BLOG | Digital Health: Let’s do better next time!

You would think we have learnt our lessons by now, right? Apparently not fully. Apparently, we, researchers and implementers of digital health interventions, keep falling for the same mistakes over and over. If you don’t believe me, keep on reading.

Recently, we conducted a scoping review to map digital health interventions in South and Southeast Asia (including RESPIRE countries and a few more) to get a clearer picture of the existing evidence, technologies, opportunities, and gaps related to respiratory digital health interventions in the region and propose relevant recommendations¹.

The results were encouraging and disappointing all at once.

Encouraging because many of the RESPIRE countries are leapfrogging by adopting and integrating new technologies (such as artificial intelligence and machine learning) fast and effectively, allowing them to move forward quicker and position themselves as references in the region, as is the case of Malaysia². Our results showed that researchers were cautious to fully endorse artificial intelligence and machine learning applications, although demonstrating safety and accuracy. Indeed, to maximise their benefit, emerging best practices for ethical use of data and algorithms must be followed so that interventions can be safe and effective while being ethical and equitable.

Disappointing because despite a vast body of literature describing some of the main, longest-standing problems of digital health³, they are still significant, as our review found. The excessive development of pilot projects that lead nowhere was a prevalent issue in our findings. Small proof-of-concept interventions developed for a specific project without any plan to scale up to maturity and thus, to meaningful health impact represented more than 80% of the interventions included in the review. Before initiating a new project, we should evaluate the need for a prototype or a pilot project with a rigorous needs assessment and justification process that considers micro- and macro-level factors.

Moreover, we should consider whether building on what already exists is a better option for sustainability and impact.

Another disappointing result was the lack of systematic assessment and evaluation of digital health interventions. There have been repeated calls and initiatives seeking to standardise assessment and evaluation mechanisms for digital health interventions, some by widely recognised entities such as the World Health Organization⁴.

Nevertheless, as a community, we continue falling short in evaluating digital health interventions as rigorously as we do other aspects of our research.

Incomplete or inconsistent reporting hampers the ability to meaningfully compare outcomes, distil learnt lessons, and inform policy. Before starting a project, we should decide on developmental, formative and summative evaluation metrics and parameters used for reporting. Deciding beforehand will increase the reliability of the project and allow the entire digital health community to learn more valuable lessons.

I do not think that anyone questions that digital health interventions are here to stay.

Technology permeates every aspect of our lives, personally and professionally, and this is true for most countries of the world, including our RESPIRE countries. We, as researchers and practitioners of digital health, can inform and shape the development and deployment of such interventions in such a way that they impact the health and lives of entire communities in a positive manner, reducing the burden of respiratory disease while ensuring equitable access to healthcare and health tools.

For that, we need to look beyond our immediate project requirements and plan the development and implementation of digital health interventions with a holistic lens, considering the long-term feasibility of the intervention, planning ways to evaluate at each major milestone of the project, and applying a person-centred, equitable framework through the entire lifecycle of the intervention. I think this is doable and worthwhile, so let’s get to it!

This blog was written by Laura Evans, RESPIRE's Digital Health and Innovation Platform Support, based on findings published in the paper, Mapping respiratory health digital interventions in South and Southeast Asia: a scoping review.

References

1. Evans L, Evans J, Barach P et al. Mapping respiratory health digital interventions in South and Southeast Asia: a scoping review. Journal of Global Health. 14 November 2025. doi:10.7189/jogh.15.04310

2. Naim N, Kuroda Y, Yamada S et al. The evolution of healthcare digitalisation policies in Malaysia: A four-decade narrative review (1985–2025). Digital Health. 02 July 2025. doi:10.1177/20552076251353279.

3. Mumtaz H, Riaz MH, Wajid H et al. Current challenges and potential solutions to the use of digital health technologies in evidence generation: a narrative review. Frontiers in Digital Health. 28 September 2023. doi:10.3389/fdgth.2023.1203945.

4. World Health Organization. Monitoring and evaluating digital health interventions: a practical guide to conducting research and assessment. Published on 12 December 2016.