Several policies aimed at developing a digital health care system in Mexico have seen the costs associated with bureaucracy decrease significantly. According to a policy brief published by the OECD in 2018, the simplification of government procedures across all sectors has seen the cost of administrative burdens decrease from 4.3% of GDP in 2012 to 2.7% in 2017. The health care sector stands to gain from state digitalisation efforts, especially as the administration of President Andrés Manuel López Obrador works towards its goal of universal health coverage. With this, we see a new emphasis on developing digital health as new technologies evolve to enhance coverage and quality.
Public Sector
The National Digital Strategy (Estrategia Digital Nacional, EDN) 2013-18, launched by then-President Enrique Peña Nieto, was the first step in this process to adopt and develop ICT infrastructure. In 2019 Mexico ranked fifth out of all OECD countries in terms of government efforts to implement open data. Overall goals outlined in the EDN 2013-18 included the centralisation of information systems, the creation of digital birth certificates and a vaccination database, and the development of telehealth mechanisms to expand health coverage across the country. As part of these objectives, in 2016 the government launched a digital platform for the Mexican Institute of Social Security (Instituto Mexicano de Seguridad Social, IMSS) called IMSS Digital. The platform allows IMSS users to register and make appointments, among other services. Since its launch, IMSS Digital has become one of the most highly visited government websites, second only to the Tax Administration Service. “If the government guarantees the availability of medical information, big data is going to play a key role in sector,” Sandra Ramírez, the general manager of US pharmaceutical firm Bristol-Myers Squibb in Colombia and Mexico, told OBG. “Providing real-time information about individual patients allows providers to quickly make the right decisions for treatment on a case-by-case basis.”
However, despite greater digitalisation in recent years, a number of hurdles remain. Public investment in research and development in tech fields has remained unaltered since 2013, at around MXN3bn ($155.1m) per year. Additionally, only 63.9% of the population over the age of six had access to wireless internet and broadband in 2017, placing Mexico at the bottom of OECD member states. Although the current government promised to deliver connectivity to 100% of the population via its Internet para Todos (“Internet for All”) plan, little progress has been seen. The extension of internet connectivity is being held back by falling investment in infrastructure and limited signal range. With no clear strategy in place for greater connectivity, near-future advances seem unlikely.
Social Awareness
Nonetheless, progress in the public sector can be seen through the development of online resources for the prevention of non-communicable diseases (NCDs). As part of the National Strategy for the Prevention and Control of Overweight, Obesity and Diabetes, the government launched two digital campaigns: the Chécate, Mídete, Muévete (“Get Checked, Measure Yourself, Exercise”) programme in 2013 and the Cambiar Es Tu Decision (“Change Is Your Decision”) initiative in 2014. Both are aimed at encouraging people to improve their diet and exercise habits to prevent NCDs. While this is a step in the right direction – with one government study showing around half of the population aware of such initiatives in 2017 – the number of overweight and obese people continues to rise.
Universal System
Public investment in digital health in Mexico is in its nascent stages, and greater funding is needed to ensure these systems evolve with new technologies. The highly fragmented public health system is a matrix of information, much of which is kept in physical form or digitised within each hospital’s internal network. The difficulties doctors face in sharing information quickly across institutions has been shown not only to have deleterious effects on patient outcomes, but also contributes to funding inefficiencies. “Electronic record systems within each hospital work well, but trying to share a record between two different hospitals is impossible,” Alexandro Arias, the director of business development at Deloitte México, told OBG. “The worry is that the state could be paying to insure the same patient across multiple institutions due to the lack of a national patient registry.”
Regulatory System
In 2017, as part of the EDN 2013-18, the government announced it would digitalise the sector regulator, the Federal Commission for Protection against Sanitary Risks (Comisión Federal para la Protección contra Riesgos Sanitarios, COFEPRlS). That year a digital system for user applications was implemented to speed up processing times. Again, the lack of a national digital system has hindered advancement, with pharmaceutical companies often citing the slow processing times for new drugs (see analysis). “Despite the digitalisation of public health services in Mexico, much of the documentation across different institutions continues to be in paper form,” Gabriela Dávila, the regional director of clinical research for Latin America at US firm Pfizer, told OBG. “COFEPRIS has adopted a digital pilot programme, which the new government should take into consideration moving forward. While the process has begun, there is still room for digitalisation efforts to be efficient and transparent.”
Private Sector
Recognising the issues with digitalisation, the government is turning to public-private partnerships (PPPs) to speed up efforts. Mexico was one of the first Latin American countries to launch health care PPP projects, tendering its first pilot programme in 2005. In 2018 the Digital Health Forum Mexico (DHFM) brought together private firms, government representatives and academics to discuss ways in which disruptive technologies via PPPs could improve provision. “We have evolved the legal and regulatory framework concerning medical devices, which included digital devices,” Julio Sánchez y Tépoz, general commissioner of COFEPRIS, said at the DHFM conference. “This has allowed for better use of financial resources, and more efficient authorisation of such devices.”
A number of drug, medical equipment and insurance companies are already involved. US multinational Johnson & Johnson, for example, announced in July 2019 that it had committed its resources to providing digital training tools for Mexican surgeons. Meanwhile, smartphone applications and online platforms, such as Google Fit, remain popular. In January 2019 local media reported that 30m people in Mexico, or around 46% of those with internet access, used a health care-related site.
On a management level, the government could also encourage private firms to embrace digital initiatives. Greater digitalisation across local firms could potentially drive investment in digital health as has been the case in other OECD states. Sweden, for example, plans to become a leader in health tech by 2025 by investing in digital health initiatives to drive its e-health scheme.
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