HIMSS23: Global leaders seek a balance between tech innovation and health equity

One in 10 Ukraine hospitals has been hit by Russian attacks, said Oksana Markarova, Ukraine’s ambassador to the U.S., in a prerecorded message presented at the HIMSS 2023 conference this week.

The session focused on wrangling the rampant excitement surrounding breakthrough technologies like generative AI and large language models to address global health inequalities. Markarova put U.S. workforce challenges into focus by referencing the medical professionals working around the clock in Ukraine since the Russian invasion a year ago.

Hal Wolf, HIMSS president and CEO, prompted panelists to place new tech within the context of health equity, a concept, he said, that takes on more dimensions every year health IT professionals meet at the annual conference.

“Through the health tech ecosystem, there have been some amazing applications,” Wolf said during the panel. “Are we at risk of creating inequity in these advancements, or is it an opportunity to get everything you can and then work back downstream?"

Lester Martinez-Lopez, assistant secretary of defense for health affairs at the U.S. Department of Defense, responded by discussing the ever-evolving landscape of health inequality. Rural lack of access to technology is a challenge many players are addressing, and data analytics are already being used to chip away at racial inequality in healthcare.

But advancements with tech like predictive analytics rely on patients’ allowing their data to be used. As things stand now, Martinez-Lopez said, Americans do not trust large industries with their data. If that is not handled, a new layer of inequality may open up a chasm, he noted.

Patients who have been courted by large industries like the military and healthcare and offer their trust and related data will gain access to ultra-precise medicine. Patients who lack trust in the system could be left behind, to the detriment and cost of the entire country, Martinez-Lopez predicted.

“If you have a fancy solution that only addresses fancy people in cities, you have to go back to the drawing board,” Martinez-Lopez said in response to Wolf’s question. “That’s something I’m very concerned about.”

Ernst Kuipers, minister of health, welfare and sport of the Netherlands, gave a brief presentation on the state of global health. Kuipers celebrated that the global life expectancy average increased by 6.3 years between 1990 and 2013. However, he pointed out, healthy years did not increase. Those 6.3 years are sick years.

To explain the current global state of healthcare, Kuipers used the metaphor of an orchestra where musicians are given new instruments at random and many do not have sheet music and can’t hear the other musicians. Without a conductor, they are just making noise. He imagines a future where global and local health players function as a jazz ensemble to move as one in addressing issues like interoperability, climate change and patient trust.

Kuipers pointed out that as healthcare seeks to solve today's biggest problems, it is creating the problems of tomorrow. Worldwide, the health sector contributed 4.6% of total greenhouse gas emissions. In the U.S., that number jumps to 8.5%, according to The New England Journal of Medicine.

As a trained infectious disease expert, he employed those in attendance to put global climate change at the top of their minds to avoid the increase of global disease spread. For global healthcare to work, stakeholders need to be looking at inequity today to address inequity far in the future, Kuipers said.

“We know from data dating back to World War II that early births and low birth rates are a predictor of getting cardiovascular disease and cancer 60 years from now,” Kuipers said. “So if today you can provide in pregnancy equal access to maternal care, nutrition, all that, it’s an investment in the health system in 2090.”

Päivi Sillanaukee, ambassador for the health and well-being ministry for foreign affairs of Finland, touched on how the EU is attempting to orchestrate a unified data and interoperability strategy.

Key European tourism shakers signed a Code of Conduct in March to share data, while a new collaboration between 10 countries within the EU is working to address interoperability within issues like water rights decision-making.

With recent EU conferences addressing widespread interoperability, Sillanaukee sees a move toward unlocking biological and behavioral data coming down the pike, both holding huge potential for the continent. “The door is open, there is a willingness,” Sillanaukee said.

“One of the big challenges that we have learned is that health goes beyond the healthcare center because the root causes are social determinants of health,” said Hans Kluge, regional director for Europe at the World Health Organization (WHO). “It means we need a massive effort to work across the sectors.”

Wolf recognized several international delegations to the conference including 11 countries that participated in an international digital health roundtable.

Players from abroad like Taiwan’s Chang Gung Memorial Hospital were recognized with the HIMSS Digital Health Indicator Award. Samsung Hospital in South Korea was awarded in the same category and was celebrated for being the first hospital to reach the seventh stage of HIMSS maturity models in digital implementation.  

In September 2022, HIMSS signed a collaboration agreement with WHO Europe. The duo plans to create a new agenda for transatlantic digital health collaboration including monitoring the progress of digital implementation across the region.

“We need to put health and equity at the heart of all policies. Health must not only be seen as a beneficiary of economic development but a requirement. We need to do change in a modest way, but without health, there is nothing,” Kluge said.