WHO Digital Health Guidelines: a milestone for global health
Alain Labrique, Smisha Agarwal, Tigest Tamrat, Garrett Mehl
Abstract
On April 17, 2019, the World Health Organization (WHO) reached a new milestone as it released the first evidence-based guidelines on digital health 1 . These nine recommendations were the culmination of a multi-year process, identifying, distilling, and synthesizing the evidence around the impact of digital interventions for health systems strengthening. The earliest period of mobile-phone augmented digital health, sometimes referred to as mHealth, was characterized by widespread use of phones to overcome persistent infrastructural and health service delivery challenges 2 , 3 . These new guidelines focus on Digital Health interventions that leverage a mobile phone or device 4 . This is a subset of the definition of Digital Health used in the May 2018 World Health Assembly Resolution which included a wide range of technologies across the spectrum of eHealth, mHealth, telemedicine, and even emerging areas of advanced computing such as “big data”, machine learning, and artificial intelligence. The WHO has played a critical leadership role in building consensus across the field of digital health, including characterizing the ways in which digital technologies are being used to support health needs 5 , proposing standard procedures unique to evaluating digital health interventions 6 , the establishment of a formal Department of Digital Health and now with these guidelines, proposing best practices for country governments to consider as they develop and scale digitized health systems 1 . While donor agencies and governments have both expressed keen interest in identifying ways to leapfrog gaps in infrastructure and leverage digital tools to enhance the coverage and quality of service delivery, much of the implementation has occurred in the absence of careful examination of evidence. The paucity of evidence in digital health requires the global digital health community to take a more deliberate and coordinated approach to identifying and addressing research gaps, perhaps as part of a global action plan guided by the needs of different stakeholders, principally Ministries of Health.