The internet, computers, and smartphones have changed our lives forever and these technologies have not left the healthcare industry untouched. The Covid-19 pandemic accelerated this change and the adoption of digital health technologies. Health apps and tele-health platforms have brought a new way for patient-doctor interaction, access to health information, and patient self-monitoring. ALSO READ: Inside Rwanda’s plan to fast-track digital transformation by 2026 According to IQVIA, a multinational company focused on health information technology and clinical research, in 2020, 90,000 new health apps were released, which is 250 every day. In 2024, Statista, a global data and business intelligence platform, reported that the Apple and Google stores featured 35,000 and 36,000 apps designed for medical practice. ALSO READ: Digital transformation and productivity However, if we pause to reflect on the impact and implementation of digital health innovation in resource-limited communities, we are left with more questions than answers. We have seen new health apps and software launched with the hopes of improving health services. However, patients still face long waiting times at hospitals, miss appointments, staff are overworked, and community health workers abandon slow, internet-dependent apps. ALSO READ: Why men don't see doctors and how we can bring care to them This gap between access and impact is a digital health paradox. Placing digital tools in the hands of the user is not enough to unleash their potential. Real impact stems from relevant, ethical, and inclusive design. There is a need for contextualized digital health innovation in resource-limited settings. First, start with people, not with tools. If you meet health center nurses who see 100 patients daily and ask what slows them down, you will design your technology accordingly. When those using a tool are engaged in its design, they will use it and keep using it. Second, meet people where they are. When people can't access the internet or smartphones, digital health should leverage basic phones or offline technologies. A quick text, Clinic tomorrow at 9 a.m., Bring the child's card, can do more than a complex app no one uses. Simple, clear, and timely beats fancy but unused. Third, digital health should match the rhythm of real work. It is not functional if a nurse enters the same information twice. Clinics operate on a rhythm: triage, consult, treat, document, refer. Technology must maintain that rhythm and flow into stock systems so the clinic knows when medicines are running low before the shelves are empty. Support and feedback are also essential. Health workers should receive more than a one-off workshop on new tools. Frequent refreshers, simple job aids, incentives, and a helpline with answers and feedback on data gathered keep them motivated and updated. Ensure the ethical use of the users' and patients' sensitive data. Health innovators should be transparent on the data collected, the reason, and their protection. Transparency, privacy, and respect for patients' dignity build trust and encourage participation. Quantify what truly happens to families. Too many tools track downloads and logins. Real indicators are days lost before treatment, timely referrals, fewer missed visits, no stockouts, and minutes saved per patient. These are numbers that tell the truth. Plan beyond the pilot. Too many digital health tools die after launch. From day one, define ownership, funding, and sponsors. Utilize open standards, engage the ministry and districts, and establish local teams to sustain, enhance, and expand the tool within the health system. What does real digital health impact look like? A mother gets a reminder and arrives on time for her child's immunization, finding the nurse ready. A community health worker presses refer, and the nurse sees it before the patient's arrival, so treatment starts on the same day. A stock alert prevents a shortage before somebody's turned away. A teenager receives confidential counselling through a simple text chat. A nurse arrives home on time since recording is faster and wiser. Digital health innovations are not about software and gadgets. It’s about solving real problems that people face and implementing solutions in a context-sensitive, ethical, and sustainable approach. When we design technologies with their users, we weave tools into life, respect privacy, and measure actual results. That is how a phone in a pocket becomes health in a home, and how technology serves the community, not the other way around. The author is a medical doctor and passionate public health advocate committed to advancing community health in Rwanda.
