It's late, but not too late to transform health systems: a global digital citizen science observatory for local solutions to global problems.

A key challenge in monitoring, managing, and mitigating global health crises is the need to coordinate clinical decision-making with systems outside of healthcare. In the 21st century, human engagement with Internet-connected ubiquitous devices generates an enormous amount of big data, which can be used to address complex, intersectoral problems via participatory epidemiology and mHealth approaches that can be operationalized with digital citizen science. These big data - which traditionally exist outside of health systems - are underutilized even though their usage can have significant implications for prediction and prevention of communicable and non-communicable diseases. To address critical challenges and gaps in big data utilization across sectors, a Digital Citizen Science Observatory (DiScO) is being developed by the Digital Epidemiology and Population Health Laboratory by scaling up existing digital health infrastructure. DiScO's development is informed by the Smart Framework, which leverages ubiquitous devices for ethical surveillance. The Observatory will be operationalized by implementing a rapidly adaptable, replicable, and scalable progressive web application that repurposes jurisdiction-specific cloud infrastructure to address crises across jurisdictions. The Observatory is designed to be highly adaptable for both rapid data collection as well as rapid responses to emerging and existing crises. Data sovereignty and decentralization of technology are core aspects of the observatory, where citizens can own the data they generate, and researchers and decision-makers can re-purpose digital health infrastructure. The ultimate aim of DiScO is to transform health systems by breaking existing jurisdictional silos in addressing global health crises.