Connected diagnostics and the future of global health

Investments in digitizing global health delivery have seen success worldwide. Across the countries where PATH works, for example, governments and partners have improved data collection and reporting, strengthened clinical care facilitation, and further democratized access to health services.

But the approach to digitization cannot be technology-first, says Dykki Settle, PATH’s Chief Digital Officer. “Without intentionality, digitization risks exacerbating, rather than alleviating, the digital divide,” Dykki says. “Disparities in digital literacy and access to data are some of the pernicious health inequities PATH tackles every day.”

A true digital transformation must engage countries and communities to envision new ways to deliver health care with innovative tools and technologies.

With this vision, ministries of health, digital health technology developers, medical device manufacturers, and partners across the globe are developing standards, principles, policies, and partnerships that enable interoperability and effective harmonization, such as the Health Data Governance Principles. Along with an enabling policy environment for data access and protections, interoperability allows for further transformative opportunities in analytics, artificial intelligence and machine learning, and further global health innovation.

PATH works with these stakeholders to enable an intentional and holistic approach to digital technologies in health care. Key among these efforts is our work in connected diagnostics.

Connected diagnostics are diagnostic systems that are digitalized to adapt and integrate with the broader health care ecosystem in order to improve the accuracy, efficiency, and accessibility of medical diagnostic technologies and data.

For instance, connected diagnostics include electronic health record systems, laboratory surveillance networks, handheld diagnostic devices with internet connectivity, mobile-based health applications, and more.

Connected diagnostics can be made available as global public goods—open-source digital health tools or freely available services to be accessed, adapted, and implemented in different contexts. They can also be commercial systems purchased and configured for local use.

Connected diagnostics offer several important advantages that can improve patient results and strengthen health systems. For instance, connected diagnostics can be accessible at both the community and facility level, helping to engage and empower patients as active participants in their own care. They do this by making health data and information available to patients regardless of their physical proximity to a health facility or health care worker.

Additionally, health care workers can act as data detectives to improve follow up on test results—a key priority of the World Health Organization’s World Alliance for Patient Safety. Connected diagnostics can also streamline health care worker efforts, increase guideline adherence, and improve data accuracy, timeliness, completeness, and security.

Further, with improved quality, visibility, and access to data, connected diagnostics unlock the potential for analytics and decision support systems that optimize clinical care processes, demand forecasting, procurement, outbreak responses, and more. One such application can be seen in global efforts to collaborate on disease surveillance through the Global Antimicrobial Resistance and Use Surveillance System (GLASS) and WHONET.

As a digital tool, connected diagnostics also have the potential to scale up to help address global health inequities. In Kisumu, Kenya, for example, a connected diagnostics system brought together a digital reader—which photographs, interprets, and stores results in cloud-based databases—and a mobile payment system. Together, they improved efficiencies in the diagnosis and treatment of malaria. Use of the tool demonstrated the potential for both cost savings and quality improvements.

As the COVID-19 pandemic has shown, diagnostics serve a critical role in the patient care pathway, as well as the broader national and global pandemic response effort. In addition to the SARS-CoV-2 diagnostics that hit the market early in the pandemic, digital health market investments jumped by more than US$24 billion in 2020.

During the pandemic, many connected diagnostics emerged to support virtual health care, contact tracing and surveillance efforts, and detection of respiratory diseases and illness, among others. For example, the ResAppDx smartphone app uses machine learning algorithms to analyze cough sounds and help detect respiratory diseases in challenging clinical settings.

Along with this surge in use and investment, the pandemic revealed challenges of connected diagnostics on a global scale. Major concerns emerged around privacy, transparency, bias, ownership, and data storage. Additionally, the need for more enabling policies to support data access and use were highlighted. Other gaps reveal that health care workers frequently lack digital and data literacy skills, while health care systems often lack the basic infrastructure, connectivity, and interoperability necessary for suitable use.

The appropriate expansion of digital health tools will require a careful and systematic approach to address these challenges in a way that ensures equitable access to high-quality, affordable connected diagnostics.

“PATH champions a systematic approach to digital transformation and data use that focuses on maximizing country ownership and leadership,” says Dykki. “Digital health leadership, governance, strategy, investment road maps, and architecture are essential to rationalizing existing applications and selecting new ones.”

PATH has a unique breadth of experience and expertise across diagnostics development, including research, commercialization and market access, and policy and advocacy. This diverse set of skills enables PATH to form effective and holistic partnerships across the connected diagnostics ecosystem to support sustainable and equitable solutions to pressing health challenges.

The articles in this series explore the growing field of connected diagnostics through global, national, and local perspectives on their design, development, implementation, adoption—and their potential to improve global health.

Read the second article in the series here.

Learn more about PATH’s work in diagnostics.