Digital health, eHealth, mHealth: Breakthrough for public health or creating new dependency? A critical look at the current hype

“Digital technologies, such as mobile wireless technologies, have the potential to revolutionize how populations interact with national health services." (WHO)

The rapid propagation of digital technology in the health sector is not only fuelled by changing demographics, scientific progress and societal expectations, but also driven by the health technology industry and by powerful actors in international health policy and cooperation. In January, the WHO Executive Board discussed the use of appropriate digital technologies for public health. The overall tone was optimistic to enthusiastic, and there have been only few critical statements such as those by the World Medical Association and by Medicus Mundi International:  

“Digital technologies have the potential to transform many fields of human activity, including healthcare. However, their impact can be predictable and beneficial only if there is strong public control on the use of such technologies.” (MMI)

In fact, digital health technology needs a sound assessment with a focus on its impact on public health – and this requires also a political debate: Will the new technologies really be the “revolution” expected in the provision of universal access to prevention, diagnosis and treatment as part of universal health coverage? How to make sure that they will not rather lead to new dependencies and new inequity and add to the burden and confusion of those who are responsible for health care planning and delivery?

“The implications of technology in terms of opportunities, increasing recurrent costs, additional support services, change in medical practice and training needs are often underestimated. As a result, the widespread irrational use of technology leads to wasting of scarce resources and weakens health systems performance. The most current knowledge is required to ensure that health service provision makes the best use of available technology.” (Swiss TPH)

Even if you do not appreciate the term “technocolonialism”, let us talk about the challenge of ownership, integration and adaption of technology-driven innovation within a national health policy and a people centred health system – as a public health challenge for all countries in the global South and North.

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