LAUSR

INTRODUCTION The variation of coronavirus disease (COVID-19) outbreaks across rural and remote jurisdictions makes it imperative to invest in scalable digital health platforms to not only minimize the impact of subsequent COVID-19 outbreaks, but also to utilize such approaches to predict and prevent future communicable and non-communicable diseases. METHODS The methodology of the digital health platform comprised: (1) Ethical Real-Time Surveillance to Monitor Risk: evidence-based artificial intelligence-driven individual and community risk assessment of COVID-19 by engaging citizens using their own smartphones; (2) Citizen Empowerment and Data Ownership: active engagement of citizens using smartphone application (app) features, while enabling data ownership; and (3) Privacy: development of algorithms that store sensitive data directly on mobile devices. RESULTS The result is a community-engaged, innovative, and scalable digital health platform, with three key features: (1) Prevention: this feature is based on risky and healthy behaviours, and has the sophistication to continuously engage citizens; (2) Public Health Communication: based on their risk profile and behaviour, citizens receive specific public health communication that helps them make informed decisions; and (3) Precision Medicine: risk assessment and behaviour modification is individualized so that the frequency, type, and intensity of engagement is based on individual risk profile. DISCUSSION This digital health platform enables the decentralization of digital technology to effect systems-level changes. With more than 6 billion smartphone subscriptions globally, digital health platforms enable direct engagement with large populations in near real-time to monitor, mitigate, and manage public health crises, particularly in rural communities that do not have equitable access to health services.