistance, maximize patient safety and training.
6. Health information systems
Reliable information is the foundation of decision-making across all health system building blocks. It is essential for health system policy development and implementation, governance and regulation, health Research, human resources development, health education and training, service delivery and financing.
The health information system provides the underpinnings for decisionmaking and has four key functions: Data generation, (ii) compilation, (iii) analysis and synthesis, and (iv)communication and use. The health Information system collects data from health and other relevant sectors, analyses the data and ensures their Overall quality, relevance and timeliness, and converts the data into information for the decision-Making.
To know more: Tap Here.
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What are the health system models?
There are 4 Major National Models. Essentially, the government acts as the single-payer, removing all competition in the market to keep costs low and standardize benefits. As the single-payer, the national health service controls what “in-network” providers can do and what they can charge.
1) The Beveridge model:
2) The Bismarck model
Within the Bismarck model, employers and employees are responsible for funding their health insurance system through “sickness funds” created by payroll deductions. Private insurance plans also cover every employed person, regardless of pre-existing conditions, and the plans aren’t profitbased.
3)The national health insurance model
The national health insurance model blends different aspects of both the Beveridge model and the Bismarck model. First, like the Beveridge model, the government acts as the single payer for medical procedures.
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4)The out-of-pocket model
The out-of-pocket model is the most common model in less-developed areas and countries where there aren’t enough financial resources to create a medical system like the three models above. In this model, patients must pay for their procedures out of pocket. The reality is that the wealthy get professional medical care and the poor don’t, unless they can somehow come up with enough money to pay for it. Healthcare is still driven by income.
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Health System
Health Syst
Beveridge Bismarck
Source of fund Taxes
Employers and employe (sickness fund)
Providers Government Private hospitals
Who is covered
Everyone who is a taxpaying citizen is guaranteed the same access to care
Only employees who contribute financially
-Potential risk of overutilization,Without restrictions, free access could potentially allow patients to demand healthcare services that are unnecessary or wasteful. The result would be rising costs and higher taxes.
-In wars or health crises, the government's ability to provide healthcare could be at risk as spending increases or public revenue decreases.
Health care services are not provided for those who are unable to work or can't afford contributions, including aging populations and the imbalance between retirees and employees.
D i s a d v a n t a g e s
tem Models
National Health Insurance
Government run nsurance program that every citizen pays into
Out-ofPocket
Health System
Source of fund Patients must pay for their procedures out of pocket
Providers Private hospitals Private hospitals
Only employees who contribute financially
The wealthy and the poor when they can somehow come up with enough money
Who is covered
The primary criticism of the national health insurance model is the potential for long waiting lists and delays in treatment
The wealthy get professional medical care and the poor don't, unless they can somehow come up with enough money to pay for it.
D i s a d v a n t a g e s
UHC in Egypt
Egypt is embarking on a new universal health insurance (UHI) system to cover all Egyptians by 2032, in line with the UHI law. The implementation of the first phase started in Port Said in 2019 with gradual geographic expansion to follow. When fully implemented, the system is expected to ensure quality health services and adequate levels of financial protection for all. UHI is a compulsory system based on social solidarity, where those who cannot afford contributions will be exempted, based on a decree issued by the prime minister to regulate exemptions. The family is the main insurance coverage unit within the new system, in contrast to the existing system, which provides uncoordinated, separate coverage to each family member, leaving some uninsured.
Coverage of the informal sector has been one of the challenges facing the current health insurance scheme and previous attempts to expand insurance coverage. The current system, operated and administered by the Health Insurance Organization (HIO), the main public insurer, is highly fragmented, making it difficult to ensure equity, quality of health services and financial protection. Moreover, the system does not cover informal workers, irregular workers, the unemployed, and out-of-school children. The new UHI is thus a major step in expanding coverage to include vulnerable groups and to leaving no one behind.
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Gaps in Health System
Here we will discuss two of the most important of these gaps: doctorpatient relationship & lack of resources.
The Doctor–Patient Relationship
Why is the doctor-patient relationship so important?
The doctor-patient relationship involves vulnerability and trust. It is one of the most moving and meaningful experiences shared by human beings. However, this relationship and the encounters that flow from it are not always perfect.
The doctor-patient relationship has been defined as “a consensual relationship in which the patient knowingly seeks the physician’s assistance and in which the physician knowingly accepts the person as a patient. the doctor-patient relationship represents a fiduciary relationship in which, by entering into the relationship, the physician agrees to respect the patient’s autonomy, maintain confidentiality, explain treatment options, obtain informed consent, provide the highest standard of care, and commit not to abandon the patient without giving him or her adequate time to find a new doctor.
However, such a contractual definition fails to portray the immense and profound nature of the doctor-patient relationship. Patients sometimes reveal secrets, worries, and fears to physicians that they have not yet disclosed to friends or family members. Placing trust in a doctor helps them maintain or regain their health and well-being.
اow does the nature and quality of the doctor-patient relationship affect health outcomes?
Gordon and Beresin asserted that poor outcomes (objective measures or standardized subjective metrics that are assessed after an encounter) flow from an impaired doctor-patient relationship (eg, when patients feel unheard, disrespected, or otherwise out of partnership with their physicians). Thus, there are many different outcome measures. However, these measures can be divided into 3 main domains: physiologic/objective measures, behavioral measures, and subjective measures.
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What is patient satisfaction and how is it affected by the doctor-patient relationship?
Patient satisfaction is defined as “the degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, RELATIONSl.” Moreover, all 4 elements of the doctor-patient relationship impact patient satisfaction.
Trust: Bennett et al found that, among patients with systemic lupus erythematosus, those who trust and “like” their physician had higher levels of satisfaction. In another study, patients’ perceptions of their physician’s trustworthiness were the drivers of patient satisfaction.
Knowledge: When doctors discovered patient concerns and addressed patient expectations, patient satisfaction increased as it did when doctors allowed a patient to give information.
Regard: Ratings of a physician’s friendliness, warmth, emotional support, and caring have been associated with patient satisfaction.
Loyalty: Patients feel more satisfied when doctors offer continued support; continuity of care improves patient satisfaction.
Which factors can adversely influence the doctor-patient relationship?
While the attributes and benefits of a favorable doctor-patient relationship have been characterized, few studies have provided solutions for an impaired relationship. Therefore, we propose 4 categories (patient factors, provider factors, patient-provider mismatch factors, and systemic factors) that can interfere with the doctor-patient relationship.
Lack of resources
What is the impact of resource limitations on care delivery and outcomes?
Resource limitation, or capacity strain, has been associated with changes in care delivery, and in some cases, poorer outcomes among critically ill patients. This may result from normal variation in strain on available resources, chronic strain in persistently under-resourced settings, and less commonly because of acute surges in demand, as seen during the coronavirus disease 2019 (COVID-19) pandemic.
How can we Improve health-care quality in resource-poor settings?
Improvements in health-care quality can contribute to healthier populations. However, many global and national health strategies are not sufficiently considering the issues of measuring and improving health-care quality in low-resource settings. similar across different health systems. However, the extent and mechanisms through which these barriers affect quality improvement interventions may be different in resource-poor settings.
: : : :
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Investments in health systems strengthening without continuous quality improvement is thought to be a useless effort. Conversely, only focusing on quality improvement in a resource-poor context without engaging the broader health system for support is of limited value. Hence, both areas must be improved simultaneously.
Here, we call for renewed focus on quality improvement of health-system delivery by policy-makers, managers and health-care providers, working at all levels of health-care systems in resource-poor settings. To maximize the potential of quality improvements, we propose an approach focusing on five elements: (i) systems thinking; (ii) stakeholders’ participation; (iii) accountability; (iv) evidence-based interventions; and (v) innovative evaluation.
some of the elements are well supported by peer-reviewed literature, while other elements are lacking good evidence. We base our ideas on our experience in diverse countries and settings. We hope that bringing all these elements together into a unified approach will stimulate debate, highlight important research gaps and support policy-makers, health-care providers and patient and community representatives working in this field.
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Health literacy & UHC
, pp p p interventions to maximize health outcomes. It is, therefore, increasingly suggested that evidence-based research should investigate how HL may operate in the context of universal health coverage (UHC).
However, the role of HL in the relationships between elements of UHC such as access to health care and health insurance has not been widely explored. This applies in particular in Sub-Saharan Africa, although service coverage and health outcomes vary hugely between and within many countries. This article addresses this lacuna in Ghana, today one of Africa's most promising health systems.
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Health Literacy
What is Health Literacy?
Healthy People 2030 recognizes two components of health literacy, personal health literacy and organizational health literacy.
Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
What is the Aim of Health Literacy?
On the organizational health literacy front, its goals include promoting changes in the health care system that improve communication, informed decision-making, and access to culturally and linguistically appropriate health information and services.
Why is Health Literacy Important?
Health literacy can help us prevent health problems, protect our health, and better manage health problems when they arise. They aren’t familiar with medical terms or how their bodies work. They have to interpret statistics and evaluate risks and benefits that affect their health and safety.
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What are the Barriers that can face it ?
Most written health information materials use language that exceeds the reading level of the intended audience.
The receipt of the materials alone is not enough. Comprehension and understanding of health information is key to improving health outcomes.
Some patients may have disparities between written and verbal fluency, and stigma around low literacy levels may lead to exaggeration of reading ability.
Communication barriers impact verbal interactions between patients and providers.
Conversations are often brief, involving complex medical jargon, and from a patient perspective can feel largely one-sided. Patients should be engaged in a way that makes them feel comfortable and able to listen and ask questions.
In rural areas with fewer healthcare providers overall, a lack of culturally and ethnically diverse healthcare providers that reflect the population can lead to distrust and ineffective communication.
Clear and open communication between patients and providers plays a major role in treatment adherence to help prevent serious health complications and hospitalizations.
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Conditions associated with living in poverty, like health insurance status (being un- or under-insured can impact health literacy levels)
Low educational attainment, which is often associated with more limited levels of health literacy
Racial and ethnic minority groups with limited English proficiency who report having low health literacy levels
A lack of resources and infrastructure to address limited health literacy
For example, approximately 22% of rural Americans and 28% of tribal communities lack access to broadband. Broadband has been shown to improve access to education and telehealth services.
Our role as a public health advocate:
Our public
1-Improve the Usability of health Information
2- Improve the Usability of health services
3- Build Knowledge to improve Decision Making
4- Advocate for health Literacy Improvement
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SecondPiece
DIGITAL HEALTH
-Digital Health Tools
-Importance of Digital Health
-Advantages of Digital Health
-10 e’s in Digital Health
-Difference between E-health & digital health
-Types of digital health
-Challenges facing digital health
-Application of digital health in Egypt
Digital Health
What is Digital Health?
Is the use of technologies, computing platforms, connectivity, software, and sensors for health care and related uses. It includes categories such as mobile health (mHealth), health information technology (IT), wearable devices, telehealth and telemedicine, and personalized medicine.
What are Digital Health Tools:
1. AI Tech
Artificial intelligence is a fast-glowing technology changing how we interact with each other and with computer. AI can monitor heart rates, signal early signs of diabetes, and even predict an individual’s risk for Alzheimer’s. The healthcare industry has been quick to adopt AI, as they are the future assistants to the doctors, helping in diagnosing and treating illnesses, some AI-powered tools have already proven themselves reliable enough for use by consumers daily.
2. Telemedicine Apps
Many healthcare apps are used by physicians and patients worldwide. In addition, a growing number of them can be used on smartphones meaning you don’t necessarily need access to your doctor or hospital to benefit from these technologies. Telemedicine-oriented tools for health monitoring and for exchanging information about medications between doctors and patients. In addition, these tools could prove useful for connecting hospitals with residents who are located remotely but still want access to care at home.
3. A Billing & Coding System and documentation
A billing and coding system can reduce time and money spent. It might even be easier and more eco-friendly than using papers to generate reports.
4. Health Information Exchange (HIE)
HIE is a collaboration between hospitals, health systems, and other healthcare providers to share patient information.
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It provides an effective way for doctors to keep track of their patient’s medical histories, helping avoid duplication in testing and care. HIE creates a central hub for your medical records, which makes it easier for the physicians to avoid recording data from each patient you've seen previously.
5. Remote Patient Monitoring
Today, many people carry smartphones, meaning there’s an app for that: Remote patient monitoring lets you remotely transmit data from healthmonitoring devices (like glucose monitors and blood pressure cuffs) right onto your phone or computer. It automatically puts all of your data into easyto-read charts and graphs so you can get a quick view of how you’re doing throughout each day.
6. Electronic Health Records
Health Records
EHRs provide an easy-to-access medical history for patients, allowing them to quickly talk with their healthcare provider about medications or conditions that may affect their visit. They also increase efficiency by enabling providers to share information electronically. EHRs discover how diseases progress over time that may have previously been hidden.
What is the Importance of Digital Health:
1.Speed up and improve doctor’s diagnostic capabilities by better managing information flow as it will help organize the massive amount of information collected so that a patient's health problem becomes visible more quickly.
2.Provide health databases to measure accurately diagnostic errors and reduce the chance of these errors recurring in the future.
3.More convenient delivery as mobile healthy applications, which can fully cover their needs, assist them until help is sent. They are also being used as an adapter with electrocardiogram electrodes to transmit data to detect silent atrial fibrillation, so super dangerous diseases that cost thousands of lives can be easily detected and rapidly treated from the beginning.
4-Entering the long-promised golden age of personalized healthcare. By better understanding an individual’s genetic profile, more effective therapies can be used. In the future, before treating any woman for breast cancer for example, a genetic test could determine what genetic variations are present.
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5-Digital health can be a powerful enabler to improve healthcare outcomes in communities of low capacity of healthcare workers and skilled health professionals.
6-Reduce the time and resources required to bring a medicine to the market by allowing thr virtual screening of millions. Digital solutions such as clinical trial simulation, modeling and simulation, computer-assisted trial design, model-based drug development and model-informed drug discovery and development could also begin to replace certain lab experiments.
What are the Advantages of Digital Health?
Digital health offers real opportunities to improve medical outcomes and enhance efficiency.
These technologies can empower consumers to make better-informed decisions about their own health and provide new options for facilitating prevention, early diagnosis of life-threatening diseases, and management of chronic conditions outside of traditional health care settings. Providers and other stakeholders are using digital health technologies in their efforts to:
Reduce inefficiencies.
Improve access.
Reduce costs.
Increase quality.
Make medicine more personalized for patients.
Patients can better manage and track their health and wellness-related activities.
The use of technologies, such as smart phones, social networks, and internet applications providing innovative ways for us to monitor our health and well-being and giving us greater access to information. Together, these advancements are leading to a convergence of people, information, technology, and connectivity to improve health care and health outcomes.
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What are the 10 e’s in Digital Health?
1. Efficiency
Digital health increases efficiency in health care, thereby decreasing costs by avoiding duplicative or unnecessary diagnostic or therapeutic interventions, through enhanced communication between health care establishments and patients.
2. Enhancing quality of care
Digital health improves quality of health care provided by allowing comparisons between different health care services.
3. Evidence based
Digital health interventions should be evidence-based in a sense that their effectiveness and efficiency should not be assumed but proven by rigorous scientific evaluation. Much work still has to be done in this area.
4. Empowerment of consumers and patients by making the knowledge bases of medicine and personal electronic records accessible to consumers over the Internet, e-health opens new avenues for patient-centered medicine and enables evidence-based patient choice.
5. Encouragement of a new relationship between the patient and health professional, towards a true partnership, where decisions are made in a shared manner.
6. Education of physicians through online sources (Continuing medical education) and consumers (health education, tailored preventive information for consumers)
7. Enabling information exchange and communication in a standardized way between health care establishments.
8. Extending the scope of health care beyond its conventional boundaries. This is meant in both a geographical sense as well as in a conceptual sense. e-health enables consumers to easily obtain health services online from global providers. These services can range from simple advice to more complex interventions or products such a pharmaceuticals.
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9. Ethics
Digital health involves new forms of patient-physician interaction and poses new challenges and threats to ethical issues such as online professional practice, informed consent, privacy and equity issues.
10. Equity
People, who do not have the money, skills, and access to computers and networks, cannot use computers effectively. As a result, these patient populations (which would actually benefit the most from health information) are those who are the least likely to benefit from advances in information technology, unless political measures ensure equitable access for all. The digital divide currently runs between rural vs. urban populations, rich vs. poor, young vs. old. Actually, the ratio for people who do not have an access the Internet is very low roughly 2 %.
In addition to these 10 essential e's, digital health should also be:
easy-to-use, entertaining (no-one will use something that is boring!) and exciting
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What is the difference between E-health & digital health?
eHealth has a goal of providing quality life by uplifting the healthcare system which is not limited to the usage of some Smartphone applications, whereas Digital health has a goal of reaching as many people as possible who need help via the digital channel.
Digital health is a broad concept that includes e-health, m-Health, and telehealth, and incorporates everything from electronic patient records to remote monitoring, connected equipment, and digital therapies, among other things.
What are the Types of digital health ?
The broad scope of digital health includes categories such as mobile health (mHealth), health information technology (IT), wearable devices, telehealth and telemedicine, and personalized medicine.
What is Cyber medicine:
Cybermedicine is the science of applying Internet and global networking technologies to the area of medicine and public health, of studying the impact and implications of the Internet and of evaluating opportunities and the challenges in health care.
What is Telemedicine ?
telemedicine is the use of electronic information and communications technologies to provide and support health care when distance separates the participants.
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What are the Challenges facing digital health?
Outdated governance and policies: primary care relies on regulations that can ensure high-quality care, patient data protection.
Fragmented landscapes of digital innovation: As care shifts to mobile and virtual provision, either with or without a provider (e.g., via artificial intelligence chatbots), the public and private sectors will need to work together to ensure continuity of care. This is counter to the optimization of services, which often seeks to minimize costs for acute care.
Limited and uneven levels of digital literacy and access: For digital primary care need to be accessible to all. This will require broader and more affordable access to internet and mobile phones and a more widespread capacity to use new tools.
Weak supporting infrastructure: Each technology required strong infrastructure of digital health and connectivity, which in turn rests on interoperable and connected systems (such as health information management systems).
Security
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Application of digital health in Egypt
“The National Health Insurance System or the Universal Health Insurance, is a new system approved by the Egyptian Government in 2019. It makes healthcare insurance compulsory for all citizens.
An app that has been making healthcare accessible for all in Egypt is Vezeeta Its founder/CEO Amir Barsoum’s aim is to empower consumers to make more informed healthcare decisions. The app allows users to book online appointments, teleconsultations, doctors’ home visits and can also be used for online ordering and delivery of medications.
Digital health education:
Advocating for digital health access, digital health education and equality for pediatric populations. Improved digital access improves better healthcare access and equality: prior to the COVID-19 pandemic, United Nations experts reported more people had access to cellphones than flushing toilets. During COVID-19 pandemic imposed online education, initially children were reporting sharing phones and running out of monthly data allowances when trying to access online education. UK foundations, charities and campaigns (eg, BBC ‘give a laptop’) supplied computers and devices to children. Mobile networks provided dongles, sims and unlimited data allowances. Schools and council initiatives provided WiFi assistance.
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