From chatbots combatting vaccine hesitancy to crowd-sourced data informing immunisation services, Health Europa spoke to Moz Siddiqui, head of Strategic Innovation and Partnerships at Gavi, about the adoption of digital solutions in healthcare.
Gavi is a global organisation dedicated to improving vaccine coverage and supporting their equitable and sustainable use. Following the sharp uptake in digital healthcare solutions during the COVID-19 pandemic, Health Europa spoke to Moz Siddiqui about the challenges healthcare systems and technology providers may face when implementing new technologies and how Gavi is helping countries in their endeavour to empower health workers, and communities, to enhance the delivery of care.
How has the COVID-19 pandemic impacted the adoption of new digital solutions in healthcare and how is Gavi supporting the uptake of such technologies?
Gavi has supported many countries over the last 20 years and a lot of the routine work that we support is being pivoted towards the pandemic response. Whilst there remains a lot of areas for development, many countries already have digital health interventions in place. However, one of the constraints we often see relates to the lack of human capacity that exists within healthcare systems, particularly in low-and-middle-income countries (LMICs). It is important that we are aware of this particularly when considering new innovations. Lack of widespread digital initiatives thus far is because you simply cannot target a massive population without having either a sophisticated digital health infrastructure in place, or a lot of people.
COVID accelerated the need for robust digital platforms and logistical information systems, these have become more widespread and deployed across health immunisation systems as a result. They are the backbone of an effective distribution system. Where you see the application of newer technologies, for instance in the vaccine hesitancy space, there has been a reformulation or reimagining of how validated information is being deployed. The COVID-19 pandemic has highlighted the need for us to be a little more sophisticated in our approach to behavioural and economic research and use digital solutions to better understand how information is transmitted.
We work with many organisations that are really invested in looking at how you empower health workers and improve healthcare delivery. That has become a really strong area that we have to focus on and continue to invest in. We know that the number of health workers is not going to increase exponentially based on the demand, so the question becomes: how do you make sure you strengthen health workers and put the right digital solutions in their hands? Additionally, how do you support partners who are coming forward with new innovations?
I think we will continue to see more patient and community-centric engagement technology but we need to ensure new digital solutions are fit for purpose and individuals can own, manage and use supporting data. One organisation that Gavi works with called Premise Data uses mobile collection data via an app to facilitate a real time analysis of vaccination sessions and in turn, support governments in their immunisation efforts. This type of tool would be useless without a skilled team behind it that can understand and build upon that data to make valuable insights.
Even in a population that is predominantly offline, there are ways for them to consume and digest online messages, through an offline medium, using the correct delivery method such as a door-to-door worker or NGO. They can take learnings from a community that is online and relay them to the offline community. There is a digital divide but at the same time, we must be creative in how we bridge that divide and translate those messages correctly to the offline community.
Can you highlight some of the barriers concerning the adoption of new technologies in healthcare and also the challenges faced by technology providers?
Regarding the challenges incurred as part of this pandemic response, the ability to track and understand population data is one, we are seeing solutions to help overcome data fragmentation. Gavi has been supporting countries and deploying more cutting-edge technology, including Machine Learning, to track the number of vaccines coming through the system and where they are going. Breaking down data silos and aggregating data to understand how many people have been traced versus where the vaccines are and where you have deficits in data is incredibly important.
For routine immunisation, and certainly during COVID the challenge has been aligning these aforementioned systems. As countries have started to hone in on potential deficits in COVID-19 vaccines they have become more familiar with these types of digital tools.
The issue for many technology pioneers or innovators is having access to sufficient amounts of relevant information. Likewise, you can convene a group of partners to offer their solutions but unless a country or community’s needs and problems are identified it is really difficult for a supplier, vendor, or producer to target that need. Often, supply comes before demand and so what we are trying to do is engage with the private sector to flip that dynamic, putting the needs and demands of the consumer first and making that information available to the producer.
A lot of technology providers are private sector partners so there is often a mismatch of language and terminology between the private sector and the public health system. This is where Gavi is well positioned to connect those two sectors. I think we will see a bigger role for trusted organisations like Gavi to voice the needs of countries or communities but also highlight technologies that can support them.
What are some of the reasons behind vaccine hesitancy and refusal, and how could AI solutions be employed to encourage vaccine uptake?
Vaccine hesitancy is a global challenge, and a complex issue. Factors including lack of access to quality information and misinformation can contribute to this. At Gavi, we are trying to understand the totality of vaccine hesitancy in a number of countries and work with key stakeholders including politicians and the medical community to understand how we can best disseminate key messages.
It is one thing to have information going out, but we also have to understand the information that is being relayed back to the community. Often, with social media and messaging platforms, it is a one-way type of communication. Employing chatbots that utilise AI to interact with the community and help overcome vaccine hesitancy is one area being developed. Gavi is also working with an organisation that is utilising WhatsApp communication to analyse the information coming back to the community. When you put natural language processing on top of gathered data you can start to pick up keyphrases and trends and that data could then be used to inform the communication around vaccine hesitancy and improve the delivery of that information.
Interactive technologies help communities feel engaged and in turn, improves the healthcare workforce and delivery of care. Another example where this technology could be of benefit, particularly in low-income countries, is if a patient has to drive a couple of hours to a clinic and can only see the health worker for a couple of minutes, with no recourse. To improve this, patients could share their issue or symptoms via WhatsApp, SMS or hotlines and as more information is shared, companies can then aggregate that data and look for keyphrases and trends. That data could then inform training programmes for health workers and as a result, improve their interaction with the patient in the community. The richer the data, the more targeted the response can be.
Chatbots, in themselves, are a great tool but again they have to be connected to a community and a broader communication network, without that ecosystem approach they are merely isolated tools. You need the right team; these tools need to be in the right hands to be optimised.
Countries should be applauded for driving efforts in understanding the deficiencies they have in terms of workforce and our job at Gavi is to support those countries and provide them with options.
How does Gavi aid policymakers in their support of technology adoption in healthcare?
Gavi is able to provide incentives, direction, and signals to support the adoption of technologies and build upon existing capacity for the use of those technologies. Particularly with public healthcare in low-income countries, understanding the national e-Health and digital strategy is really important. Some countries have actually put forward and achieved technology offices within their ministries of health. Another factor around digital technology that must be considered is ensuring a clear strategy around data ownership, data access and data use. Gavi has been trying to push forward the need for clarification on data ownership, and certainly on the policy side, that helps organisations to use that data and build systems around it, thus ensuring optimised data use.
Moz Siddiqui
Head of Strategic Innovation and Partnerships
Gavi
www.gavi.org
https://www.linkedin.com/company/Gavi/
https://www.facebook.com/GAVI/
https://twitter.com/gavi
This article is from issue 21 of Health Europa Quarterly. Click here to get your free subscription today.
