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CC BY-NC-ND 4.0 · Yearb Med Inform 2022; 31(01): 047-059
DOI: 10.1055/s-0042-1742502
Special Section: Inclusive Digital Health
Working Group Contributions

Towards Equitable and Resilient Digital Primary Care Systems: An International Comparison and Insight for Moving Forward

IMIA Primary Care Informatics Working Group
Craig Kuziemsky
1   Office of Research Services and the School of Business, MacEwan University, Edmonton, Alberta, Canada
,
Siaw-Teng Liaw
2   WHO Collaborating Centre on eHealth, School of Population Health, UNSW Sydney, Kensington, NSW, Australia
,
Meredith Leston
3   Clinical Informatics and Health Outcomes Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Eagle House, Oxford, UK
,
Christopher Pearce
5   Outcome Health, Blackburn, Victoria, Australia
6   Monash University, Clayton, Victoria, Australia
,
Jitendra Jonnagaddala
2   WHO Collaborating Centre on eHealth, School of Population Health, UNSW Sydney, Kensington, NSW, Australia
,
Simon de Lusignan
3   Clinical Informatics and Health Outcomes Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Eagle House, Oxford, UK
4   Royal College of General Practitioners Research and Surveillance Centre, London, UK
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Summary

Objective: While the COVID-19 pandemic provided a global stimulus for digital health capacity, its development has often been inequitable, short-term in planning, and lacking in health system coherence. Inclusive digital health and the development of resilient health systems are broad outcomes that require a systematic approach to achieving them. This paper from the IMIA Primary Care Informatics Working Group (WG) provides necessary first steps for the design of a digital primary care system that can support system equity and resilience.

Methods: We report on digital capability and growth in maturity in four key areas: (1) Vaccination/Prevention, (2) Disease management, (3) Surveillance, and (4) Pandemic preparedness for Australia, Canada, and the United Kingdom (data from England). Our comparison looks at seasonal influenza management prior to COVID-19 (2019-20) compared to COVID-19 (winter 2020 onwards).

Results: All three countries showed growth in digital maturity from the 2019-20 management of influenza to the 2020-21 year and the management of the COVID-19 pandemic. However, the degree of progress was sporadic and uneven and has led to issues of system inequity across populations.

Conclusion: The opportunity to use the lessons learned from COVID-19 should not be wasted. A digital health infrastructure is not enough on its own to drive health system transformation and to achieve desired outcomes such as system equity and resilience. We must define specific measures to track the growth of digital maturity, including standardized and fit-for-context data that is shared accurately across the health and socioeconomic sectors.

Keywords

Primary care - digital health - maturity - health systems - COVID-19


Publication History

Article published online:
02 June 2022

© 2022. IMIA and Thieme. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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