Successfully Implementing Digital Health to Ensure Future Global Health Security During Pandemics: A Consensus Statement.

Importance: COVID-19 has highlighted widespread chronic underinvestment in digital health that hampered public health responses to the pandemic. Recognizing this, the Riyadh Declaration on Digital Health, formulated by an international interdisciplinary team of medical, academic, and industry experts at the Riyadh Global Digital Health Summit in August 2020, provided a set of digital health recommendations for the global health community to address the challenges of current and future pandemics. However, guidance is needed on how to implement these recommendations in practice. Objective: To develop guidance for stakeholders on how best to deploy digital health and data and support public health in an integrated manner to overcome the COVID-19 pandemic and future pandemics. Evidence Review: Themes were determined by first reviewing the literature and Riyadh Global Digital Health Summit conference proceedings, with experts independently contributing ideas. Then, 2 rounds of review were conducted until all experts agreed on the themes and main issues arising using a nominal group technique to reach consensus. Prioritization was based on how useful the consensus recommendation might be to a policy maker. Findings: A diverse stakeholder group of 13 leaders in the fields of public health, digital health, and health care were engaged to reach a consensus on how to implement digital health recommendations to address the challenges of current and future pandemics. Participants reached a consensus on high-priority issues identified within 5 themes: team, transparency and trust, technology, techquity (the strategic development and deployment of technology in health care and health to achieve health equity), and transformation. Each theme contains concrete points of consensus to guide the local, national, and international adoption of digital health to address challenges of current and future pandemics. Conclusions and Relevance: The consensus points described for these themes provide a roadmap for the implementation of digital health policy by all stakeholders, including governments. Implementation of these recommendations could have a significant impact by reducing fatalities and uniting countries on current and future battles against pandemics.

Too Much Information: Assessing Privacy Risks of Contact Trace Data Disclosure on People With COVID-19 in South Korea.

Introduction: With the COVID-19 outbreak, South Korea has been making contact trace data public to help people self-check if they have been in contact with a person infected with the coronavirus. Despite its benefits in suppressing the spread of the virus, publicizing contact trace data raises concerns about individuals' privacy. In view of this tug-of-war between one's privacy and public safety, this work aims to deepen the understanding of privacy risks of contact trace data disclosure practices in South Korea. Method: In this study, publicly available contact trace data of 970 confirmed patients were collected from seven metropolitan cities in South Korea (20th Jan-20th Apr 2020). Then, an ordinal scale of relative privacy risk levels was introduced for evaluation, and the assessment was performed on the personal information included in the contact trace data, such as demographics, significant places, sensitive information, social relationships, and routine behaviors. In addition, variance of privacy risk levels was examined across regions and over time to check for differences in policy implementation. Results: It was found that most of the contact trace data showed the gender and age of the patients. In addition, it disclosed significant places (home/work) ranging across different levels of privacy risks in over 70% of the cases. Inference on sensitive information (hobby, religion) was made possible, and 48.7% of the cases exposed the patient's social relationships. In terms of regional differences, a considerable discrepancy was found in the privacy risk for each category. Despite the recent release of government guidelines on data disclosure, its effects were still limited to a few factors (e.g., workplaces, routine behaviors). Discussion: Privacy risk assessment showed evidence of superfluous information disclosure in the current practice. This study discusses the role of "identifiability" in contact tracing to provide new directions for minimizing disclosure of privacy infringing information. Analysis of real-world data can offer potential stakeholders, such as researchers, service developers, and government officials with practical protocols/guidelines in publicizing information of patients and design implications for future systems (e.g., automatic privacy sensitivity checking) to strike a balance between one's privacy and the public benefits with data disclosure.