Digital health interventions for COVID-19 in China: a retrospective analysis

Background: The use of digital health technologies was an integral part to China's early response to coronavirus disease 2019 (COVID-19). Existing literatures have analyzed and discussed implemented digital health innovations from the perspective of technologies, whereas how policy mechanisms c...

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Main Authors: Mengji Chen, Shan Xu, Lewis Husain, Gauden Galea
Format: Article
Language:English
Published: Elsevier 2021-05-01
Series:Intelligent Medicine
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2667102621000024
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author Mengji Chen
Shan Xu
Lewis Husain
Gauden Galea
author_facet Mengji Chen
Shan Xu
Lewis Husain
Gauden Galea
author_sort Mengji Chen
collection DOAJ
description Background: The use of digital health technologies was an integral part to China's early response to coronavirus disease 2019 (COVID-19). Existing literatures have analyzed and discussed implemented digital health innovations from the perspective of technologies, whereas how policy mechanisms contributed to the formulation of the digital health landscape for COVID-19 was overlooked. This study aimsed to examine the contexts and key mechanisms in China’s rapid mobilization of digital health interventions in response to COVID-19, and to document and share lessons learned. Methods: Policy documents were identified and retrieved from government portals and recognized media outlets. Data on digital health interventions were collected through three consecutive surveys administered between 23 January 2020 and 31 March 2020 by China Academy of Information and Communication Technology (CAICT) affiliated to the Ministry of Industry and Information Technology (MIIT). Participants were member companies of the Internet Health alliance established by MIIT and the National Health Commission (NHC) in June 2016. Self-report digital interventions focusing on social and economic recovery were excluded. Two hundred and sixty-six unique digital health interventions meeting our criteria were extracted from 175 narratives on digital health interventions submitted by 116 participating companies. Thematic analysis was conducted to describe the scope and priority of policies advocating for the use of digital health technologies and the implementation pattern of digital health interventions. Data limitations precluded an evaluation of the impact of digital health interventions over a longer time frame. Results: Between January and March 2020, national policy directives promoting the use of digital technologies for the containment of COVID-19 collectively advocated for use cases in emergency planning and preparedness, public health response, and clinical services. Interventions to strengthen clinical services were mentioned more than the other two themes (n = 15, 62.5%(15/24)). Using digital technologies for public health response was mentioned much less than clinical services (n = 5, 20.8%(5/24)). Emergency planning and preparedness was least mentioned (n = 4, 16.7%(4/24)). Interventions in support of clinical services disproportionately favored healthcare facilities in less resource-constraint settings. Digital health interventions shared the same pattern of distribution. More digital health technologies were implemented in clinical services (n = 103, 38.7%(103/266)) than that in public health response (n = 91, 34.2%(91/266)). Emergency planning and preparedness had the least self-reported digital health interventions (n = 72, 27.1%(72/266)). We further identified case studies under each theme in which the wide use of digital health technologies highlighted contextual factors and key enabling mechanisms. Conclusions: The contextual factors and key enabling mechanisms through the use of policy instruments to promote digital health interventions for COVID-19 in China include pathway of policy directives influencing the private sector using a decentralized system, the booming digital health landscape before COVID-19, agility of the public sector in introducing regulatory flexibilities and incentives to mobilize the private sector.
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spelling doaj.art-a02651bb107743e2ab9eb0f9d6b221092022-12-22T04:09:04ZengElsevierIntelligent Medicine2667-10262021-05-01112936Digital health interventions for COVID-19 in China: a retrospective analysisMengji Chen0Shan Xu1Lewis Husain2Gauden Galea3World Health Organization Representative Office in China, Beijing 100600, China; Corresponding author: World Health Organization Representative Office in China, 401 Dongwai Diplomatic Building 23, Dongzhimenwai Dajie, Chaoyang District, Beijing 100600, China.China Academy of Information Communications Technology, Beijing 100191, ChinaWorld Health Organization Representative Office in China, Beijing 100600, ChinaWorld Health Organization Representative Office in China, Beijing 100600, ChinaBackground: The use of digital health technologies was an integral part to China's early response to coronavirus disease 2019 (COVID-19). Existing literatures have analyzed and discussed implemented digital health innovations from the perspective of technologies, whereas how policy mechanisms contributed to the formulation of the digital health landscape for COVID-19 was overlooked. This study aimsed to examine the contexts and key mechanisms in China’s rapid mobilization of digital health interventions in response to COVID-19, and to document and share lessons learned. Methods: Policy documents were identified and retrieved from government portals and recognized media outlets. Data on digital health interventions were collected through three consecutive surveys administered between 23 January 2020 and 31 March 2020 by China Academy of Information and Communication Technology (CAICT) affiliated to the Ministry of Industry and Information Technology (MIIT). Participants were member companies of the Internet Health alliance established by MIIT and the National Health Commission (NHC) in June 2016. Self-report digital interventions focusing on social and economic recovery were excluded. Two hundred and sixty-six unique digital health interventions meeting our criteria were extracted from 175 narratives on digital health interventions submitted by 116 participating companies. Thematic analysis was conducted to describe the scope and priority of policies advocating for the use of digital health technologies and the implementation pattern of digital health interventions. Data limitations precluded an evaluation of the impact of digital health interventions over a longer time frame. Results: Between January and March 2020, national policy directives promoting the use of digital technologies for the containment of COVID-19 collectively advocated for use cases in emergency planning and preparedness, public health response, and clinical services. Interventions to strengthen clinical services were mentioned more than the other two themes (n = 15, 62.5%(15/24)). Using digital technologies for public health response was mentioned much less than clinical services (n = 5, 20.8%(5/24)). Emergency planning and preparedness was least mentioned (n = 4, 16.7%(4/24)). Interventions in support of clinical services disproportionately favored healthcare facilities in less resource-constraint settings. Digital health interventions shared the same pattern of distribution. More digital health technologies were implemented in clinical services (n = 103, 38.7%(103/266)) than that in public health response (n = 91, 34.2%(91/266)). Emergency planning and preparedness had the least self-reported digital health interventions (n = 72, 27.1%(72/266)). We further identified case studies under each theme in which the wide use of digital health technologies highlighted contextual factors and key enabling mechanisms. Conclusions: The contextual factors and key enabling mechanisms through the use of policy instruments to promote digital health interventions for COVID-19 in China include pathway of policy directives influencing the private sector using a decentralized system, the booming digital health landscape before COVID-19, agility of the public sector in introducing regulatory flexibilities and incentives to mobilize the private sector.http://www.sciencedirect.com/science/article/pii/S2667102621000024Digital healthCoronavirus disease 2019TelemedicineBig dataArtificial intelligence
spellingShingle Mengji Chen
Shan Xu
Lewis Husain
Gauden Galea
Digital health interventions for COVID-19 in China: a retrospective analysis
Intelligent Medicine
Digital health
Coronavirus disease 2019
Telemedicine
Big data
Artificial intelligence
title Digital health interventions for COVID-19 in China: a retrospective analysis
title_full Digital health interventions for COVID-19 in China: a retrospective analysis
title_fullStr Digital health interventions for COVID-19 in China: a retrospective analysis
title_full_unstemmed Digital health interventions for COVID-19 in China: a retrospective analysis
title_short Digital health interventions for COVID-19 in China: a retrospective analysis
title_sort digital health interventions for covid 19 in china a retrospective analysis
topic Digital health
Coronavirus disease 2019
Telemedicine
Big data
Artificial intelligence
url http://www.sciencedirect.com/science/article/pii/S2667102621000024
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