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How Can Nurses Support Digital Health and Vice Versa?

Seven questions for Olivia Vélez, nurse, developer, and IntraHealth’s chief digital health officer. 

Digital health is key for achieving universal health coverage and equitably responding to pandemics—both on the agenda for the UN General Assembly this month. 

I sat down with Olivia Vélez, IntraHealth International’s chief digital health officer and part of our delegation heading to UNGA. She’s a registered nurse and holds a PhD in nursing informatics, in addition to master's degrees in information systems and public health. She shared how digital health can support nurses and other health workers, and how as a nurse she’s advancing digital health innovation.

1. What drove you to study and pursue both nursing and tech?

In undergrad I double majored in computer science and neuroscience. After I graduated, all my jobs as a software developer or database developer were in the health sector, at community health centers or health insurance companies. 

One day I was working with nurses, developing a mobile tool for them to do quality assurance audits, and I thought I'd do a better job at this if I was a nurse and I really understood what they needed. So I decided to go to nursing school, with the idea that I would focus on nursing informatics and community health.

2: How are you using your background in nursing in your current role as chief digital health officer at IntraHealth? 

I understand what nursing challenges are, and I bring that view and wisdom to how we design our digital health tools and how we implement them. I also understand what it’s like to be a new nurse and feel alone on your first shift, or during your first month of working. In a lot of the countries we work in, nurses are assigned to rural clinics where they're working by themselves without a lot of supervision, and there’s a shortage of nurse mentors and more experienced nurses because of brain drain and the overall health workforce shortage.

I understand what it’s like to be a new nurse and feel alone .

 So I bring my nursing experience to the forefront and think, how can we help nurses move along the path from being a novice nurse to being an expert? How can we build their confidence and ensure they stay in the field? 

My knowledge applies to other kinds of health workers too. I know that stress when you don't have the resources or the support you need. So I always look for solutions with technology and even what we can do with artificial intelligence (AI) to support mentorship, development, and growth.

3. What do you think is unique about IntraHealth's approach to digital health? What are you working on that you are excited about?

IntraHealth has primarily focused on digital health tools that are supportive infrastructure for health systems at the national level. iHRIS tracks all health workers in the country, and Open Client Registry (Open CR) safely links patient information between different databases for continuity of care. Facility Match helps ministries, as well as donors and implementing partners, create and maintain master lists of all the health facilities in the country, and eliminate duplication. 

We focus a lot on interoperability, so different information systems can share important information. And, if local entrepreneurs build mobile health tools, for example, they can be integrated. We also focus on making sure our software is safe and secure.

I'm personally really excited about the work we're doing with machine learning and predictive analytics, like how we're using iHRIS for health workforce planning—from day-to-day to redistribution of health workers to respond to an emergency or pandemic. And also our thought leadership around building a culture of data use. When we implement our tools we think, you're collecting all this data, what are you actually going to do with it? How is it going to help decision-makers improve health workforce planning or access to quality health services? 

4: Nursing is a woman-dominated field, and digital health is dominated by men. Have you had to overcome any gender-related challenges in your career? 

The general challenge a lot of women face in this field is the constant need to prove our technical expertise. Because most people know I'm a nurse, they don't realize I worked as a software developer for ten years, so I don't need the technical side dumbed down for me. Other women I’ve talked to have faced that as well, even if they have engineering degrees, etc. 

It's important to have gender representation in the design and development of tools.

To address this, we created and held a Women in Global Digital Health Leadership Workshop last December before the Global Digital Health Forum [Vélez is cochair of the Global Digital Health Network, which hosts the forum]. We talked about the common challenges we face and formed a network of women to continue to discuss these issues and find solutions. Because it's important to have gender representation in the design and development of tools, and we want to make sure that tools are implemented with a gender equity lens. There's still a big gap in the digital divide, and diversity is important. We're planning to host another workshop this December to follow up on last year's success.

5: What advice would you give to other women, particularly nurses in low- and middle-income countries, interested in digital health?

Digital health is a broad field with a lot of different specialties. You could be a solutions architect, a software engineer, a data scientist. So number one is to explore which aspect of digital health interests you. There are a lot of free Google or Microsoft online courses that can help you learn more about a particular area. If you’re interested in privacy and security, Google has a whole privacy and security track that you could take and get a good understanding. 

The International Council of Nurses has competencies for nurses interested in nursing informatics. In a few years the World Health Organization will release a digital health competency framework for health workers. Many people from IntraHealth have participated in the early stages of the development of those competencies, with low- and middle-income countries in mind. Africa CDC has a flagship initiative that we're also participating in to build digital health capacity within the African Union. And along with that we can expect to see programs and courses coming out to help nurses gain the skills they need.

6: What suggestions do you have for donors or policymakers to advance digital health? 

Donors and policymakers should invest in building digital health capacity for health workers. As more health workers have skills in digital health, they can better contribute to the design of tools, as an end user in the user-centered design process, or in leading the design and implementation of tools. 

Invest in building digital health capacity for health workers.

They should also continue to invest in open source tools, like iHRIS, so there's funding to continue core development, and to use the best technology possible, while still keeping the implementation and the total cost of ownership low for countries.

7: You’ll be attending the UN General Assembly next week. What are you listening for that could impact digital health?

I'm looking forward to the discussions on health data governance led by Transform Health. That's a big deal this year especially. IntraHealth signed on to several statements around the health data governance principles. It’s really important to make sure the health workers and patients we are including in digital health systems around the world are protected and afforded the same rights with regard to the privacy of and use of their data. We are responsible for making sure that the digital health tools we implement, and the data that goes in them, are used to improve quality of care and achieve universal health coverage. 

Follow Olivia Vélez:

  • At UNGA, Olivia Vélez will speak at a roundtable, Accelerating equitable digital innovations for women's reproductive health, on September 19 hosted by Dalberg and Resolve Global Health.
  • In October, Vélez will join the 2023 Class of Fellows of the American Academy of Nursing. She’ll be recognized for her outstanding impact on health and health care at the Academy’s annual Health Policy Conference on October 5-7 in Washington, DC. 
  • Connect with her on Linked In at