How digital health maturity can inform global goods design
By: Tara Herrick, Sarah Gannon, and Skye Gilbert
In the last three years, global digital health has grown from a small community into an integrated and high-priority part of the agenda for Sustainable Development Goal 3: ensuring healthy lives and promoting well-being for all. With its growing visibility, fractures within the community have also become increasingly visible. Investments aren’t just fragmented because people aren’t aware of each other; they are also fragmented because people fundamentally disagree on how to achieve digital transformation of health systems in low-resource settings.
At Digital Square, we believe that building alignment across these divergent views will require a common understanding of markets—and which markets are ready for different types of digital health interventions. A universally-accepted maturity model on digital health markets could help ground theoretical debates in contextual realities. Such a maturity model would also likely identify areas of alignment that are currently invisible. For example, most stakeholders would agree that proprietary models fail in a market where the cost to sell (per customer) exceeds what buyers can afford to pay. Conversely, stakeholders would probably agree that proprietary models thrive—for better or worse—when a buyer willingness-to-pay exceeds the selling costs. Thus, a digital health maturity model could be used to increase clarity on both buyer willingness to pay and selling costs, and how those vary across contexts. This clarity could build alignment across seemingly-conflicted perspectives.
Starting in 2017, the Digital Health & Interoperability Working Group (DH&I Working Group) has convened a Small Working Group focused on maturity models. Bringing together organizations working on digital health maturity models, this group works to identify opportunities for alignment and prevent duplication that could waste scarce resources or cause confusion for countries as to what tools to use and when. This work has resulted in the alignment of cornerstone tools such as the HIS Stages of Continuous Improvement (HIS SOCI), HIS Interoperability Maturity Toolkit, the Global Digital Health Index (GDHI), and the Digital Health Atlas (DHA). The DH&I Working Group continues to advocate for support to further align and harmonize these tools as they evolve. Most models have been used to inform country implementation efforts with promising case studies of success. To date, there remains no globally-available assessment of digital health maturity.
Over the coming year, Digital Square will be co-developing a series of market analyses that require a base understanding of the state of digital health maturity, worldwide. We have just posted an RFA to identify a partner for this work. Specifically, we will be researching the following questions:
How do we better match digital health interventions across different levels of digital health maturity?
Specifically, which product features are more/less important at different levels of maturity, and what increases likelihood of adoption?
What are key barriers and drivers of country adoption of global goods?
From the perspective of country stakeholders, where are proprietary products outperforming global goods and vise versa?
What is ‘affordable’ at different maturity levels?
In order to support our research, Digital Square plans to use the data that 22 countries have contributed to the Global Digital Health Index. For the remaining 127 countries for which we do not have data, we have developed an extension to the Global Digital Health Index that allows us to infer digital health maturity from 17 World Economic Forum Networked Readiness indicators. We have conducted a comparator analysis to validate concordance with the GDHI; both our methods in developing the extension and the results of the comparator analysis are available here and open for feedback.
Graphic: Amanda BenDor
Our hope is that these analytics inspire further investment and engagement in developing a worldwide, annually measured indicator of country digital health maturity and that harmonization efforts continue to drive to success. Second, we hope our research supports countries decision-makers in thinking about what product attributes may be most critical for their national or sub-national context, given the level of maturity. Finally, we hope that global goods providers can use these findings to inform software development efforts, targeting attributes that are most critical for the markets they serve.
We welcome your input, thoughts and engagement on both the interim maturity model we are using and the research we are proposing to conduct. We will be hosting open webinars to share more information gather input in January 2020.