The year is 2025, and in a rural area where medical personnel are in short supply, a woman with diabetes is dealing with her illness. What can you do? Who do you contact …? On your smartphone. In just two years, healthcare – and many other services – could look very different than it does today. Technologies like artificial intelligence and the internet could enable this woman to get health care at the touch of a button. An adhesive could use your sweat to measure blood sugar levels. A microchip in his phone would send that data to his electronic health record in the cloud, and he could then place an order for insulin to be delivered to his door by a drone, or ask the local pharmacy to 3D his metformin pills to print and confirm their identity via SMS.
A comprehensive digital primary health care system could mitigate or even overcome systemic problems such as absenteeism (…), low quality and lack of responsiveness, and structural inefficiencies
Another way to detect diabetic retinopathy, which if left untreated can damage your eyes and lead to blindness, is to take a selfie-like picture of your retina with your smartphone. An artificial intelligence algorithm would analyze it and make an appointment with the doctor if there were any abnormalities. She could even order a taxi to bring her and deduct the cost of transportation from her mobile wallet. Before the woman arrives at the office, the doctor may try laser therapy on her digital twin to determine the best treatment.
It may sound like science fiction, but all of these solutions already exist separately. And given the likelihood of exponential growth in computing power, continued deep learning of neural networks, and revolutionary advances in intelligent machines, robotics, and 3D printing, these systems will become more widespread and more powerful.
If it’s technically possible to build a complete digital primary health care system tailored to the needs of resource-poor facilities, then why hasn’t anyone put these elements together? There is no financial incentive for private companies to connect independent technologies, nor for national health systems, which are often underfunded.
To see the potential of this digital transformation, you need to look outside of healthcare. Especially when it comes to digital payment systems, which could herald a new era in healthcare due to their widespread adoption. Redesigning healthcare systems to integrate data and digital technologies is no longer just a task for government departments. It is increasingly being carried out by financial institutions, organizations experimenting with new technologies, and online retailers.
In the three years that I have been Chairman of Ehsaas, Pakistan’s largest social security and poverty alleviation program, I have observed the infrastructure needed to facilitate digital payments. Gateways and switches form the backbone of these systems, but so do guidelines, standards and regulatory frameworks. Ehsaas itself is currently developing a unique digital ecosystem that could benefit millions of families. It includes the Ehsaas Savings Wallets initiative, implemented under the One Bank Account for Every Woman policy, and allows beneficiaries of the Ehsaas Kafaalat program, which provides monthly cash stipends to the country’s poorest women, to withdraw or save . The new ecosystem also includes the Ehsaas Rashan Riayat program, a grant-making technology initiative. With the Rashan app, eligible families receive discounts on select groceries at Kiryanas or convenience stores. Coupled with the right tax incentives, such initiatives could boost financial inclusion and accelerate the transition from cash to digital payments.
Even in the most remote parts of the world, fast food chains and taxi companies are harnessing the power of mobile technology to deliver goods and services. In theory, the same technological capabilities could underpin innovative public sector digital ecosystems that are transparent, accountable and responsive. The Ehsaas ecosystem is a step in the right direction.
A comprehensive digital primary health care system could mitigate or even overcome systemic problems such as absenteeism, supply chain losses, institutionalized theft, low quality and lack of responsiveness, parasitic rent-seeking behavior, informal payments and structural inefficiencies. Only the use of the Chain of Blocks or blockchain – a multi-purpose technology – can ensure security, increase transparency and has the potential to prevent fraud and minimize losses in healthcare systems.
Covid-19, the inflationary crisis and climate change underscore the need to reform public institutions and healthcare. In order to realize a future in which this woman with diabetes can be treated by a constellation of medical technologies, intensive investments in the digitization and modernization of payment systems as well as the development of regulatory and political frameworks are essential. The technology already exists, now we must put it at the service of all.
Spanish translation by Ant-Translation
Sania Nishtar, former Special Assistant to the Prime Minister of Pakistan for Poverty Reduction and Social Protection, served as Chair of the Ehsaas Punjab Program.
Copyright: Project Syndicate, 2023. www.project-syndicate.org
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