Skip to main content

Sustainability Triangle Framework for Digital Health Systems: A Conceptual Model for Sustainable Health Care

  • Conference paper
  • First Online:
Smart Trends in Computing and Communications (SmartCom 2023)

Abstract

COVID-19 has revolutionized the healthcare systems globally with the accelerated implementation of digital health interventions. Digital innovation in patient care through various approaches like eHealth and mHealth has gained popularity and is considered effective for encountering challenges concerning healthcare accessibility. Along with the ability of digital health systems to adapt and evolve, a congruence of social, economic, and environmental sustainability is essential for any program to be “sustainable.” In this paper, the factors associated with each form of sustainability of digital health systems are identified considering the case of the Indian digital health system, and a sustainability triangle framework for digital health systems is proposed. A blended financing model and frugal innovation strategy are proposed to enhance the economic sustainability of digital health systems. Fostering digital and health literacy and providing human assistance (e.g., through community health workers/Accredited Social Health Activists) for the vulnerable or aged population are recommended for social sustainability. Cleaner production of the ICT infrastructure, its scientific disposal, reducing the consumption of non-renewable energy, and fostering sustainable consumption to avoid rebound effects are identified as feasible strategies for environmental sustainability.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 259.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 329.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. MacNeill AJ, McGain F, Sherman JD (2021) Planetary health care: a framework for sustainable health systems. Lancet Planet Health 5:e66–e68. https://doi.org/10.1016/S2542-5196(21)00005-X

    Article  Google Scholar 

  2. Garrison LP, Pauly MV, Willke RJ, Neumann PJ (2018) An overview of value, perspective, and decision context—a health economics approach: an ISPOR special task force report. Value Health 21:124–130. https://doi.org/10.1016/J.JVAL.2017.12.006

  3. Rattan TK, Joshi M, Vesty G, Sharma S (2022) Sustainability indicators in public healthcare: a factor analysis approach. J Clean Prod 370:133253. https://doi.org/10.1016/J.JCLEPRO.2022.133253

    Article  Google Scholar 

  4. Poon SK, Liu Y, Guo R, Li M (2020) Digital health. science, technology, and innovation for sustainable development goals: insights from agriculture, health, environment, and energy. Oxford University Press

    Google Scholar 

  5. Olu O, Muneene D, Bataringaya JE, Nahimana MR, Ba H, Turgeon Y, Karamagi HC, Dovlo D (2019) How can digital health technologies contribute to sustainable attainment of universal health coverage in Africa? A perspective. Front Public Health 7:341. https://doi.org/10.3389/FPUBH.2019.00341/BIBTEX

    Article  Google Scholar 

  6. Iyawa GE, Herselman M, Botha A (2016) Digital health innovation ecosystems: from systematic literature review to conceptual framework. Procedia Comput Sci 100:244–252. https://doi.org/10.1016/J.PROCS.2016.09.149

    Article  Google Scholar 

  7. Zanetti CA, George A, Stiegmann RA, Phelan D (2022) Digital health. In: Handbook of research on the efficacy of training programs and systems in medical education, pp 404–426. https://doi.org/10.4018/978-1-7998-1468-9.ch021.

  8. Chang LW, Njie-Carr V, Kalenge S, Kelly JF, Bollinger RC, Alamo-Talisuna S (2013) Perceptions and acceptability of mHealth interventions for improving patient care at a community-based HIV/AIDS clinic in Uganda: a mixed methods study 25:874–880. https://doi.org/10.1080/09540121.2013.774315

  9. Callender C, Thompson D (2018) Family TXT: feasibility and acceptability of a mHealth obesity prevention program for parents of pre-adolescent African American girls. Children 5:81. https://doi.org/10.3390/CHILDREN5060081.

  10. Materia FT, Smyth JM (2021) Acceptability of intervention design factors in mHealth intervention research: experimental factorial study. JMIR Mhealth Uhealth 9(7):e23303. https://mhealth.jmir.org/2021/7/e23303, https://doi.org/10.2196/23303

  11. World Health Organization (2016) Monitoring and evaluating digital health Interventions: a practical guide to conducting research and assessment, Geneva

    Google Scholar 

  12. van Niekerk AJ (2020) Inclusive economic sustainability: SDGs and global inequality. Sustainability 12:5427. https://doi.org/10.3390/SU12135427

  13. Mpofu E (2020) Concepts and models in sustainable community health. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-59687-3_1

  14. Borgonovi E, Adinolfi P, Palumbo R, Piscopo G (2018) Framing the shades of sustainability in health care: pitfalls and perspectives from Western EU countries. Sustainability 10:4439. https://doi.org/10.3390/SU10124439

  15. Lyles CR, Adler-Milstein J, Thao C, Lisker S, Nouri S, Sarkar U (2021) Alignment of key stakeholders’ priorities for patient-facing tools in digital health: mixed methods study. J Med Internet Res 23(8):e24890 https://www.jmir.org/2021/8/e24890, https://doi.org/10.2196/24890

  16. Waidyanatha N, Sampath CMG (2010) mHealth revolutionizing public health: an economic study. SSRN Electron J. https://doi.org/10.2139/SSRN.1725165

  17. NITI Aayog (2022) Reimagining healthcare in India through blended finance

    Google Scholar 

  18. Labrique AB, Wadhwani C, Williams KA, Lamptey P, Hesp C, Luk R, Aerts A (2018) Best practices in scaling digital health in low and middle income countries 11 medical and health sciences 1117 public health and health services. Glob Health 14:1–8. https://doi.org/10.1186/S12992-018-0424-Z/FIGURES/3

    Article  Google Scholar 

  19. Mohamed AMO, Paleologos EK (2020) Sustainable pollution assessment practices. Elsevier. https://doi.org/10.1016/B978-0-12-809582-9.00001-3

  20. Kandachar P (2014) Materials and social sustainability. Materials experience: fundamentals of materials and design, pp 91–103. https://doi.org/10.1016/B978-0-08-099359-1.00007-2

  21. Balaman ŞY (2019) Sustainability issues in biomass-based production chains. In: Decision-making for biomass-based production chains, pp 77–112. https://doi.org/10.1016/B978-0-12-814278-3.00004-2

  22. Hutchins MJ, Sutherland JW (2008) An exploration of measures of social sustainability and their application to supply chain decisions. J Clean Prod 16:1688–1698. https://doi.org/10.1016/J.JCLEPRO.2008.06.001

    Article  Google Scholar 

  23. Yao R, Zhang W, Evans R, Cao G, Rui T, Shen L (2022) Inequities in health care services caused by the adoption of digital health technologies: scoping review. J Med Internet Res 24. https://doi.org/10.2196/34144

  24. WHO (2021) Global strategy on digital health 2020–2025

    Google Scholar 

  25. Rasekaba TM, Pereira P, Vinaya Rani G, Johnson R, McKechnie R, Blackberry I (2022) Exploring telehealth readiness in a resource limited setting: digital and health literacy among older people in rural India (DAHLIA). Geriatrics (Switzerland) 7:28. https://doi.org/10.3390/GERIATRICS7020028/S1

  26. Schierhout G, Praveen D, Patel B, Li Q, Mogulluru K, Ameer MA, Pa- A, Clifford GD, Joshi R, Heritier S, Maulik P, Peiris D (2021) Why do strategies to strengthen primary health care succeed in some places and fail in others? Exploring local variation in the effectiveness of a community health worker managed digital health intervention in rural India. BMJ Glob Health 6:e005003. https://doi.org/10.1136/BMJGH-2021-005003

    Article  Google Scholar 

  27. Khan NH, Nafees M, ur Rahman A, Saeed T (2021) Ecodesigning for ecological sustainability. Front Plant-Soil Interact 589–616. https://doi.org/10.1016/B978-0-323-90943-3.00019-5

  28. Lucivero F (2019) Big data, big waste? A reflection on the environmental sustainability of big data initiatives. Sci Eng Ethics 26(2):1009–1030. https://doi.org/10.1007/S11948-019-00171-7

  29. Kunkel S, Matthess M (2020) Digital transformation and environmental sustainability in industry: putting expectations in Asian and African policies into perspective. Environ Sci Policy 112:318–329. https://doi.org/10.1016/J.ENVSCI.2020.06.022

    Article  Google Scholar 

  30. Morcillo Serra C, Aroca Tanarro A, Cummings CM, Jimenez Fuertes A, Tomás Martínez JF (2022) Impact on the reduction of CO2 emissions due to the use of telemedicine. Sci Rep 12:1–6. https://doi.org/10.1038/s41598-022-16864-2

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sanju Kaladharan .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Kaladharan, S., Dhanya, M., Rejikumar, G., Puthanpurayil, J. (2023). Sustainability Triangle Framework for Digital Health Systems: A Conceptual Model for Sustainable Health Care. In: Senjyu, T., So-In, C., Joshi, A. (eds) Smart Trends in Computing and Communications. SmartCom 2023. Lecture Notes in Networks and Systems, vol 650. Springer, Singapore. https://doi.org/10.1007/978-981-99-0838-7_46

Download citation

Publish with us

Policies and ethics