IGF 2020 WS #252 Connected Health in the Post-Covid-19 Era

Information

Session

Time:

Thursday, 12 November, 2020 - 16:10 to 17:40 UTC

Room:

Room 1

About this Session:

As much of the world has moved to severely curtail travel and caution against non-essential healthcare visits, providers have adopted telehealth and remote patient monitoring solutions to handle a greater load of cases in a manner protective of social-distancing policies and public health. This panel will explore the newfound prominence of connected healthcare, addressing both the opportunities and challenges of this development.

Thematic Track:

Data

Topic(s):

Artificial Intelligence
Inclusivity
Privacy

Organizer 1: Matthew Schwartz, Innovators Network Foundation
Organizer 2: Brian Scarpelli, ACT | The App Association

Speaker 1: Sveatoslav Vizitiu , Private Sector, Eastern European Group
Speaker 2: Jelena Malinina , Civil Society, Western European and Others Group (WEOG)
Speaker 3: Subbarao Kambhampati, Technical Community, Western European and Others Group (WEOG)
Speaker 4: Analia Baum, Government, Latin American and Caribbean Group (GRULAC)
Speaker 5: Ben Wallis, Private Sector, Western European and Others Group (WEOG)

Additional Speakers:

Ben Wallis from Microsoft is stepping aside to allow a colleague with greater subject matter expertise, Miller Geralyn, to take his place.

Format:

Round Table - U-shape - 90 Min

Description:

The COVID-19 crisis has acted as a catalyzing agent for rapid change in a number of sectors worldwide, not least of which is the connected healthcare industry. As much of the world has moved to severely curtail travel and caution against non-essential healthcare visits, providers have adopted telehealth and remote patient monitoring solutions to handle a greater load of cases in a manner protective of social-distancing policies and public health. These technologies can provide patients with greater control and personalization in their treatment and could become even more beneficial with the continued advancement of certain promising AI technologies. However, this change comes with no shortage of challenges. Often, those most in need of connected healthcare are the ones who are least able to access it. Impediments include lack of smartphone access and internet coverage in rural areas, as well as regulatory barriers stemming from legacy approaches to healthcare. Greater provision of healthcare over the internet also enhances the opportunity for cyberattacks and can create new privacy risks. This panel will explore the newfound prominence of connected healthcare, including a discussion of whether this development will be a lasting one that can improve public wellbeing beyond the crisis, or if it will recede in as the crisis inevitably wanes. The panel will also weigh the benefits of the move to telehealth and remote patient monitoring against some of the drawbacks, including strains on existing privacy architectures, the ethics of layering-on certain AI applications and the accessibility challenges mentioned above.

Issues:

i. The inclusivity challenges that threaten to make digital healthcare more available for those with certain advantages, such as smartphone access, strong internet connectivity, and social capital that helps them tap into to such resources. ii. Legislative and regulatory decisions regarding whether teleahealth is a solution that can or should enjoy greater consideration after the pandemic subsides. iii. The privacy and security threats that multiply when the provision of certain health services normally transacted in an in-person setting now flow over networks. iv. The opportunities to make healthcare easier and cheaper to access, and to layer on applications that allow for greater personalization of healthcare than was available in the past.

Policy Question(s):

i. Is connected health the right solution to improve healthcare outcomes even after the exigencies of the COVID-19 crisis subside? ii. What is the best way to bridge the digital divide that not only separates rural areas from urban, but the global south and developing nations from the rest of the world in terms of access to digital health? iii. How can policymakers ensure that patients retain strong privacy and security assurances as the provision of some healthcare moves from in-person to online? iv. What are the opportunities and risks of supplementing traditional healthcare with AI-powered analytics tools.

Expected Outcomes:

1. Understand the spectrum of opportunities and challenges that telehealth will bring to bear on communities during and after the COVID-19 pandemic, and how those opportunities and challenges are mediated by socio-economic factors. 2. Learn about what the IGF community can do to further action and cross-sector collaboration to realize the potential and work through challenges surfaced in the conversation. 3. Share diverse perspectives regarding the discrete priorities and/or changes needed from the IGF community to combat these challenges and harness opportunities.

Relevance to Internet Governance: Internet governance is, and must continue to be, a leading force in advancing appropriate safeguards and standards when it comes to connected health. Meaningfully advancing such safeguards will not be possible without using the open and inclusive multi-stakeholder Internet governance process to develop norms, incentives and rules for digital health.

Relevance to Theme: Finding a viable, responsible path toward the provision of digital health via smartphones and other connected devices after the COVID-19 crisis in a way that respects the privacy of individuals and does not exacerbate existing access imbalances hinges on appropriate data governance.

Moderator:

Brian Scarpelli, Private Sector, Western European and Others Group (WEOG)

Online Moderator:

Matthew Schwartz, Civil Society, Western European and Others Group (WEOG)

Rapporteur:

Matthew Schwartz, Civil Society, Western European and Others Group (WEOG)

Discussion Facilitation:

For each of the areas of interest, introductory short presentations/remarks by experts will provide basic knowledge and discuss important trade-offs from their perspective. The moderator will ensure the active participation of the audience, who will be able to intervene and ask questions to the experts. Sufficient time will be given to online participants to ask questions, by the online moderator. Following these initial interventions, the roundtable will get to the heart of the debate, guided by the moderator who will begin by giving an opportunity to online and in-person participants to pose questions and discuss views on the perspectives presented. The moderator will guide the debate with the goal of finding common ground between views brought forward. In addition to the background documents and papers that will be prepared ahed of the IGF< additional articles of itnerest, reference materials and social media conversations will be published and distributed ahead of the workshop. The moderator and organizing team will work with speakers in advance as to ensure the quality and content of the discussion.

Online Participation:

Usage of IGF Official Tool. Additional Tools proposed: The online moderator will encourage remote participation through various social networking platforms in addition to the platform provided by the IGF Secretariat. After the first round of interventions, the discussion section of the roundtable will open up an invitation to online participants to weigh in on strategies discussed and pose questions to the speakers. The organizing team will work to promote the activity on social media, and will specially invite relevant stakeholders to join the session and share questions ahead of the debate. Online participants will be given priority to speak, and their participation will be encouraged by the online and in-person moderators.

SDGs:

GOAL 1: No Poverty
GOAL 3: Good Health and Well-Being
GOAL 5: Gender Equality
GOAL 8: Decent Work and Economic Growth
GOAL 9: Industry, Innovation and Infrastructure
GOAL 10: Reduced Inequalities
GOAL 11: Sustainable Cities and Communities
GOAL 16: Peace, Justice and Strong Institutions
GOAL 17: Partnerships for the Goals

Report

1. Key Policy Questions and related issues:

What does a successful statutory and regulatory regime look like when it comes to empowering positive uses of connected health technologies, and what does success look like in terms of preventing some of the downsides?

What is the best way to bridge the digital divide that threatens to leave some outside of the positive advances made in digital health?

What are the opportunities and risks of supplementing traditional healthcare with AI-powered analytics tools?

2. Summary of Issues Discussed:

What about current connected health use-cases is encouraging and what do still needs to be addressed?
Whether this is a trend that should or will last beyond the public health crisis.
- The panel agreed that the trend will last and has plenty of positives.
How much are the current AI use cases in healthcare built on "hype" and how much are real benefits to patients.
- Panelists agreed there are many positive use-cases, but there needs to be care taken to ensure that policymakers continue to be skeptical, instead of "cheering on" AI uncritically.
The need for human intervention into AI systems.
The additional privacy and security threats that the provision of healthcare over the internet brings.
- Panelists agreed on the existence of a new threat but disagreed about the solutions to mitigate them.
The inclusivity challenges that arise when healthcare is provided over the internet.
- Panelists offered several different solutions, including broad-based technology education campaigns and universal broadband deployment.

3. Key Takeaways:

The panel was able to identify and create an understanding of the spectrum of opportunities and challenges that telehealth will bring to bear on communities during and after the COVID-19 pandemic. The panel discssed how the identified opportunities and challenges may be mitigated by the socioeconomic factors of discreet communities. For example, rural patients in the global south have less opportunity to benefit from connected health interventions due to lack of access to smartphones, broadband, and health providers who are willing to adopt the technology.

Panelists reached agreement that broadband access, legacy regulatory approaches, interoperability, technological literacy issues, privacy and security risks, and immature technology (from an AI diagnostics perspective) are all challenges. However, panelists also agreed that the opportunities that connected health presents are immense: greater penetration into underserved markets, more personalized care, optimizing new and existing data flows, and allowing for greater regional resource sharing are all ways that connected health can help improve patient outcomes.

Panelists offered several different solutions to help mitigate some of the challenges, including broad-based technology education campaigns, universal broadband deployment, and bridging the divide between policymakers and technologists.

4. Policy Recommendations or Suggestions for the Way Forward:

What policy sector(s) does this fall under? (leave blank if not sure):

Economic

Overarching governance issues

Issue and Recommendation:

Broadband access is still limited in many areas, which prevents uptake of these useful technologies - though the capacity (unused bands of broadband spectrum) and technologies (5G) do exist to mitigate these concerns.

Who should take it?:

This where an area for governments and private entities can collaborate to generate a positive outcome.

What policy sector(s) does this fall under? (leave blank if not sure):

Social-cultural

Issue and Recommendation:

Technological literacy is an issue that prevents uptake of digital health technologies - the private sector and government players need to work together to create campaigns that increase understanding and familiarity with the benefits and risks of digital health tools.

Who should take it?:

This is an educational issue that intersects government and the private sector.

What policy sector(s) does this fall under? (leave blank if not sure):

Social-cultural

Issue and Recommendation:

Legacy regulatory approaches contribute to lower uptake of digital health technologies - lawmakers need to update approaches to insurance and interoperability to meet the 21st century.

Who should take it?:

Governments.

5. Other Initiatives Addressing the Session Issues:

Initiative:

-COVID notification systems -City of Buenos Aires/WeChat Partnership (COVID symptom checking ChatBots) -https://www.citiesforglobalhealth.org/initiative/buenos-aires-chatbot-helps-protect-citizens-against-coronavirus

Initiative:

-End-to-end diagnostic solution for early detection of disease (Diabetic Retinopathy) -Microsoft's telemedicine IRIS Diabetic Retinopathy Diagnostic Solution -https://appsource.microsoft.com/en-us/product/web-apps/iris-intelligentretinalimagingsystems.iris?tab=Overview

Initiative:

-Lack of broadband access -Microsoft's Airbands/television white spaces initiative -https://www.microsoft.com/en-us/corporate-responsibility/airband/technology

6. Final Speakers:

Moderator: Brian Scarpelli, ACT | The App Association

Speaker 1: Sveatoslav Vizitiu , Private Sector, Eastern European Group
Speaker 2: Jelena Malinina , Civil Society, Western European and Others Group (WEOG)
Speaker 3: Subbarao Kambhampati, Technical Community, Western European and Others Group (WEOG)
Speaker 4: Analia Baum, Government, Latin American and Caribbean Group (GRULAC)
Speaker 5: Geralyn Miller, Private Sector, Western European and Others Group (WEOG

8. Session Outputs:

-https://www.citiesforglobalhealth.org/initiative/buenos-aires-chatbot-he...

-https://www.microsoft.com/en-us/corporate-responsibility/airband/technology

-https://appsource.microsoft.com/en-us/product/web-apps/iris-intelligentr...

9. Group Photo:

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IGF 2020 WS #252 Connected Health in the Post-Covid-19 Era

Information