key: cord-0910977-5idcxm7c authors: Al Knawy, Bandar; Adil, Mahmood; Crooks, George; Rhee, Kyu; Bates, David; Jokhdar, Hani; Klag, Michael; Lee, Uichin; Mokdad, Ali H; Schaper, Louise; Al Hazme, Raed; Al Khathaami, Ali M; Abduljawad, Joud title: The Riyadh Declaration: the role of digital health in fighting pandemics date: 2020-09-22 journal: Lancet DOI: 10.1016/s0140-6736(20)31978-4 sha: 37655867f3f882797a522e7feab77285bb46c91b doc_id: 910977 cord_uid: 5idcxm7c nan The COVID-19 pandemic has exposed weaknesses in health and care systems and global public health responses, some of which can be addressed through data and digital science. The Riyadh Declaration on Digital Health was for mulated during the Riyadh Global Digital Health Summit, Aug 11-12, 2020, a landmark forum that highlighted the importance of digital technology, data, and innovation for resilient global health and care systems. Our panel of 13 experts articulated seven key priorities and nine recommendations (panel) for data and digital health that need to be adopted by the global health community to address the challenges of the COVID-19 pandemic and future pandemics. The first priority is for the health and care sectors to adopt applied health intelligence (HI). HI represents a systematic approach and comprehensive methodology applied to the collection, linkage, analysis, and use of appropriate health data. HI is used for the surveillance, monitoring, and improvement of population and patient outcomes, and for assessing the efficiency and effectiveness of policies, programmes, and services. 1 The second priority relates to interoperable digital technology and for this technology to be scaled up and sustainable. Digital health tools and services require a secure, trusted flow of data with scalability and interoperability support. The advent of commercial cloud computing services and distributed systems has paved the way for scalable, cost-effective service provision. The third priority is to support the adoption of artificial intelligence (AI). Use of AI in health systems demands rapid access to various data types, often not possible in health-care settings with slow data flows. 2 AI also requires vast amounts of high-quality data to achieve acceptable accuracy and validity. Health-care organisations and systems need to provide the necessary technology to collect and share high-quality data. Effective communication about public health crises and risk is the fourth priority. Such communication requires an understanding of risk and the timely dissemination of information; seamless digital integration of case reports and deaths; and effective data visualisation tools such as map-based dashboards. 3 Effective communication to change knowledge, attitudes, and behaviours mandates the systematic exploration of diverse digital channels and the innovative design of digital tools for citizen engagement. 4 The fifth priority concerns health data governance, quality, policy, regulation, and use. Passively generated digital location data from mobile phones and internet services provide crucial information about human mobility and interactions. 5 However, ethics and privacy are essential and must be adhered to when using these ubiquitous data. Projections about disease epidemics require human mobility and interaction data that are aggregated in time and space to reconstruct populationlevel behaviour. 6 The sixth priority relates to the quality and effectiveness of digital technology for improved patient and population outcomes. Digital technologies offer many opportunities to improve the quality and effectiveness of care, patient outcomes, and population health. 7 Digital health systems should be designed and implemented to maximise data quality and access for clinicians and patients and these systems should be interoperable. The seventh priority is research and innovation. Investing in, conducting, publishing, and promoting transparent research are foundational to digital health advances that leverage data, analytics, and AI. 8 It can take an average of 17 years to translate a major medical research discovery to widespread delivery. 9 The competitive, commercial culture of technology revolves around disruptive innovation, iterative discoveries, and the delivery of new technologies over months, not years. To translate life-saving innovations in digital health into widespread applications, collaboration across the best of research and innovation in health and technology is essential. The Riyadh Declaration on Digital Health is a call to action to create the infrastructure needed to share effective digital health evidence-based practices and high-quality, real-time data locally and globally to provide actionable information to more health systems and countries. Digital and data technologies have a role in promoting the coordinated development of shared global public health policies and resilient health and care systems. These technologies can support health systems and governments to perform better in future pandemics and other global health challenges. We call on state actors to ensure that digital technology and innovation become the cornerstone of a resilient global health and care system that places individual and population health at the forefront of our future endeavours. Saudi Arabia Division of General Internal Medicine, Brigham and Women's Hospital Australia (LS); and Ministry of National Guard-Health Affairs COVID-19 exposed systemic weak points. How to get it right next time Artificial intelligence vs COVID-19: limitations, constraints and pitfalls Communicating in a public health crisis Digital public health and COVID-19 An early warning approach to monitor COVID-19 activity with multiple digital traces in near real-time Key data for outbreak evaluation: building on the Ebola experience Current challenges in health information technology-related patient safety Monitoring and evaluating digital health interventions: a practical guide to conducting research and assessment. Geneva: World Health Organization The answer is 17 years, what is the question: understanding time lags in translational research KR is an employee of International Business Machines Corporation (IBM) and receives IBM stock as part of compensation; IBM was not involved in the summit discussed in this Comment. BAK was the President of the Riyadh Global Digital Health Summit hosted by the Ministry of National Guard-Health Affairs. The other authors declare no competing interests. We thank Caitlin Ahern and Christian Liberty Marshall for their technical support in preparing this Comment. This Comment is published as part of the G20 Riyadh Global Digital Health Summit (Aug 11-12, 2020) activities. Saudi Arabia hosted this virtual summit to leverage the role of digital health in the fight against current and future pandemics.