THE IMPERATIVE FOR DIGITAL HEALTH

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1 FMG INSIGHTS THE IMPERATIVE FOR DIGITAL HEALTH 60 Paya Lebar Road #05-02 Paya Lebar Square Singapore ISSUED: 01/07/2017

2 Over the past several decades there has been an increasing elasticity in the concept of health. Once confined strictly to the physical it expanded to envelope the mental as well. In more recent times we have seen a discourse over financial health typically centered on issues of retirement adequacy, healthcare financing and prudent financial planning - and social health with an emphasis on ensuring a cohesive society and strengthening bonds amid diversity. In all these dimensions of health the same trajectories of evolution have been followed. 1

3 Collective Responsibility, Strong State Role and Prevention First, an awareness that in both impact and responsibility the effects extend beyond the individual. Treated originally as a purely personal matter, over time, the growing complexity of the issues, has seen a recognition that these are also concerns at the community level. In physical health, we have seen grassroots initiatives to promote healthy living and embracing the concept of an active society. In mental health, we have a growing awareness of the nature of mental health and the importance of eroding the associated social sigma. Crucially, the recognition of all of our vulnerability to challenges to mental health has had a humbling effect on the historical social arrogance that the mentally ill are different or defective. In financial health matters, there is public awareness of the dangers of entrapment and the dangers of problem gambling. Second, the growing role of the State. The past decade and a half has seen the role of the State in ensuring social welfare rise dramatically. There has also been a transformation from a focus on public education on the various health issues to substantial investments in enabling programmes to help affected citizens cope. Advisory panels and civic bodies have been established and sponsored to ensure sustained attention to specific issues such as problem gambling, drug abuse, mental health, coping with children with special needs and a whole range of physical health challenges. The State has also come in to give legitimacy and to strongly support grassroots initiatives politically, technically and financially. Third, prevention. In the past the focus was on treatment but today we have progressed to thinking in terms of prevention. State and community level programmes focus on problem avoidance by adoption of good practices, recognising danger signals and beginning early to build up resistance. These are as applicable to financial and social health as they are to physical and mental health. 2

4 Digital Progress and Threats We are today in parallel realities with the digital and the analog still operating alongside each other. This convenient condition will not last much longer. The accelerating pace of digitisation will soon mean that our world will be defined almost exclusively in digital terms from education, commerce and even public services. The social media space is challenging traditional forms of information origination, dispersion and access. It also confounds the distinction between truth and misinformation. It is a safe haven for good and evil alike. The commercial transactional space will increasingly move towards digitisation as its efficiency gains are profound. Banks moved away from branch offices to Automatic Teller Machines or ATMs in the 1990s. Soon, ATMs will also be discarded in favour of digitised transactions and access via secure internet channels. These same efficiency advantages and ease of remaking norms are disrupting industries from the taxi, with Uber and Grab, to hospitality, with Airbnb and the like. Soon we can expect Government to also push in the direction of delivering services from a place to any place via digital means. All of our identities for transactional purposes will be digital. This will mean convenience and access to services. 3

5 All of these should rightly be seen as progress. However, we must also beware of the risks. First, there is the risk of crime. Cybersecurity is no longer the concern of only institutions with money at risk such as banks. Today the commodities of greatest value are information and identity. Thus, all businesses, institutions, and every individual has something of value to cybercriminals. Second, dependency. In a fully digital world we will not have the contingency of the parallel analog. The digital space has to be protected from hijack, disruption and destruction. Our way of living, working and communicating depend on its integrity. Third, we run the risk of a digital divide. As the analog parallel erodes, it is critical that we ensure that businesses and citizens successfully transition to the digital world. Those that do not will not be able to fully participate in society and commerce. This alienation will impact that standard and quality of commerce and living respectively. 4

6 Collectively, managing these risks, is a matter of ensuring digital health. To do so we need to apply the lessons learned from the preceding issues defined in health terms. We must first recognise that the vulnerability to cybercrime and of the digital space as a whole is both an individual and a collective responsibility. The weakest links are the pathways for infiltration by criminals. We need to work together to strengthen cyber defences, adopt best practices and to report and respond to these threats. The State has important roles to play to research, set standards, collaborate with industry to raise awareness and to invest in capabilities to protect the system. It should also evolve and enact legislation to deal with the new digital reality both from regulatory as well as enforcement perspectives. The State, the community and industry should also emphasis prevention. This can be done through public and industry education. The State, civic and industry bodies should consider subsiding access to the digital space for the lower income in the same way that has been done for healthcare and education. Without that assurance of digital access, we risk a digital divide between poor and the rest. All our children, regardless of socioeconomic background need to access and effectively function in the digital space to underpin their future social and professional mobility. It is also important to ensure that the elderly do not think they can opt out of the digital future. They too should receive policy and civic attention to overcome anxiety, ignorance and distrust to pull them into the digital future. The Digital Health Imperative The imperative for digital health is no longer notional and is critical for advancing economies such as Singapore. We should start to adopt the perspective of ensuring digital health in order to grasp both the centrality of the issue and its reality shaping nature. 5