Digital Health Strategy to Enhance National Health Security

Kamarul Imran Musa, MD PhD
drki.musa@gmail.com

School of Medical Sciences, Universiti Sains Malaysia

Overview

Overview

  • Introduction to Digital Health
  • National Health Security Fundamentals
  • Digital Health’s Role in Health Security
  • Recommendations for Stakeholders
  • Summary

Digital Health and National Health Security

Biography

Career and interests

  • I am an Public Health Medicine Specialist and Professor in Epidemiology and Statistics.
  • My interest is in disease modelling using epidemiological, statistical and AI modelling.
  • Listed in the top 2% scientists since 2021
  • You can find my complete biography at my personal website here

Our Medical School

School of Medical Sciences, Universiti Sains Malaysia Universiti Sains Malaysia

Part 1: Introduction to Digital Health

What is Digital Health?

Definition

Digital health encompasses a wide range of technologies including:

  • Mobile health (mHealth)
  • Health IT
  • Wearable devices
  • Telehealth/telemedicine
  • Personalized medicine

Key Features

  • Data-driven
  • Patient-centered
  • Seamless information flow
  • Real-time monitoring
  • Interconnected systems

Digital Health

Digital Health

Roles of Digital Health

  1. Individual Health Management
    • Remote monitoring
    • Self-management tools
    • Personal health records
  2. Clinical Practice Enhancement
    • Decision support systems
    • Diagnostic tools
    • Treatment personalization
  3. Population Health
    • Disease surveillance
    • Outbreak prediction
    • Resource optimization

Digital Health, Public Health and Data

Digital Health, Public Health and Data

Part 2: National Health Security

National Health Security

  • National health security refers to a nation’s ability to prevent, prepare for, and respond to public health emergencies. 

National Health Security

Core Components and Objectives of National Health Security

Core Components:

  • Disease surveillance
  • Outbreak preparedness
  • Emergency response capacity
  • Health system resilience

Key Objectives:

  • Protect populations
  • Prevent pandemics
  • Rapid detection
  • Coordinated response

Why Health Security Matters

COVID-19 Lessons:

  • Pandemics spread rapidly across borders
  • Health systems face unprecedented strain
  • Data gaps compromise response
  • Coordination challenges delay action
  • Economic and social disruption

Global Impact: Health security is essential for economic stability, social cohesion, and international cooperation

Digital Health Enabling Environment

Digital Health Enabling Environment

Part 3: Digital Health’s Role in Health Security

Enhanced Surveillance Systems

Digital Advantages:

  • Real-time data collection
  • Early outbreak detection
  • Contact tracing automation
  • Hotspot identification
  • Predictive analytics

Example: BlueDot detected COVID-19 early through AI-powered analysis of travel and health data

Enhanced Surveillance Systems

MySejahtera App

Data-Driven Decision Making

Capabilities:

  • Evidence-based protocols
  • Resource allocation
  • Intervention planning
  • Outcome prediction

Benefits:

  • Faster response times
  • Better targeting
  • Cost efficiency
  • Improved outcomes

Vaccine Delivery and Management

Digital Support for COVID-19 Response:

  • Planning and population identification
  • Pre-registration systems
  • Supply chain tracking
  • Records management
  • Digital certificates
  • Adverse event monitoring
  • Community engagement

Vaccine Delivery

Registration for Vaccination

Vaccination Status and Checking

Emergency Communication

Digital Tools Enable:

  1. Clear public messaging
  2. Misinformation combat
  3. Behavior change campaigns
  4. Trust building
  5. Multi-channel outreach

Challenge: Balancing speed with accuracy and transparency

Cross-Border Coordination

Global Digital Infrastructure:

  • International data sharing
  • Standardized reporting
  • Interoperable systems
  • Coordinated responses
  • Resource mobilization

Key Platforms: WHO Data Platform, ECDC systems, CDC networks

Cross-Border Coordination

Border Closure

Part 4: Challenges in Integration

Challenge 1: Ethical and Privacy Issues

Privacy Concerns:

  • Personal health data exposure
  • Re-identification risks
  • Data breaches and hacking
  • Unauthorized access
  • Lack of consent mechanisms

Trust Deficit: Privacy incidents erode public confidence in digital health systems

Ethical and Privacy Issues

Protect Your Privacy

Ethical Considerations

Key Issues:

  • Data ownership
  • Consent complexity
  • Algorithmic bias
  • Equitable access
  • Accountability gaps

Requirements:

  • Transparency
  • Individual control
  • Fair governance
  • Community engagement
  • Legal protections

Challenge 2: Infrastructure Gaps

Common Barriers:

  1. Connectivity: Inadequate internet access, especially rural areas
  2. Power Supply: Unreliable electricity
  3. Hardware: Insufficient devices and equipment
  4. Integration: Siloed systems
  5. Interoperability: Incompatible platforms

Impact: Data backlogs, delays, incomplete information

Interoperability

Interoperability using HL7 FHIR Standard

Standards and Key Stakeholder

Standard and Stakeholders

The Digital Divide

Inequities in:

  • Technology access
  • Digital literacy
  • Infrastructure quality
  • Resource availability
  • Training opportunities

Result: Vulnerable populations most affected during health emergencies

Challenge 3: Workforce Capacity

Skills Gaps:

  • Data literacy
  • Digital tool proficiency
  • System management
  • Cybersecurity awareness
  • Analytics capabilities

Workforce Issues: Shortages, high workload, inadequate training, retention challenges

Digital Skills Spectrum

Four Levels:

  1. Digital Literacy - Basic user skills for all citizens
  2. Operational Skills - Using digital health tools (general workforce)
  3. Managerial Skills - Systems thinking and decision-making (leaders)
  4. Technical Skills - Development and innovation (IT professionals)

Digital Skills Spectrum

Digital Skills Spectrum

Challenge 4: Data Quality and Standards

Quality Issues:

  • Incomplete data
  • Inconsistent formats
  • Lack of standardization
  • Poor data governance
  • Bias in datasets

Consequences: Unreliable analytics, ineffective interventions, wasted resources

Types, Functions and Standards

Types, Functions and Standards

Evidence and Validation

Key Questions:

  • How do we validate digital health tools?
  • What evidence standards apply?
  • How do we ensure safety and efficacy?
  • What about AI-driven decisions?

Need: Robust regulatory frameworks and evaluation methodologies

Challenge 5: Governance and Coordination

Governance Gaps:

  • Fragmented policies
  • Unclear data ownership
  • Weak accountability
  • Limited oversight
  • Insufficient coordination

International Challenge: Inconsistent regulations across countries

Part 5: Recommendations From the Riyadh Global Digital Health Summit

Recommendations From the Riyadh Global Digital Health Summit

  • Implement data-driven and evidence-based protocols for clear and effective communication with common messaging to build citizens’ trust.
  • Work with global stakeholders to confront the propagation of misinformation or disinformation through social media platforms anm assmedia.
  • Implement a standard global minimum dataset for public health data reporting and a data governance structure tailored to communicable diseases.
  • Ensure that countries prioritize digital health, particularly improving digital health infrastructure andreaching digital maturity.
  • Enable health care organizations by providing the necessary technology to collect high-quality data in a timely manner and promote sharing to create health intelligence.

Recommendations From the Riyadh Global Digital Health Summit

Global Digital Health Summit 2020

Recommendations From the Riyadh Global Digital Health Summit

  • Cultivate a health care workforce with the knowledge, skills, and training in data and digital technologies required to address current and future public health challenges.
  • Ensure surveillance systems combine an effective public health response with respect for ethical andprivacy principles.
  • Develop digital personal tools and services to support comprehensive health programs globally.
  • Maintain, continue to fund, and innovate surveillance systems as a core componentofthe connected global health system for rapid preparedness andoptimalglobal responses.

Part 6: Recommendations for Stakeholders

For Higher Education Institutions

Curriculum Development:

  1. Integrate digital health into medical and public health programs
  2. Offer specialized training in health informatics
  3. Teach data science and analytics
  4. Include ethics and governance modules
  5. Develop interdisciplinary programs

Research Focus: Health data science, AI in healthcare, digital epidemiology

Academic Capacity Building

Faculty Development:

  • Digital health literacy
  • Teaching innovation
  • Industry partnerships
  • Continuing education

Student Preparation:

  • Hands-on training
  • Real-world projects
  • Internships
  • Competency-based learning

For Health Agencies

Strategic Priorities:

  1. Invest in Digital Infrastructure
    • Interoperable systems
    • Cloud infrastructure
    • Secure data platforms
  2. Develop National Digital Health Strategies
    • Clear roadmaps
    • Costed implementation plans
    • Regular assessments

Health Agency Recommendations (cont.)

  1. Implement Standard Minimum Datasets
    • Pandemic-specific indicators
    • Standardized reporting
    • Data quality protocols
  2. Build Surveillance Capacity
    • Real-time monitoring
    • Predictive analytics
    • Automated reporting

For Ministry of Health

Policy Leadership:

  1. Data Governance Frameworks
    • Privacy protections
    • Access protocols
    • Sharing agreements
    • Security standards
  2. Public-Private Partnerships
    • Co-investment models
    • Data sharing agreements
    • Innovation incentives

Ministry of Health Actions (cont.)

  1. Workforce Development
    • National training programs
    • Competency standards
    • Retention strategies
    • International collaboration
  2. Enable Interoperability
    • Adopt international standards
    • Mandate compliance
    • Support integration

For Private Health Sector

Industry Responsibilities:

  1. Adopt Ethical Practices
    • Transparent data use
    • Robust security
    • Fair pricing
    • Benefit sharing
  2. Support Standards Development
    • Participate in standard-setting
    • Implement FAIR (Findability, Accessibility, Interoperability, and Reusability) principles
    • Enable data portability

Private Sector Engagement (cont.)

  1. Invest in Innovation
    • User-centered design
    • Evidence generation
    • Regulatory compliance
    • Accessibility features
  2. Collaborate with Public Sector
    • Share expertise
    • Support capacity building
    • Co-develop solutions

Cross-Cutting Recommendations

The 5 T’s Framework:

  1. Team: Multi-stakeholder collaboration
  2. Transparency: Open communication and trust
  3. Technology: Appropriate, accessible, scalable tools
  4. Techquity: Address digital divide
  5. Transformation: Systemic change for resilience

The 5 T’s Framework

The 5 T’s Framework

Part 7: Summary

Key Takeaways (1/2)

  1. Digital health is essential for modern health security
  2. COVID-19 exposed gaps in digital infrastructure globally
  3. Data-driven approaches enable faster, more effective responses
  4. Multiple challenges must be addressed: privacy, infrastructure, workforce, governance
  5. All stakeholders have critical roles to play

Key Takeaways (2/2)

  1. Investment in digital health enabling environment is crucial
  2. International cooperation and standardization are necessary
  3. Trust is the foundation for successful digital health
  4. Equity must be central to digital health deployment
  5. Preparedness today protects populations tomorrow

All five must be fulfilled simultaneously

From Declaration to Action

Riyadh Declaration (2020) → Implementation (2022) → Future

  • Global consensus on digital health priorities
  • Roadmap for practical implementation
  • Ongoing adaptation to emerging challenges

Next Steps: National action plans, monitoring progress, sharing best practices

References

Key References (1/3)

  1. Sichel A, Waugaman A, Rosenbaum R, et al. How emergency digital health and data use investments can strengthen health systems and support global health security. Oxford Open Digital Health. 2024;2:i1-i6.

  2. AlKnawy B, Kozlakidis Z, Tarkoma S, et al. Digital public health leadership in the global fight for health security. BMJ Global Health. 2023;8:e011454.

  3. Al Knawy B, McKillop MM, Abduljawad J, et al. Successfully implementing digital health to ensure future global health security during pandemics: A consensus statement. JAMA Network Open. 2022;5(2):e220214.

Key References (2/3)

  1. Vayena E, Haeusermann T, Adjekum A, Blasimme A. Digital health: meeting the ethical and policy challenges. Swiss Medical Weekly. 2018;148:w14571.

  2. World Health Organization. Global strategy on digital health 2020-2025. Geneva: WHO; 2020.

  3. OECD. Recommendations for health data governance. Paris: OECD; 2019.

Key References (3/3)

  1. Fast L, Waugaman A. Fighting Ebola with information: Learning from the use of data, information, and digital technologies in the West Africa Ebola outbreak response. Washington, DC: USAID; 2016.

  2. General Data Protection Regulation (GDPR). Regulation (EU) 2016/679. Brussels: European Union; 2016.

  3. Swiss Federal Act on the Electronic Patient Dossier (EPDG). Bern: Swiss Confederation; 2017.

Thank You

  • National Defense College - Sultanate of Oman

Questions and Discussion

Do contact me at drkamarul@usm.my for collaboration and networking.

Together, we can build a digitally-enabled, health-secure future