Digital innovation for primary health care: aligning public–private partnerships for scale, trust and public good

Part 2 of a three part blog series

Reflections from the symposium “How can the public–private mix advance PHC in a transforming world order?”, convened by the Health Systems & Policy Research Cluster at UCL Global Business School for Health in collaboration with Health Systems Global’s Private Sector & Commercial Determinants of Health Technical Working Group, May 2026.

Digital health is now central to strengthening primary health care (PHC). Yet the harder question is no longer whether new tools can be developed. It is whether they can move beyond isolated pilots to become trusted, equitable and sustainable parts of health systems.

This question shaped a session on digital innovation at the symposium, How can the public–private mix advance PHC in a transforming world order?, convened by UCL’s Global Business School for Health with the Health Systems Global Private Sector and Commercial Determinants of Health Technical Working Group. The discussion pointed to a shared conclusion: technology creates public value only when public and private actors align around capable institutions, accountable partnerships and people-centred models of care.

Different cases, shared lessons
Illustrative cases included Health-E-Net’s work on digitising paper-based health records, Televita S.p.A.’s telecare and telemedicine model, HBSUK’s digitally enabled NHS pathways, and the Modera-SP prevention initiative involving the São Paulo municipal health system, the University of São Paulo and the AB InBev Foundation. Although the initiatives differed, they highlighted common conditions for successful digital transformation. Innovations were most valuable when they responded to a defined health-system need, worked with existing services, and strengthened rather than displaced relationships between patients and health workers. The cases showed that reaching scale depends on the quality of a digital product and the readiness of institutions to govern, finance, integrate and sustain it.

Start with the health-system problem
Across the cases, a consistent message emerged: people, not technology, must remain at the centre of innovation. This requires a shift from volume to value—from counting appointments, inputs, outputs and procedures to asking whether health systems genuinely improve people’s lives. Successful innovation therefore begins with a defined health-system need.

Four tests follow: is the intervention understandable, trusted, actionable and fit for life? These questions are important in public–private partnerships, where commercial incentives, public health goals and community expectations must be aligned. A technically sophisticated tool that fragments workflows, increases reporting burdens, or is not trusted and usable by those it is intended to serve will not strengthen PHC.

Design with existing systems and relationships
Digital transformation does not always require replacing established processes overnight. In many settings, health workers continue to depend on paper records because infrastructure is uneven and familiar routines remain important. Innovations that bridge paper and digital systems can reduce duplicate work, reporting delays and data loss while allowing services to evolve at a realistic pace.

The same principle applies to prevention, remote care and digitally enabled clinical pathways. These approaches are more likely to be used and sustained when they are integrated into existing services, supported by workforce training and designed around real patient and provider journeys. Co-design is therefore not an optional consultation exercise; it is central to creating solutions that fit local institutions, capabilities and patterns of care.

Digital tools should also strengthen—not substitute for—the relationships at the heart of PHC. Remote monitoring, artificial intelligence and automated decision support may extend reach and improve responsiveness, but they must preserve opportunities for professional judgement, empathy, explanation and referral.

System readiness determines whether pilots endure
Digital innovations perform well in demonstration sites but struggle to expand. The obstacle is often not the product. It is the absence of interoperability, long-term financing, procurement pathways, workforce capability, data governance, regulation and institutional ownership.

Scaling private digital solutions through public systems therefore requires more than adoption. Public agencies need the capacity to assess value, negotiate terms, protect data, establish standards, monitor performance and adapt implementation over time. Private partners need incentives that reward health-system outcomes rather than rapid expansion or user volume alone.

Growth should not automatically be treated as evidence of success. Expansion can create complexity, weaken responsiveness and burden the organisations responsible for delivery. Good scale is purposeful: it extends an innovation where it addresses a recognised need, remains usable and improves care without undermining the institutions expected to sustain it.

The central question must therefore shift from “Does the tool work?” to “Can the health system govern, finance and sustain it—and for whom?”

Keep public purpose visible
Public–private collaboration can bring technical expertise, investment and implementation capacity to PHC. But durable partnerships require explicit public purpose, transparent roles, accountable decision-making and safeguards against exclusion, conflicts of interest or the distortion of health priorities.

The next phase of digital PHC should therefore be judged less by novelty and more by public value. The innovations most likely to endure will be those that fit frontline realities, strengthen public-sector capability, preserve the human dimensions of care and align public and private contributions around equitable access, quality and the public good.

Priya Balasubramaniam is a public health practitioner and clinician scientist with extensive experience in health systems research, implementation, and strategic programme development across South and Southeast Asia and Africa. Her work spans universal health coverage, private sector engagement, and digital health innovation, with a focus on strengthening mixed health systems in low- and middle-income countries.

Catherine Etseoghena Khanoba is a clinician and health systems and policy researcher. She is currently an Impact Fellow at the UCL Global Business School for Health, and will begin her PhD in October, examining the political economy, fiscal sovereignty, and strengthening of health systems in low- and middle-income countries.

• Read Part 1 of our three-part blog series, also available: Balancing business and accountability: governing equitable primary healthcare partnerships with the private sector - Health Systems Global (HSG)

• Read Part 3 of our three-part blog series, now available: Rethinking blended financing for primary healthcare - Health Systems Global (HSG)

Image copyright: Dr Pratap Kumar, Health-E-Net