[MUSIC] Good morning and thank you for the question. Before considering the new technologies, what we have to consider is that before COVID, there were a lot of technologies that were already ready to be used and implemented in the health system in Catalonia and I think in the different health systems around Europe. The problem was not technology, the problem was organization or were healthcare professionals and policymakers. They were the ones that were not really ready for the change of the digital transformation of the health system. So for instance, the electronic health record already existed, the electronic prescription already existed and even there was portal for patients that was available but, most of the citizenship did not know about it or never used it before. I'm talking about something that we call it La Meva Salut, this is something that started to be popular due to COVID because it was the channel that citizens had to use in order to communicate with the health system. So of course, some new technological issues were performed and were delivered such as apps for contact tracing or a new way of communicating with people, with the citizenships in order to organize all the vaccination system. But this was not really new technology, the big change was the mindset shift. So that means that before COVID for instance, teleconsultation was not really used but after COVID or during COVID pandemics, most of the relation between citizenships and health care professionals were done through teleconsultation. That means video consultation but mainly, it means through telephone which is not really a big innovation in technology but the way it is being used, it's the new thing. So we are not really talking about changes in technology but changes in the culture and changes in the way that people approach the health system. So also due to COVID, some needs in the health system were very clear. From the digital transformation point of view, these needs are mainly the interoperability between the different electronic health records, between different organizations and different levels. And the need to be communicating with other regions in Europe which is a challenge and it has been even clearer now due to COVID. But also new technologies such as artificial intelligence, blockchain and other technologies are being developed and there's some research behind them but they are not really implemented yet. So there's some need now to invest in resources but mainly in developing new strategies and new research. But as I was saying, the big change was the change of culture that has been starting due to COVID in the health system. Yes, in fact inequity is an issue when we talk about digital transformation and digital literacy of the population. In fact, the Lancet has a commission that launched an editorial in November 2021 under the title, Can Digital Technologies Improve Health? So that's, what's now on the table is should we consider digital access as a determinant of health, social determinant of health? It's clear and there have been some examples during COVID that people having a good access to technology, they have had better access for instance, to vaccination. There are some cities with studies in different areas of the city that they have different ratios in terms of vaccination and it seems to be related with the access to technology although it's very difficult to really say this is the cause. But it's clear that when it was changed, when the approach that policy makers were changing the way they were approaching the population and not using only technological channels The ratios, the vaccination ratios has improved at the same level as in other areas in the same city. So it seems clear that digital literacy, digital access is an issue to be tackled by the government, by the health systems in order to improve equity among all the citizens and how is it done? First, this has to declare that the need and then the policy that people, that the policy makers perform and implement, they have to tackle this issue, how? So improving the access of the people through sometimes it can be like having a specific areas where people can go there and be helped in order to use all the different technological devices for instance. But other questions are not really related to the health system but to the infrastructures and economy and everything goes together in terms of having good connection, with connectivity. And having the resources to have the devices needed to really perform the different interventions that use digital issues. So first of all, there has to be an awareness of this is an issue and then the policymakers have to implement what's needed in a specific context. That is a very interesting question, in fact one of the main issues to really be aware of is data governance. So to whom data belongs to and what do you do with this data and all these issues So what has happened is that the citizens have not really a problem giving our data to big companies such as Apple, Amazon or Google. But when we talk about giving data to the health system, to the government, to you really don't know who will have access to this data, that's another issue. And in fact, it seems to be a barrier for people really being ready to use technology, it's not the only one of course. So one of the aspects that should be addressed is really communicating and having transparency in data governance issues, that's one point. The other point is when you use digital health intervention, you need to feel that this is really having an added value. It's not really just changing things because now it looks more cool to use them but because they are more useful and more effectiveness behind it. So that means that evidence have to be developed in terms of defining that this intervention is really working and convincing not only citizenships but also healthcare professionals to use these tools, these devices in performing different interventions. So for me, there are like three topics as I was saying in the beginning, data governance and transparency, added value and evidence, generating evidence. And these three things together make help that people trust much and better on the health authorities when using and implementing these digital health interventions. We humans tend to do things in the way we have been doing them for ages, so in fact innovation is not an attitude that it's really common in most of people. So when performing change, we have to prepare it, it's not that things will change suddenly because you decided that things are going to change. It's just defining an implementation strategy in terms of what's going to happen and what do you want to happen for this change being implemented? I mean you have, yes or yes, to identify which are the barriers and the drivers that are going to facilitate or not, the change you are willing to see. So when not digitalizing the health system but when performing the digital transformation, which is not exactly the same, you need to identify how are you going to perform this? And this is not easy sometimes because this is very different depending on the regions, depending on the people, depending on the organizations. Again, it's the human factor that's going to be the key issue and you have to know how to address this human factor, you have to convince the people that this change is good and needed. And then not adding extra work to what was being done before, that changing the way you're performing your work, your task, your interventions and having the feeling that this is going to be successful. So you need to identify these key informant people that are going to be drivers and also these aspects of intervention that will block your change. So these aspects are really a must when performing this culture of change. And on the other hand, changes are not achieved suddenly so you need time and any change needs time but a change of paradigm that we're talking about when we talk about digital transformation, that needs a lot of time but any travel starts from home. So first steps are always needed and once you start with the first steps, that's going to last and that's going to end with the change you are willing to see. My recommendation will be like five points. The first one is identify the value-based interventions as I mentioned before. The second one will be to generate evidences in order to improve the trust of the healthcare professionals and the citizens in the interventions. The third would be the transparency, as I was saying before, data governance. The fourth point, very important point is the change, the cultural change so the management of this change. And finally, last but not least is having a very clear awareness of the need of the social impact of these digital interventions. So if there is no social impact and when I say social impact, I mean in terms of health, in terms of economy, in terms of resources, in terms of environmental sustainability, it's not really a must that we should then perform this change. So the social impact is the way that we can summarize all the needed things that have to happen in order to implement a new digital intervention or the transformation of the health system into a more digital approach. [MUSIC]