Innovation and Digital Transformation in Health Education: Opportunities to Drive Technological Development in the Training of Future Professionals

Innovación y Transformación Digital en la Educación en Salud: Oportunidades para Impulsar el Desarrollo Tecnológico en la Formación de los Futuros Profesionales

DOI: https://dx.doi.org/10.17981/ingecuc.20.2.2024.10

Scientific Research Article

Date of Receipt: 18/11/2024 Date of Acceptance: 16/12/2024

Yelson Alejandro Picón-Jaimes

Fac Ciències Salut Blanquerna, Univ Ramon Llul, Barcelona, España

yelsonalejandropj@blanquerna.url.edu

To cite this paper:

Y. Picón-Jaimez, “Innovation and Digital Transformation in Health Education: Opportunities to Drive Technological Development in the Training of Future Professionals,” INGE CUC, vol. 20, no. 2, 2024. DOI: https://dx.doi.org/10.17981/ingecuc.20.2.2024.10

I. Introduction

Digital transformation has been identified as a critical factor in the modernization of health systems and medical education worldwide [1]. Within a constantly evolving landscape of public health needs, the integration of digital technologies into the training of healthcare professionals is regarded not merely as a trend but as an urgent necessity [2]. Nonetheless, this transition remains highly inconsistent. According to the World Health Organization (WHO)’s Global Strategy on Digital Health 2020–2025, more than 50% of low- and middle-income countries encounter significant barriers to adopting digital technologies in their health and education systems [3].

The adoption of tools such as artificial intelligence (AI), virtual reality (VR) and augmented reality (AR)-based simulation, as well as distance learning platforms, has been demonstrated to hold transformative potential for redefining traditional models of health education [4]. Recent scientometric and conceptual analyses have indicated a consistent annual growth in publications related to “digital health and education” over the past decade, underscoring the increasing interest of the scientific community in this field [5, 6].

However, unequal access to these technological innovations continues to exacerbate disparities in the training of healthcare professionals [3]. These disparities directly impact the quality of health services provided and the global indicators of healthcare quality. In the European Union, for instance, 75% of healthcare professionals have access to training in advanced digital competencies, whereas this figure falls below 30% in Latin America and sub-Saharan Africa [7].

Given these challenges, it becomes essential to continuously evaluate and address the obstacles, gaps, and opportunities faced by digital health, particularly in the education of future healthcare professionals. Such efforts are vital to effectively, efficiently, and optimally meet the health needs and priorities of populations. The aim of this manuscript is to analyze the current gaps and opportunities in research on digital health and professional health education.

II. Key Current Challenges and Their Potential Impact on Healthcare

The WHO Global Health Observatory has identified chronic non-communicable diseases, specifically cardiovascular diseases, cancer, and chronic respiratory conditions, as leading health challenges [8]. A significant proportion of these deaths is attributed to preventable risk factors, such as elevated blood pressure, pollution, smoking, and hyperglycemia [9]. One of the most pressing challenges remains the real-world, particularly community-level, control of these risk factors to mitigate the development or exacerbation of acute and chronic conditions. Over time, advancements in health technologies have enabled risk factors to be addressed through monitoring, intervention, and direct prevention [10].

Data from the World Bank indicate a more than 500% increase in global internet usage over the past decade [12], signaling greater integration with technologies and communication networks. Innovative strategies have leveraged these channels to deliver health promotion and disease prevention initiatives within communities [12]. Robust evidence has demonstrated the potential of digital health research and development as tools for health education and intervention, breaking down traditional barriers to timely and quality healthcare access [13].

Low- and middle-income countries face the greatest challenges in implementing digital health strategies to improve health indicators through technology-driven interventions. Several key obstacles remain:

• Disparities in access to technology: Inadequate technological infrastructure persists as a fundamental barrier, particularly in resource-limited settings. Low-income regions continue to struggle with limited connectivity, high costs of technological devices, and insufficient training for effective use of these tools [14]. This imbalance directly affects equity in learning and the quality of healthcare future professionals can provide.
• Resistance to change: Despite demonstrated benefits, significant resistance to the adoption of digital technologies is still observed among educators and institutions. The position of some health educators—who consider digital platforms to be less effective than face-to-face methods despite evidence suggesting otherwise [15]—has been previously discussed. Rejection in the implementation of digital health transitions is also caused by other barriers, such as personal issues, psychological factors, and work overload among health professionals [16]. These issues should be explored in a personalized and contextualized manner to seek definitive and reproducible solutions at the local level.
• Lack of standardization in digital competencies: The “Global Strategy on Digital Health” emphasizes that digital competencies must be integrated as an essential component in the training of health professionals [3]. However, a considerable gap is observed between countries in terms of definitions, content, and assessment of these competencies. While robust initiatives such as the Digital Competence Framework for Educators (DigCompEdu) are present in Europe, such frameworks are scarce or nonexistent in Latin America and sub-Saharan Africa [3].
• Traceability in health indicators: The capacity of health systems to respond efficiently to contemporary challenges is directly impacted by the lack of training and fragmented digital transition. Consequently, a significant gap in the recognition of health indicators that can be continuously evaluated is generated, hindering higher levels of continuity in healthcare delivery and the education of new professionals. This may be one of the reasons why, during the COVID-19 pandemic, a 30% increase in interruptions of essential health services was reported in regions with low levels of digitization [17].

III. Gaps and Opportunities in Digital Health and Health Education in Latin America

To examine the background and scientific growth of digital health and its integration into the education of future healthcare professionals, a brief bibliometric analysis was conducted using the Scopus database. The search employed terms derived from MeSH, including “Digital Health” and subcategories of the descriptor “Professional Education,” related to professional or continuing education in fields such as medicine, nursing, pharmacy, dentistry, neuroscience, and healthcare professions. Only serial publications in peer-reviewed journals undergoing standard editorial evaluation were included. Excluded documents consisted of book chapters, books, conference papers, and retracted documents. The search was performed on December 13, 2024. Additionally, scientific production by Latin American authors was compared using affiliation country tags to contextualize the related literature. This methodology has been previously employed and validated for assessing research trends and gaps [18-20].

The global evidence on digital health yielded 11,182 results. A notable increase in publications has been observed since 2016, with sustained growth to date (Figure 1A). The United States and the United Kingdom lead scientific production in this area (Figure 1B), with prominent contributions from institutions such as Harvard Medical School and the University of Toronto (Figure 1C). As shown, the majority of publications consist of research articles (Figure 1D), highlighting the originality in developing experimental ideas, likely attributed to the multidisciplinary nature inherent to digital health.

Fig. 1. Evolution and characteristics of global research on digital health. A. Scientific growth over time. B. Most prolific countries. C. Most prolific institutions. D. Distribution of scientific output by publication type.

Filtering by Latin American countries revealed that the region accounted for only 3.13% (n=350) of the total scientific production, with marked and sustained growth observed starting in 2019 (Figure 2A), a few years behind the global trend. Brazil emerged as the leading country in the region, followed by Mexico and Chile (Figure 2B). Among the top 10 most active institutions in this field within Latin America, nine are located in Brazil, underscoring its regional dominance (Figure 2C). Regarding the disciplines contributing to this evidence, the majority of research has been conducted in Medicine (62.9%), followed by Nursing (6.8%) (Figure 2D).

Fig 2. Evolution and characteristics of Latin American research on digital health. A. Scientific growth over time. B. Most prolific countries. C. Most prolific institutions. D. Distribution of publications by research area

When examining evidence on digital health specifically linked to the professional education of healthcare providers, a markedly different scenario emerges. Globally, only 293 scientific documents have been published, with notable progress beginning in 2018 (Figure 3A). This area is again led by the United States and the United Kingdom (Figure 3B). Medicine and nursing represent the most frequently explored fields (Figure 3C). In this context, the leading institutions are more diverse, including organizations from Asia, Europe, and North America (Figure 3D).

Scientific production in Latin America on digital health and the education of healthcare professionals remains notably limited, with only 16 documents representing 5.46% of the total publications on digital health and professional health education, and just 0.14% (n=16/11,182) of the global evidence on digital health. This topic clearly represents a niche for transformative innovation that requires further exploration to generate valuable interdisciplinary knowledge spanning health, innovation, education, and productivity.

Fig 3. Evolution and characteristics of global research on digital health and professional health education . A. Scientific growth over time. B. Most prolific countries. C. Distribution of publications by research area. D. Most prolific institutions.

The literature highlights several strategies that could be implemented in Latin America, including Colombia, to address challenges in digital health implementation and its integration into professional healthcare education [21,22]:

1) Strengthening technological infrastructure: Investments must be prioritized to ensure equitable access to digital platforms. This involves not only improving internet connectivity but also promoting subsidies for the acquisition of devices and technological tools in resource-limited regions [23].

2) Integrating digital competencies into curricula: Educational systems for healthcare professionals should restructure curricula to incorporate digital competencies comprehensively. Such efforts would enhance professional preparedness while helping to bridge the technological skills gap between regions [23].

3) Fostering international collaboration: The establishment of global networks for knowledge exchange and best practices in digital health is essential. Initiatives such as the WHO’s Strategic Partners’ Initiative for Data and Digital Health provide models for collaborations that transcend borders and economic contexts [24]. Figures 1C, 2C, and 3D identify potential collaborators with expertise and a track record of generating innovative evidence.

4) Evaluating and adapting emerging technologies: Emerging tools such as artificial intelligence and machine learning hold significant potential to transform health education. However, their adoption must be accompanied by rigorous evaluations to ensure effectiveness and equity. The application of these technologies could substantially reduce the time required for training in critical clinical skills [25].

In alignment with international standards, efforts, resources, and human talent must be directed toward innovative projects and technological strategies with real-world impacts on health indicators [26]. Digital health interventions and the integration of digital health into professional healthcare education represent two critical areas requiring in-depth research and support for their development.

IV. Conclusions

Innovation and digital transformation present an unprecedented opportunity to revolutionize health education and reduce global disparities in the training of healthcare professionals. Achieving this goal requires addressing current challenges through a strategic and collaborative approach, supported by scientific evidence and coordinated efforts among governments, educational institutions, and international organizations. Digital health education must not only be prioritized but also serve as a catalyst for the sustainable and equitable development of health systems worldwide.

CRediT Authorship contribution statement

Yelson Alejandro Picón-Jaimes: Conceptualization, Data curation, Formal analysis, Investigation, Writing – original draft, Writing – review & editing.

References

[1] Stoumpos AI, Kitsios F, Talias MA. Digital Transformation in Healthcare: Technology Acceptance and Its Applications. Int J Environ Res Public Health. 2023; 20(4):3407. doi: 10.3390/ijerph20043407

[2] Castiglia P, Dettori M, Arghittu A, Campus G, De Vito D. Use of digital technologies in public health: a narrative review. Acta Biomed. 2023; 94(S3):e2023164. doi: 10.23750/abm.v94iS3.14589.

[3] World Health Organization. Global strategy on digital health 2020-2025 [Internet]. [Consulted 5 Dec 2024]. Available in: https://www.who.int/docs/default-source/documents/gs4dhdaa2a9f352b0445bafbc79ca799dce4d.pdf

[4] Aulenkamp J, Mikuteit M, Löffler T, Schmidt J. Overview of digital health teaching courses in medical education in Germany in 2020. GMS J Med Educ. 2021; 38(4):Doc80. doi: 10.3205/zma001476

[5] Tudor Car L, Poon S, Kyaw BM, Cook DA, Ward V, Atun R, et al. Digital Education for Health Professionals: An Evidence Map, Conceptual Framework, and Research Agenda. J Med Internet Res. 2022; 24(3):e31977. doi: 10.2196/31977

[6] Krahe MA, Larkins SL, Adams N. Digital health implementation in Australia: A scientometric review of the research. Digit Health. 2024; 10:20552076241297729. doi: 10.1177/20552076241297729

[7] International Labour Organization. Digital Transformation in European Healthcare [Internet]. [Consulted 5 Dec 2024]. Available in: https://www.ilabour.eu/blog/digital-transformation-in-european-healthcare/

[8] Our World in Data. Causes of death, World, 2021 [Internet]. [Consulted 5 Dec 2024]. Available in: https://ourworldindata.org/causes-of-death#all-charts

[9] Our World in Data. Deaths by risk factor, World, 2021 [Internet]. [Consulted 5 Dec 2024]. Available in: https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor

[10] Chidambaram S, Goh EL. The Effect of Digital Health Intervention on Reducing Cardiovascular Risk. JAMA Cardiol. 2017; 2(3):345-346. doi: 10.1001/jamacardio.2016.4243

[11] Our World in Data. Internet [Internet]. [Consulted 5 Dec 2024]. Available in: https://ourworldindata.org/internet#all-charts

[12] Stark AL, Geukes C, Dockweiler C. Digital Health Promotion and Prevention in Settings: Scoping Review. J Med Internet Res. 2022; 24(1):e21063. doi: 10.2196/21063

[13] De Santis KK, Mergenthal L, Christianson L, Busskamp A, Vonstein C, Zeeb H. Digital Technologies for Health Promotion and Disease Prevention in Older People: Scoping Review. J Med Internet Res. 2023; 25:e43542. doi: 10.2196/43542

[14] World Economic Forum. The digital divide between rich and poor countries is growing larger [Internet]. [Consulted 5 Dec 2024]. Available in: https://www.weforum.org/videos/digital-divide-growing/

[15] Lenz S. “More like a support tool”: Ambivalences around digital health from medical developers’ perspective. Big Data & Society. 2021; 8(1). doi: 10.1177/2053951721996733

[16] Borges do Nascimento IJ, Abdulazeem H, Vasanthan LT, Martinez EZ, Zucoloto ML, Østengaard L, et al. Barriers and facilitators to utilizing digital health technologies by healthcare professionals. NPJ Digit Med. 2023; 6(1):161. doi: 10.1038/s41746-023-00899-4

[17] European Union. COVID-19 and digitalisation [Internet]. [Consulted 5 Dec 2024]. Available in: https://www.eurofound.europa.eu/en/covid-19-and-digitalisation

[18] Lozada-Martinez ID, Ealo-Cardona CI, Marrugo-Ortiz AC, Picón-Jaimes YA, Cabrera-Vargas LF, Narvaez-Rojas AR. Meta-research studies in surgery: a field that should be encouraged to assess and improve the quality of surgical evidence. Int J Surg. 2023; 109(6):1823-1824. doi: 10.1097/JS9.0000000000000422

[19] Lozada-Martinez ID, Fernández-Gómez MP, Acevedo-Lopez D, Bolaño-Romero MP, Picón-Jaimes YA, Moscote-Salazar LR. What has been researched on monkeypox in Latin America? A brief bibliometric analysis. Travel Med Infect Dis. 2022; 49:102399. doi: 10.1016/j.tmaid.2022.102399

[20] Lozada-Martinez ID, Diazgranados-Garcia MC, Castelblanco-Toro S, Anaya JM. Global Research on Centenarians: A Historical and Comprehensive Bibliometric Analysis from 1887 to 2023. Ann Geriatr Med Res. 2024; 28(2):144-155. doi: 10.4235/agmr.24.0043

[21] Mayol J. Transformación digital de la educación médica. Innova Medica. 2023; 1:12-14.

[22] Competencias digitales clave de los profesionales sanitarios. Educ Med. 2020; 21(5):338-344.

[23] Livesay K, Walter R, Petersen S, Abdolkhani R, Zhao L, Butler-Henderson K. Challenges and Needs in Digital Health Practice and Nursing Education Curricula: Gap Analysis Study. JMIR Med Educ. 2024; 10:e54105. doi: 10.2196/54105

[24] Ravik M, Aase I, Akerjordet K, Laugaland K, Gonzalez MT. Nurse educators’ suggestions for a digital educational resource suitable for undergraduate student nurses’ placement studies: Qualitative empirical research. Nurs Open. 2023; 10(8):5433-5445. doi: 10.1002/nop2.1782

[25] World Health Organization. Strategic Partners’ Initiative for Data and Digital Health [Internet]. [Consulted 5 Dec 2024]. Available in: https://www.who.int/europe/initiatives/strategic-partners-initiative-for-data-and-digital-health

[26] Lozada-Martinez ID, Lozada-Martinez LM, Fiorillo-Moreno O. Leiden manifesto and evidence-based research: Are the appropriate standards being used for the correct evaluation of pluralism, gaps and relevance in medical research? J R Coll Physicians Edinb. 2024; 54(1):4-6.