Meso Overview

The meso level refers to activities at the regional or subregional level as well as among local health authorities and primary care networks. The planning phase describes the early pre-implementation stage of digital health where the solution is conceptualized and designed. Actions at this phase will include determining service type and target users, identification of team members, community leaders and partners, regulatory and resource requirements. The aim is to establish a solid foundation for implementation, health system impact and long-term sustainability. Engaging should also be considered during this early phase. The key questions for this phase are:

  • What are we doing and why?
  • What should we be considering?
  • Who do we involve/How do we involve them?
For the complete Meso level Planning Matrix please download the PDF with the full table.
  • Equity


    Health equity implies that everyone has a fair opportunity to attain long and healthy lives and that no one is disadvantaged from achieving this potential irrespective of their social, economic, geographic, demographic, racial or ethnic grouping.

    Digital Health Equity is achieved when all people have equal opportunity to access, use and benefit from digital health tools and services to attain long and healthy lives.

  • Stakeholder Engagement


    This involves identification and meaningful partnership with any individuals, groups or institutions that can influence or be impacted by the digital health solution at any timepoint, including the target populations (care providers, patients, families), in order to facilitate uptake and acceptance.

    The involvement or exclusion of certain groups at the planning impacts implementation success, uptake and long-term sustainability. Some people may fill multiple roles in their capacity as stakeholders.

    Engagement as a means not an end, recognizing engagement as a continuum. The goal is to ensure that the right and necessary people are involved early on in the process and their input/influence is recognized

  • Value Proposition


    This refers to promises that the vendor or proponent makes about what benefits the user can expect to receive from a digital health solution and considers how this solution may be different from others in the market. It includes short or long-term value that purchasers, users and beneficiaries hope to attain by implementing and maintaining the particular digital health solution. A value proposition also addresses issues of sustainability in terms of how the technology was procured (technology supply model), the client-supplier relationship, and the extent that other solutions can be substituted if needed.

  • Appropriateness


    This is related to the fit, relevance, and compatibility of the digital health solution for a given setting, provider or patient, to address a specific health condition.  Digital health solutions should be clinically relevant and tailored to align with the comfort, needs and preferences of target end user and beneficiaries.

    It includes ensuring an optimum fit between the solution, policy priorities for health and health system resources to drive population-level outcomes.

  • Feasibility


    This is the ability of the digital health solution to work as intended and the extent to which it can be used successfully in each setting.

  • Costs


    The financial, infrastructural and operational needs to facilitate digital health implementation. It encompasses the direct and indirect financial resources required to develop, implement and sustain the digital health solution, and the implications of these for overall system performance.

  • Data Privacy and Security


    This includes the National, regional, and territorial standards for data sharing and management (e.g., PHIPA, PIPEDA, OCAP), including data governance agreements between institutions and provinces/territories. Security covers the ability to protect the integrity and use of the data captured, and to ensure only authorized access to the digital health solution.  For instance, privacy impact assessments (PIAs) on a proposed digital solution can identify any real or potential impacts on an individual’s privacy.

  • Interoperability and Portability


    Interoperability can be defined as the ability of digital health solutions to “talk to each other” (i.e., information access, exchange and use) and work with other technologies within the system in a seamless and coordinated manner. Depending on the complexity and use case of a digital solution, interoperability may be foundational, structural, semantic or organisational.

  • Contextual Factors


    This encompasses the wider institutional, sociocultural and economic environment of digital health implementation at the macro, meso, and micro levels that can act to enable or constrain implementation.

  • Regulatory Compliance


    This is the adherence and compliance to benchmarks, regulations, or policy as it relates to digital health technologies and the data collected from its use. It is accompanied by evidence of endorsement, certification, accreditation, or recommendation by relevant regulatory bodies.