Say you’re looking to launch a digital tool to improve vaccine uptake. How will you launch your platform in coordination with existing digital infrastructure? And how will you know if your approach is successful? In most cases, you will need to create or build on existing technology to gather patient information, track vaccination uptake, and securely share data within your own operations and with governments and health organizations.
Digital infrastructure is the foundation required for a technology to operate optimally—from fiber optics to cloud services to privacy regulation—and it rarely gets the attention it deserves. When the operating environment lacks critical digital infrastructure, established companies and health tech innovators in emerging markets struggle to launch and monitor innovative products and services to improve health access. They also waste time and effort navigating murky or nonexistent regulations.
In addition, individual organizations lack macro-level systems to collect and aggregate data to monitor health solutions or identify new opportunities. This can and has led to the failure of otherwise promising healthcare solutions.
To explore how to leverage technology to scale global health outcomes more proactively, we teamed up with the Bay Area Global Health Alliance and “A Shot in the Arm” podcast host Ben Plumley.
With a panel featuring Paul Musser from Mastercard, Clay Sader from Zenysis Technologies, and Temi Filani from Co-creation Hub Nigeria (CcHUB), we dove into questions related to COVID-19, policy, and how to make infrastructure sexy. Below, we share our panelists' top takeaways.
How To Leverage Technology to Improve Patient Outcomes in Emerging Markets
1. For better health data, pay attention to the human side of digital infrastructure.
Software and hardware infrastructure development may command the attention of health tech companies, but Mastercard’s Paul Musser insists that “technology is usually the easiest portion of the conversation.”
Data is one piece of the health infrastructure puzzle; it requires standardized systems to track, aggregate, and share information across the public and private sectors. When asked about the importance of good health data, the Mastercard SVP argued that it’s much more difficult and important to first understand how people currently collect and track data in target geographies.
“If you start with the technology, you are off base to begin with,” said Musser. “The conversation needs to start with that nurse who really knows her community and knows why the process is being done the way it is.”
Further, data siloing is a common challenge for digital infrastructure globally. Different organizations track related and complementary information, but this data is rarely shared. To combat this and better coordinate important health data to improve health outcomes, companies and health innovators should know how governments and local health ministries access and track data to inform health policy, investment, and programs.
Musser gave the example of an initiative underway between Mastercard, Gavi: The Vaccine Alliance, and The Global Fund. He noted that many countries don’t have a solid registry of children, so they can’t determine the percentage of children that need to be vaccinated.
In some places, Gavi received reports of 120% vaccination rates, evidence of a clear paperwork problem. He urged innovators to step back and establish a sound baseline—and to anticipate and plan for likely gaps in existing data. Here, there is also an opportunity for companies, global development players, local governments, and local health actors to collaborate to clean up and strengthen foundational data that underpins priority health initiatives.
2. Engage patients and end users to re-think digital health infrastructure needs.
In the health sector, technology solutions aren’t simply about gaining users or selling products. They need to improve patient outcomes. Because healthcare systems are so complex, innovators must take a systems approach. But first, who do you involve, and how do you involve them?
“If you’re not linking [beautiful solutions] directly to health outcomes, how is this infrastructure... translating to lives saved?” asked CcHUB’s Temi Filani.
She added that to achieve tangible outcomes, we need to expand the definition of who we call policymakers. “Perhaps we need to make room for other people—the subject matter experts, the end-users, those who would benefit from this—and have them be a part of the conversation from the onset.”
She shared an example that CcHUB co-developed with tuberculosis (TB) patients two years ago. The team sat with patients to understand why they were not taking their TB drugs, and they learned that patients had to present a document almost daily to hospitals to confirm they had taken their medication and receive more. They co-created a solution to digitize that process, enabling more patients to better follow their TB treatment plans.
3. Policymakers must get proactive about investing in health infrastructure.
If no one entity or organization is responsible for owning or improving a region’s digital health infrastructure, what happens when it fails?
Zenysis Technologies’ Chief Operating Officer, Clay Sader, argues this “tragedy of the commons” means that digital infrastructure is always someone else’s problem. “There’s… a tragedy of the commons problem when it comes to digital infrastructure,” he explained. “We need focused investments on the system itself, not just trying to address the system in the periphery of other programs."
In other words, policymakers do not focus enough attention on addressing the underlying weaknesses in critical digital health infrastructure, leading to weak, fragmented, or lapsed health and technology systems. Private sector players can step up to fill in gaps, but this can exacerbate digital infrastructure fragmentation with various incompatible systems in one region.
“The first and most important thing that we can do is to start to treat infrastructure as something worth investing in directly, rather than investing in it in a secondhand way through other projects,” said Sader.
He points to one of the advantages of the public health sector that could help address this shortfall: a relatively high concentration of funding from just a few sources.
“We have to start with where the money is coming from,” he added. “Not only, ‘Are we spending our money in the right way?’ but ‘Are we asking for the right things?’ ...There’s some amount of reform that needs to happen at the global donor level and the government level about how we think about this and where we invest our money.”
Musser also emphasized that policymakers should set and “vehemently enforce” regulations around data, privacy, and confidentiality so that companies and health innovators understand the rules and can instead focus on building incredible new health services and solutions.
Moving Forward to Leverage Technology for Health Impact in Emerging Markets
The COVID-19 pandemic has prompted health stakeholders to embrace digital technology as an affordable, effective way to improve health outcomes. Yet tech solutions themselves are only part of the equation.
Digital infrastructure enables these solutions to exist and flourish, playing an increasingly important role in driving the success of patient outcomes in markets worldwide. By understanding patient perspectives, making the most of health data, and investing proactively and comprehensively in digital infrastructure, companies and policymakers can help ensure the ride is a smooth one.
Mastercard, Resonance and Zenysis are all members of the Bay Area Global Health Alliance.