The Potential of Digital Health Technologies in Combating Against the Non-Communicable Diseases in the Context of UN’s SDGs. A Case Study on DiaWatch.

Abstract: Increasing prevalence of non-communicable diseases, aging, and population growth pose significant sustainability challenges to health systems. Especially the health systems of low- and middle-income countries are more vulnerable to the risks related to non-communicable diseases and demographic changes. As the Covid-19 pandemic demonstrates, the quality of health systems is vital to save lives, and even the most developed countries are not immune to the consequences of global health crises. The World Health Organization estimates that non-communicable diseases such as cardiovascular diseases, chronic respiratory diseases, cancers, and diabetes cause around 40 million deaths in a year, and 15 million people aged between 30 and 69 suffer from premature deaths mostly in low- and middle-income countries. The United Nations aim to address this problem through the Sustainable Development Goal 3.4 that stresses to reduce by one third premature mortality from non-communicable diseases through prevention and promote mental health and well-being until 2030. Poor quality health systems and inadequate access to healthcare services by the most vulnerable groups are some of the main reasons for premature deaths. Improving the quality of health systems through innovation and digitalisation is strategic to deliver essential healthcare services to the most vulnerable people. Digital health technologies such as mobile health applications for chronic disease self-management play a key role in improving the health status of individuals and the accessibility of healthcare services. Type 2 Diabetes Mellitus (‘T2DM’) is one of the most prevalent non-communicable diseases suffered by almost half a billion people, and current developments in digital health technologies offer innovative methods for its treatment. Hence, this study investigates the effectiveness of a T2DM self-management smartphone application called DiaWatch and its potential benefits for the Sustainable Development Goals in terms of addressing the challenges of health systems. Methodology: Using the Technology Acceptance Model as an overall conceptual framework, a comprehensive literature review was performed to clearly define the objectives and methods for the study. Based on these findings, two sets of semi-structured qualitative interview questions have been prepared for collecting empirical data. Ten healthcare professionals working at a university hospital in Istanbul, Turkey, and ten T2DM patients using a T2DM self-management app called DiaWatch have been interviewed from mid-February to early-March. A thematic analysis has been carried out to analyse the empirical data collected through the semi-structured interviews. Results: Firstly, the results of the interviews with T2DM patients using the DiaWatch app suggest that the health status and chronic condition self-management experience of the majority of the interviewees improved since using the app and they adopted behavioural changes, such as being more adherent to the treatment, increased physical activity, having a healthier diet and measuring blood glucose level more regularly. The interviewees reported less dependency on healthcare facilities and increased accessibility of healthcare services, as they are tele-monitored by their physicians. Secondly, the results of the interviews with healthcare professionals highlight the benefits of digital health technologies for the health systems in terms of facilitating the job of healthcare staff, reducing the costs, and saving time. The interviewees state that tele-monitoring helps to decrease the number of redundant hospital admissions and screenings; however, data privacy and irreplaceability of face-to-face medical examinations are the main concerns before the acceptance of these technologies.