Telemedicine, Remote Monitoring, Wearables & Cybersecurity: Adancing Equity through the VIRAL Framework

The paper presents and elaborates a novel theoretical framework, the VIRAL Framework that aims to inform the fair, safe, and cost-effective implementation of digital health technologies into modern healthcare systems. VIRAL is an acronym which has a Value, Integration, Risk and Resilience, Access and Literacy, and Learning. The VIRAL Framework brings telemedicine, remote patient monitoring, wearables, and cybersecurity together into a single model of the management-economics model, which explicitly considers both efficiency and equity, unlike the current approaches that consider them as independent domains. What is new about the Framework is that it links the economic assessment to health equity and systems leadership to provide a systematic approach to policymakers and managers to evaluate the trade-offs of the cost, security, and access. The merits of the model are that it is comprehensive, it specifically considers cybersecurity as an element of health economics, and both prioritizes literacy and equity as well as more conventional financial and clinical outcome measures. Simultaneously, the Framework also has constraints: it is intuitive, not empirically validated; it assumes that it can be scaled to other health systems, and its implementation needs high managerial potential. Unlike past models focusing on the cost-effectiveness or technical feasibility, VIRAL puts the focus on the resilience to cyber threats, the importance of health literacy as an adoption determinant, and the necessity to engage in continuous organizational learning. These distinctions make VIRAL more comprehensive in vision, as well as more sensitive to the weaknesses of digital health transformation. The opportunities of the VIRAL Framework are that it can be applied in comparative policy research, can be used to model the costs and benefits of the digital health interventions, and can be used to design fair reimbursement plans. It also provides a blueprint of how librarians, clinicians, and digital navigators can be incorporated in care teams to address disparities. Finally, VIRAL gives healthcare leaders a platform to strike a balance between innovation and justice so that telemedicine, remote monitoring, and wearable technologies can serve to build systems that are efficient, but also inclusive, resilient, and secure.