Introduction
Hilary Pinnock 1,2 ,Vitalii Poberezhets 3 and David Drummond 4
1 Usher Institute, University of Edinburgh, Edinburgh, UK. 2 Whitstable Medical Practice, Whitstable, UK. 3 Department
of Propedeutics of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Ukraine.
4 Department of Pediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, AP-HP
Université Paris Cité Inserm UMR 1138, HeKA team, Centre de Recherche des Cordeliers, Paris, France.
Corresponding author: Hilary Pinnock (hilary.pinnock@ed.ac.uk)
@ERSpublications
Respiratory care is embracing digital transformation. This Monograph discusses technological opportunities,
explores societal implications and describes exemplar applications. We hope these expert views stimulate
interest and discussion. https://bit.ly/ERSM102intro
Copyright ©ERS 2023. Print ISBN: 978-1-84984-172-6. Online ISBN: 978-1-84984-173-3. Print ISSN: 2312-508X. Online
ISSN: 2312-5098.
The potential and challenges of digital healthcare
Information and communication technology has revolutionised most aspects of contemporary
life [1]. Healthcare systems are also undergoing major changes as they (relatively cautiously)
embrace the digital transformation [2]. Time-honoured approaches to delivering care are being
challenged by technology-based initiatives offering potential benefits in terms of functionality,
efficiency and reach [3]. The World Health Organization (WHO) promote technology as
contributing to achieving universal health coverage by providing accessible care to those living in
remote areas [4], and enhancing support for vulnerable and ageing populations [5]. An increasing
literature addresses the potential for digital healthcare to: monitor disease progress and medication
adherence support assisted living implement cloud-based healthcare information systems and
enable personalised health and preventive medicine [3]. The need for infection control in a
pandemic forced a dramatic move to remote consulting [6], virtual wards [7], home treatments and
therapy [8, 9], and digital support for self-management [10], which seems likely to have
established a new norm for those who welcome the convenience of not needing to travel [11, 12].
Counterbalancing the many positives of digital healthcare is the risk of exacerbating inequities,
as the most needy may be the least able to access/use essential technology [13]. Whether the
barrier is unreliable infrastructure or individual limited e-health literacy (or both), the concern is
that the “digital divide” may be the 21st century expression of the inverse care law, which states
that the availability of good medical care tends to vary inversely with the need for care in the
population served [14]. Policymakers and healthcare professionals must ensure that “fairness” is
a pre-requisite of the implementation of digital healthcare [15].
Insights from the analysis of “big data” and the value of “data-enabled healthcare” were amply
demonstrated during the coronavirus disease 2019 (COVID-19) pandemic, but the public need
confidence in how their personal data are protected and used [3]. Data security, privacy, design,
performance, efficiency, heterogeneity, interoperability and legal issues are recurring themes in
the literature [3]. Cross-border harmonisation is currently being addressed in Europe by the
https://doi.org/10.1183/2312508X.10016623 ix
Hilary Pinnock 1,2 ,Vitalii Poberezhets 3 and David Drummond 4
1 Usher Institute, University of Edinburgh, Edinburgh, UK. 2 Whitstable Medical Practice, Whitstable, UK. 3 Department
of Propedeutics of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Ukraine.
4 Department of Pediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, AP-HP
Université Paris Cité Inserm UMR 1138, HeKA team, Centre de Recherche des Cordeliers, Paris, France.
Corresponding author: Hilary Pinnock (hilary.pinnock@ed.ac.uk)
@ERSpublications
Respiratory care is embracing digital transformation. This Monograph discusses technological opportunities,
explores societal implications and describes exemplar applications. We hope these expert views stimulate
interest and discussion. https://bit.ly/ERSM102intro
Copyright ©ERS 2023. Print ISBN: 978-1-84984-172-6. Online ISBN: 978-1-84984-173-3. Print ISSN: 2312-508X. Online
ISSN: 2312-5098.
The potential and challenges of digital healthcare
Information and communication technology has revolutionised most aspects of contemporary
life [1]. Healthcare systems are also undergoing major changes as they (relatively cautiously)
embrace the digital transformation [2]. Time-honoured approaches to delivering care are being
challenged by technology-based initiatives offering potential benefits in terms of functionality,
efficiency and reach [3]. The World Health Organization (WHO) promote technology as
contributing to achieving universal health coverage by providing accessible care to those living in
remote areas [4], and enhancing support for vulnerable and ageing populations [5]. An increasing
literature addresses the potential for digital healthcare to: monitor disease progress and medication
adherence support assisted living implement cloud-based healthcare information systems and
enable personalised health and preventive medicine [3]. The need for infection control in a
pandemic forced a dramatic move to remote consulting [6], virtual wards [7], home treatments and
therapy [8, 9], and digital support for self-management [10], which seems likely to have
established a new norm for those who welcome the convenience of not needing to travel [11, 12].
Counterbalancing the many positives of digital healthcare is the risk of exacerbating inequities,
as the most needy may be the least able to access/use essential technology [13]. Whether the
barrier is unreliable infrastructure or individual limited e-health literacy (or both), the concern is
that the “digital divide” may be the 21st century expression of the inverse care law, which states
that the availability of good medical care tends to vary inversely with the need for care in the
population served [14]. Policymakers and healthcare professionals must ensure that “fairness” is
a pre-requisite of the implementation of digital healthcare [15].
Insights from the analysis of “big data” and the value of “data-enabled healthcare” were amply
demonstrated during the coronavirus disease 2019 (COVID-19) pandemic, but the public need
confidence in how their personal data are protected and used [3]. Data security, privacy, design,
performance, efficiency, heterogeneity, interoperability and legal issues are recurring themes in
the literature [3]. Cross-border harmonisation is currently being addressed in Europe by the
https://doi.org/10.1183/2312508X.10016623 ix