Experts publish framework for global adoption of digital health in medical education

A group of 211 international experts from 79 countries has published a new framework to facilitate the design, development and implementation of digital health curricula in medical education worldwide.

Published in JAMA Network Open, the Digital Health Competencies in Medical Education (DECODE) framework is designed to help medical institutions better equip future physicians for the ongoing digital transformation in health care.

The framework is already beginning to be adopted across the globe, including in the UK, where it has influenced a new Medical Schools Council report containing recommended data science learning outcomes for medical graduates.

The international steering group that oversaw the development of the framework included subject matter experts in medical education and digital health research from King’s College London, Nanyang Technological University, Singapore (NTU Singapore), Imperial College London, and Harvard University.

“The DECODE framework represents a significant step forward in preparing future physicians for the digital transformation of health care. By providing a globally adaptable set of competencies, we aim to ensure that medical graduates are equipped with the knowledge, skills, and behaviors needed to navigate and leverage digital health technologies effectively,” says Professor Josip Car, Professor of Population and Digital Health Sciences at King’s and co-lead author of the framework.

“This international consensus effort highlights the urgent need to integrate digital health education into medical curricula worldwide. The DECODE framework not only addresses this gap but also provides a flexible roadmap for institutions to tailor digital health training to their unique contexts and resources.”

Digital health is the use of digital information and technologies to improve health outcomes. From mobile health apps and wearable devices to electronic health records and artificial intelligence, digital tools are driving a transformation in health care. But research suggests that many medical students and physicians don’t feel adequately prepared for using new health care technologies in practice.

“It is important for medical education to keep pace with the rapid digitalization in health care. To do so, targeted training and education in digital health is needed to ensure that future doctors can use these technologies efficiently and safely in care delivery,” says Dr. Qi Chwen Ong, research assistant at NTU Singapore’s Lee Kong Chian School of Medicine and co-lead author of the framework.

“This framework provides comprehensive coverage of widely adopted and emerging digital health technologies. It also addresses critical areas such as ethical and regulatory considerations, as well as broader population health aspects, including the digital determinants of health.”

After generating and refining an initial list of competencies and learning outcomes for the framework, the steering committee engaged with over 200 subject matter experts from 79 countries and territories, spanning all World Health Organization (WHO) regions and World Bank income groups. Through several rounds of feedback, experts reached consensus on the relevant and essential learning outcomes, which shaped the framework.

The final DECODE framework is made up of four domains—Professionalism in Digital Health, Patient and Population Digital Health, Health Information Systems, and Health Data Science—with each domain encompassing a set of competencies and mandatory and discretionary learning outcomes.

“Future doctors must be equipped with the competencies that allow them to respond best to the demands of a digital transformation in health care, and to ensure positive patient outcomes. Achieving a consensus on the core competencies, and building a digital health competencies framework, will enable medical schools to deliver the digital health curriculum through their own existing approaches and resources. We are delighted to have co-led such a positive collaboration with colleagues internationally, and to see this effort come to such a constructive conclusion,” says Professor Amir H. Sam, Head of Imperial College School of Medicine, and co-author of the framework.

“Digital health permeates every aspect of the care continuum. It is the critical ingredient for AI-enabled transformation of health systems to generate better value for individuals and societies. These benefits will be realized with the rapid introduction of digital health education into medical curricula to train current and future doctors and health professionals,” says Professor Rifat Atun, Professor of Global Health Systems at Harvard University and co-author of the framework.