The current COVID-19 vaccination distribution programme had me thinking about the best ways to quickly identify segments of the population that could be most at risk, not just for COVID, but for any health issue that may come up and that we have to address nationally. We speak a lot about the social determinants of health, and now we can apply them to our healthcare planning, with technology, to get a better sense of the state and needs of the population and how we can address them with specific interventions.
The World Health Organization defines the social determinants of health as the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. It also notes that these conditions can lead to disparities in health outcomes. Even health-seeking behaviour might be affected by people’s social circumstances and may require more thought-out and creative intervention by governments.
Almost every citizen at some point has to interface with the healthcare system, whether public or private. Most of our population use public facilities, and even more use a combination of both. This means that the data that can be collected to identify issues in health is extensive. Incorporating technology can make this process easier and seamless. Data, including geographic area where one resides, age group, social and economic status, household composition, and health status and history, to name a few, can create the means by which interventions can be personalised.
Presently, the COVID-19 vaccine is being given based on age and vulnerability, such as one’s profession. The Government could be able to specifically target these groups and personalise their experience if they were able to adequately identify them through their health records, public and private. The way to achieve this is to digitise health and use the electronic medical record to easily find the most vulnerable in terms of health and their socio-economic status.
In this way, the most at-risk population can also be better identified and prioritised. Workers, for example, who cannot work from home or whose incomes are affected by tighter restrictions can be given faster access to vaccines. If persons are not able to provide for themselves and their families, it will be much harder for them to adhere to the COVID-19 restrictions. I believe if we can also move these people up on the list of those who are vaccinated, we can make a larger dent in the spread of the virus much earlier. The WHO states that “poverty has a direct impact on access to decent housing, services, education, transport, and other vital factors for overall health and well-being. In fact, poverty is arguably the single largest determinant of health”. Health, or any other policy, cannot be fully effective without taking this into consideration.
Clinical care plays an important role in overall health, but it is not the only factor that significantly contributes to holistic wellness. The data can also be used to put in place prevention and other strategies that focus on other facets of health, as well as specific disease-prevention models for vulnerable groups.
Although I spoke of vaccine distribution earlier, using the social determinants of health as the main analytic factor through electronic medical records (EMR), it can be applied to any health-related intervention that there is need to organise on a national level. It can also be useful for evidence-based planning that goes beyond health to include other relevant sectors, such as the economy and education.
We only need to incorporate more health technology into our public and private hospitals, and other facilities, and ensure that they are interoperable so that there can be linkages. If all the disparate databases could be linked, if someone moved from private to public care, for example, their information and care pathway remains consistent. The EMR can achieve this. We already have the relevant software locally and the Government is taking steps to digitise hospitals, which is a move in the right direction.
Doug Halsall is chairman and CEO of Advanced Integrated Systems. Send feedback to firstname.lastname@example.org.
Published: Friday | April 9, 2021 | 12:16 AM