The COVID-19 pandemic is without doubt one of the greatest challenges that human beings had to face in recent times. Since the first days of the pandemic, communication technologies have been the cornerstone of the strategies to mitigate the impacts of the crisis. From economy and education to governments, the crisis has massively pushed forward the use of communication technologies, with teleconference platforms becoming the only remaining way to interact with others, and with social media becoming one of the main sources of information. The digitalizing of our society – something that has been referred to as the digital transformation – had started long before the first outbreak of the coronavirus. Yet, the pandemic has acted both as catalyser and as an accelerator of these changes.
That being said, not all of these changes we observed will necessarily be transformative. Indeed, it is unclear how enduring the changes of our use of technology that happened during the pandemic will be. Once the pandemic will finally be over, will we go back to a pre-COVID situation? Will we reach a status quo, a form of equilibrium between offline and online communications? Or will we keep the momentum to accelerate even more the computerizing of societies? Although foreseeing the future is always a challenging task, some elements are hinting that a return to the pre-COVID situation could – at least partially – happen for quite a few activities. All across the world, teachers from primary schools to universities can witness the fact that students want to come back in classrooms. Companies want their workers back in their main facilities. More generally, this pandemic has proven once more – if needed – the importance of physical social interactions for human beings: people crave physical contact, from grand-parents dreaming to hold their grand-children again to people willing to simply meet their friends again and share simple yet precious moments.
There is one area, however, where these changes might, could, and should be transformative. This area is human health. Indeed, in spite of the turmoil we are living since the beginning of the year 2020, at least one positive element has emerged worldwide in patient care – the large increase of the use of communication technologies to support health care delivery. The use of technology to convey medical information is not something new. In fact, it can be traced back to the ancient times, with the Homeric Iliad reporting the Greek fleet using fires and smoke signals to communicate from boat to boat in order to control the propagation of a deadly plague – a very early form of telemedicine. Powerful examples of telemedicine were seen during the course of the twentieth century. Yet, despite its promise, telemedicine never truly succeeded in reaching the expected audience and remained limited to very specific niches, such as maritime and space medicine. The raise of digitalized spaces in the last few decades enlarged the possibilities, and led to what became to be known as eHealth. Still, while often innovative, eHealth initiatives were typically limited in scope and range. The COVID-19 crisis changed this situation. By stretching public health systems to their last limit, the pandemic has forced to employ all available means to compensate for the overwhelming pressure on health care systems. As for the other domains, technology was the key to pass through the crisis. Telediagnosis became one of the flagships of eHealth interventions from the earliest stages of the pandemic, quickly followed by numerous other applications.
A very large and inclusive definition of eHealth could be the use of digital technology for human health, from health promotion and patient education to telemedicine and mHealth. With this definition in mind, it is easy to foresee the tremendous benefits of increasing the development of eHealth. All actors of health systems, as well as all those interested in decreasing health inequalities should call upon an acceleration of this movement. Increasing massively the relative weight of eHealth would have numerous positive consequences, from reducing the time to get access to health care, reducing the incidence of nosocomial infections, to increasing the global health of the population. As an appreciable side-effect, this would also represent a small step toward sustainability, as it would contribute to several of the Sustainable Development Goals (SDGs) identified by the United Nations.
This is however a double-edged sword. Indeed, the road of hell is paved with good intentions. Although the use of technology would ideally increase the access to health services in a broad understanding, in order to benefit from technology-conveyed health care, people still need to be able to access to the technology itself, and to have the skills required to make a proper use of the technology (what is known as digital literacy). While conventional inequalities are well identified and well known, digital inequalities are a new layer of socio-economical wall. The COVID-19 crisis has demonstrated that access to technology is not evenly distributed across the population, and that the patterns of vulnerability distribution mimic those of classical inequalities. In other words, technology – or, for that matter, the lack to access to it – is making the population that are traditionally vulnerable even more vulnerable. What is supposed to decrease inequalities should not increase them. With a large-scale increase of eHealth, the risk is real to replace a set of inequalities by another form of inequalities. The risk in a world where eHealth would become prominent is for digital inequalities to become a core determinant of health inequalities, moving from a socio-economical inequalities framework to a techno-socio-economical inequalities framework. Yet, the advantages of eHealth are overwhelmingly surpassing the costs that would results if we would not be moving forward. What makes human beings move forward is our capacity to learn from the past, and ideally, not to replicate our former mistakes. Clearly, the COVID-19 crisis stroked us unprepared. The next worldwide pandemic should not. Investing on eHealth will results in massive profits for public health systems. At the same time, investing on reducing digital inequalities will have benefits that will spread way further than health care. Research and education will have a key role to play here. Research should however be applied. Indeed, the pioneering times of eHealth should be over: eHealth initiatives don't anymore need to be based solely on good will of investigators and trial-and-error strategies. They should instead be evidence-based like for any other fields of medicine.
As for anything related to the societal impacts of technology on human behavior, the Computers in Human Behavior family journal (i.e., Computers in Human Behavior and Computers in Human Behavior Reports) pledges to accompany the research community in exploring these avenues. Yet, this wish for eHealth goes further than purely conventional academic research perspective and than an “identifying research gaps” approach. Instead, it should be understood as a global call to action both for those involved in cyberpsychology or health science research, and, maybe more importantly, to politicians and other decision leaders to develop new mindsets and strategies to fill major societal gaps. During the last year, health has been at the center of the public attention. Health inequalities were always here, but they became more visible during the crisis. Let's hope that a large scale rise of eHealth will allow not only to fight these inequalities, but also to further human health at a global level. There is no doubt that the cyberpsychology research community will be instrumental in promoting those changes.
Declaration of competing interest
There is no conflict of interest with this paper.