Supplemental / additional document to the Global Digital Compact Survey from UN IGF DC Data Driven Health Technologies
Amali De Silva - Mitchell
To Whom It May Concern:
Re: United Nations Global Digital Compact call for inputs: submission from the United Nations Internet Governance Forum Dynamic Coalition on Data Driven Health Technologies (DDHT)
We thank you for this opportunity to make a contribution to the knowledge base of the United Nations Secretary General’s initiative, the Global Digital Compact, through the auspices of the Office of the Secretary-General's Envoy on Technology. We hope that our contribution will add value and support the conversations at the 2024 United Nations Summit of the Future.
DDHT brings together a multi-stakeholder group of persons for year around conversations in an open and collaborative space, for knowledge exchange, knowledge development and risk analysis. At the core of the mandate is the United Nations UN Sustainable Development Goas SDG number 3, Health and Well-being for All through the use of the medical internet of things MIoT and other ehealth measures.
We were established in 2019, prior to the Covid-19 pandemic. Our approach is that of the knowledgeable global citizen seeking support for effective risk management of the ehealth internet space / medical internet of things MIoT. Better quality ehealth products and services will be developed if there is knowledge sharing between the variety of stakeholders from technologists, human rights activists, lawyers, financiers, policy makers, grass roots users and so forth, coming together with the medical community, to understand the risks, issues, benefits and so forth, that allow for creation of a robust and resilient quality product, based on and for the internet. Speed of product and service development is based on a strong common understanding of ethical principles (medical, technology, people values), that then builds trust. At the Internet Governance Forum, IGF, which is part of the UN Department of Economic and Social Affairs DESA, we discuss ehealth matters from a socio-economic perspective for the internet and then participate with UN International Telecommunications Union ITU World Summit on the Information Society WSIS process, to open our work to the wider technology community.
Listed below are some of the topics that DDHT have found to be important to be considered, inherently, for the development of resilient internet based ehealth systems / the medical internet of things (MIoT) so as to enable effective international public policy where the internet bundles with healthcare to service the global population and reach the mandate for the UN SDGs.
1. Interoperability for systems, personal devices, power / electricity systems
2. Aging devices must also be able to use the up-to-date technology, as not all can afford the latest technical device or system
3. Heathcare specific use devices could be developed from re-cycled devices
4. Free onboarding to the internet should be provided for ehealthcare
5. Internet computing at the edge vs. the cloud (jurisdictional / blockchain management)
6. Meaningful standard setting for systems and operation: volunteer standards vs laws
7. Skills and integrated language translation bots: meaningful translations
8. Development of natural language systems, speech recognitions, sight optimization
9. General greening of MIoT technology
10. Education in ethics for developers and operators as well as user support
11. The role of the good Samaritan supporting ehealth initiatives: privacy training
12. The opportunities bus: sharing with rural communities the opportunities for ehealth
13. Development of ethics for emerging technologies such as Quantum Technologies, Artificial Intelligence and Machine Learning, Blockchain, Virtual Reality and Augmented Reality, Holograms, Robotics, Bio-engineering ….
14. Data sharing in an ethical manner including that for research and patient movement between jurisdictions
15. International collaboration on trials for inclusivity and diversity issues determination for new products and services
16. Intersection with other stake-holders for medicine such as insurance or legal stakeholders
17. Financing the ehealth / MIoT back-bone, could be done in global partnership. Investment is required to support existing levels of service for a global population that is increasing steadily
18. Back-up pathways for the internet are required, if there are critical outages, so that there is no loss of human life for those patients dependent on the MIoT
19. Collaboration of public and private ehealth for efficiencies and results maximization
20. Risks for personalized healthcare and data profiling / biases, securitized overrides and ethical human intervention required
21. Options for anonymous data sharing and opt in / out for the patient / user without the loss of rights
22. Embedding the UN Human Rights treaty in to systems development with a human centered approach to human computer interactions and access
23. Providing meaningful access to all peoples: income equality, disabled (visible and invisible), remote located, elderly[A1] , low-skilled and so forth, to have access to the internet for their medical services and support in an equitable manner to their region of residence.
24. Open to continuous improvement and betterment
25. Privacy protections and mandated updates to erroneous data, mis-information etc.
26. Freedom of expression protection: e.g., for collecting medical case history
27. Option for anonymous healthcare: e.g., women’s health
28. Putting medical information online for educating the public on health policy as well as symptoms recognition and management
29. Security for systems and devices (outage management) and emergency back-ups
30. Partnership and seeking opportunities to bundle services with other UN SDG based work for a holistic delivery of internet service to a community
31. Opportunity for mobile networks and partnering with the private sector such as banks to onboard patients to ehealth services
32. Integration with agricultural, entrepreneurial, business, climate governance, water systems …
33. Priority of all thing’s science such as out of space medicine be applied to terrestrial health delivery if applicable, e.g., Delayed transmission science for space communications etc.
34. That simplification with no loss of quality, be always present for developing cost and other efficiencies
35. That medical science development knowledge at the basic level be open for access to all.
36. Development of a medical internet of things technical internet commons.
37. Quality internet neutrality is essential for universal healthcare
38. That all sciences be actively encouraged to develop to enhance better accessibility for the disabled and for MIoT.
39. Transportation e.g., cars, small vans to be designed to support the MIoT, to assist patient transfer from rural areas to cities. E.g., better power sources, mobile tracking etc.
40. Medical robots (e.g., mobility assistance, cleaning, physiotherapy assistants) to be made commonly available to be used in the home, on hire and in other settings
41. E-waste and regular waste management must be practical and take in to account the issues for the disabled (e.g., physical mobility in the house or mental health). Robots could be helpful.
42. Critical to have access to algorithms for AI systems auditors. Intent and possible repercussions analysis are an important extension to the technical audit and the support of ICT policy makers must be an integral part to any audit.
43. Human computer interaction user interfaces must be friendly and non-intimidating for healthcare applications
44. Care with unregulated profiling, without consent and ethics
45. Power management optimization and storage for times of power outage
46. Richer countries have communities facing the digital divide, and these groups must also be serviced
47. Supply chain logistics management through blockchain for the medical supply chain should have priority and security in times of crisis
48. Statistical research processes are being developed. Perhaps new techniques with for instance Quantum Technology. However, as these techniques are still new, they are not universally accepted or applied. Just as data collection is not standard, privacy application is not standard even within a defined jurisdiction. Privacy is a key value to be developed for a fair human civilization that shows respect for the person as defined under the United Nations Charter of Human Rights. As such there is a need for education and knowledge sharing on already established privacy values, principles and laws so that we can all understand and value what the benefits of privacy are and design privacy compliant innovation for data sharing internationally. for the future and for universal healthcare benefit. The United Nations recognized Dynamic Coalition on Data Driven Health Technologies has Seven Rights or Rites (which means a question is asked about the data, and if it is of suitable quality, maturity and intent to pass to the next phase) of Passage for Data, Data Systems and Data Application as under well as for Artificial Intelligence, Quantum Applications or Statistics etc. Attention must be paid to data at 7 key points, which, if well applied and managed, will lead to successful outcomes, trust, reputation, speed of uptake and resiliency. They are: 1. A multistakeholder approach for Context and Intent of the application and its expected outcomes (vision the international public sharing and use of data) 2. Diversity and Inclusion in all of its forms (reduce bias, increase fairness and equity) 3. Designs (including Greening & Waste), Data Management and Ethics (values and norms of different jurisdictions and harmonization to common values and norms) 4. Protections from harm, Privacy and Security (varies by jurisdiction) 5. Communications of Human and Technology and interaction there-of (HCI and what is personal?) 6. Inter-operability and Connectivity (Internationally) 7. Feedback, Risk Monitoring and Bettering (& Best Practice) for Resiliency 8. Attention to Delivery, Service, Maintenance (with ethics) & On-boarding
49. Global togetherness for United Nations Sustainable Development Goats is a must. Healthcare integrated with all the other SDG in some manner. The impact of climate change on global health will be significant. Ehealthcare / medical internet of things must be given prominence in society as the impacts of climate change on healthcare will impact all ages.
50. The UN IGFDC DDHT’s book: “Health matters, Technologies driving change in healthcare, A Community of Thought” part 1 and 2 are found at: Dynamic Coalition on Data Driven Health Technologies (DC-DDHT) | Internet Governance Forum (intgovforum.org) . This is a comprehensive collection of papers from the DC DDHT membership, material that should be considered for any policy making.
51. Annual reports outlining the work of the UN IGF DC DDHT which include open-microphone sessions for the public, speaker series, speaker presentations, information and public education sessions can be found at: Dynamic Coalition on Data Driven Health Technologies (DC-DDHT) | Internet Governance Forum (intgovforum.org)
Kind regards,
Ms. Amali De Silva – Mitchell, Coordinator UN IGF DC DDHT
Amado Espinosa
Excellent
Happy 2023