The COVID-19 pandemic has created devastating social, economic and political impacts, challenging governments to act promptly to control the pandemic (1). Despite numerous constraints, Vietnam has been lauded for vigorous efforts in fighting the pandemic, including strong political commitment and whole-society response approach such as intensive surveillance, contact tracing, case management, massive quarantine and lock down, and transparent risk communication (2). Contributing to such success was the role of Digital Health (DH), which has not been discussed systematically elsewhere.

DH is defined as “the use of information and communications technology in support of health and health-related fields” (3), including but not limited to mobile mHealth, health information technology, wearable devices, telehealth and telemedicine, artificial intelligence (AI) and personalised medicine (4). DH plays an important role in improving effectiveness of the health system, increasing accessibility to health services while containing healthcare cost, and in working toward universal health coverage (3). DH demonstrated its prospects in infectious diseases control (5, 6). DH technology has been deployed to address the most urgent needs during the COVID-19 pandemic, including immediate outbreak response and later, impact mitigation (7). Evidence from prior research suggests that adoption of digital health, especially telemedicine and virtual care was considerably increasing during the COVID-19 and offer considerable benefits to the health care as weel ass society (8–11).

Vietnam has embraced the digital technologies in healthcare early, such as telemedicine, hospital information system, mHealth quite early (12–14). Amid rapid spreading of the epidemic around the world, there were several initiatives to implement DH applications in response to the COVID-19 pandemic in Vietnam. In this article, we aimed to provide an overview on the implementation of DH technologies the fight against COVID-19 in Vietnam.

We examined the use of digital health in Vietnam in accordance with the epidemiological development of COVID-19 in Vietnam. Although there have been several articles discussing the COVID-19 prevention experience in Vietnam (2, 15–18), there is lack of peer-reviews articles that focus on DH. We collected and summarised data and information on the use of DH from the official portal of the Ministry of Health (MOH) in Vietnam on the COVID-19 pandemic and existing legal documents, official reports of the Ministry of Health from Jan 2020 to Feb 2021. For additional information, we conducted a search on Google with keywords related to COVID-19 including “telehealth,” “telemedicine,” “digital health” “e-health,” “m-health,” “COVID-19,” “coronavirus 2019 and “ncov.” The data was entered in a standardised spreadsheet. Any discrepancies in data extraction were discussed between the researchers to reach consensus. If it cannot be resolved, a third researcher was consulted. We also employed the same epidemiological data which was used in previous study (19).

There are 07 major DH applications were implemented in Vietnam since the very beginning of COVID-19 pandemic. They were categorised into four groups based on their main purpose, including surveillance and contact tracing, health communication, telemedicine and Artificial Intelligence to support diagnosis and treatment. Table 1 summarised the roll out of DH applications, in according with the epidemiological curve of COVID-19 of Vietnam from 23 Feb 2020 to until 26 Feb 2021 (Figure 1).

Like other countries, Vietnam has seen a plethora of DH applications during the COVID-19 (32). Despite the rapid deployment of applications, including Telemedicine and AI, DH application in Vietnam is still facing numerous constrains. In terms of institutional perspective, the DH applications for combating COVID-19 are not centrally developed and managed. They have been developed in a very short time and administered by many different agencies. It has reflected the inflexible and overlapping of health authorities in the structure of Vietnamese health system (33). The discretion of applications, such as eCDS, CMS, has highlighted the need of standardised and centralised data warehouse for healthcare in Vietnam, which was initiated in 1995 (33, 34). The absence of a centralised database hinders the potential power of cutting-edge technologies in automation of big data mining, analytical, visualisation and modelling, and artificial intelligence to support diagnosing, managing and triaging (35). Although eCDS and CMS software have satisfied the information needs in fighting the pandemic, they are largely dependent on health workers to input data into a computer-based spreadsheet, confining heath authorities to achieve real-time manner of the surveillance system as patient volume increased. It also lacks consistent system in place to notify a suspected case or to track interfacility transfer of confirmed COVID-19 patient as very few hospitals in Vietnam have standard Electronic Medical Record (EMR) despite 100% of hospitals have implemented hospital information systems (36). When combined with EHR and dedicated devices, such as wearables (37), telemedicine provides additional benefits of enhancing patient-provider connectivity, creating innovative model of care, allowing physicians to view patient records remotely, prescription, lab reports, not just merely virtual communication (38). Regulations on medical procedures and protocols at the national level for telemedicine to be optimised are unavailable (29).

The utilisation of DH in the health system faces several challenges such as insufficient financial resources to invest in infrastructure, the disparity in information technology literacy of physicians and health workers at all levels. Moreover, there has not been standardised guidance for digital health services delivery for local health staff while the application of DH at local level has been scaling up too fast. That could put an extra burden on the health system as the COVID-19 pandemic continues. Additionally, all COVID-19 response activities are centrally managed by the government, not all activity data have been standardised and digitalized into a national database on COVID-19 to be used by DH applications to fight this pandemic. It is high time to conduct a health technology assessment to quantifying the effectiveness of electronic medical applications to address COVID-19 to solving outstanding institutional and technical problems, as well as figure out determinants that affecting the adoption of digital health (9). More importantly, this is an opportunity to help create a sound view and expectation of the public on DH technologies (33), removing barriers and restrictions on the provider's perspective, such as fear of medical errors, and toward consumer's perspective, concerning on privacy, confidentiality, and security enhancement (29).

The National Digital Transformation Programme toward 2025 with a vision to 2030 has been approved on 22 December 2020 (39), with specific tasks and solutions in developing digital transformation platforms in the health sector, including but not limited to legislature and institutional building, digital infrastructure development, digital data development, ensuring security, human resource development. The success of DH in the COVID-19 era may provide rewarding experience for the implementation of this programme.

Our article has several strengths, including being the first, to our best knowledge, to review the application of DH in the fight against COVID-19 in Vietnam in accordance with the epidemiological development of the pandemic. Our search captured a wide range of published and grey literature on the use of DH for COVID-19 control. However, there were potential limitations in our study. We could not quantify the contribution of DH in the response to COVID-19 due to lack of sufficient purpose-built evaluation of DH application as well as the readiness of the stakeholders in using these DH applications during the pandemic. This has yielded the need to systematically assess the effectiveness of DH in disease control and COVID-19 response.

This article provided a review on the application of DH technology in responding to COVID-19 in Vietnam. Despite several outstanding problems, DH is expected to contribute to reducing the spread, improving the effectiveness of pandemic control, and contributing to the dramatic transformation of the post-COVID era. To optimise the application of DH, we need more evidence on the effectiveness of DH applications as well as facilitators and barriers in applying DH. This would be the basis to develop comprehensive policies to facilitate the advancement of DH in the future.

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.

HMB, LVB, STH, and HNN: conceptualization. HMB, LVB, STH, and TTN: methodology. LVB, HMB, THN, STH, THT, and KT: writing—original draft. LVB, STH, HNN, TTN, THN, KT, TVT, THT, NDP, PTN, and HMB: writing—review and editing. All authors contributed to the article and approved the submitted version.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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