Addressing health equity challenges with digital innovation
Digital innovations in medicine, in the last couple of years, have experienced significant growth and widespread acceptance. This game-changing progress is not unrelated to the COVID-19 pandemic which has on health both positive and negative effects. While it is not the origin of the disparities, the pandemic has laid bare and brought into a sharper focus the issue of healthcare inequity and its well-documented impact on ethnic and racial minorities, rural communities, the underprivileged, and the elderly. Addressing these inequities, narrowing health disparities, and providing equal access to affordable and competent healthcare is key to improving patient outcomes, easing reliance on emergency and late-stage interventions, providing a better quality of life, and reducing early deaths.
Digital technologies are critical to the improvement of health equity. However, while they are often created with the best of intentions, rapidly advancing technology may worsen exclusion, amplify biases, widen the digital divide, and keep leaving some populations behind. Recently, technology and life sciences companies are making moves to address health equity challenges with digital innovation.
Why is Health Equity Important?
Health and health care disparities are not new. They have been recorded for decades and they demonstrate longstanding structural and systemic inequities deeply rooted in racism and discrimination. Despite recent efforts to expand healthcare access, some long-standing disparities persist. For instance, a 2021 Kaiser Family Foundation (KFF) study reported that concerning Americans under age 64, Hispanic are more than twice as likely to be uninsured as their White counterparts. In the same study, it was also found that Black Americans fared significantly worse than their White counterparts across 19 of 27 health measures, including pregnancy-related deaths, infant mortality, the prevalence of chronic conditions, and physical and mental health generally.
Inadequate access to healthcare has severe consequences for patients. Equalizing healthcare quality and access improves individual and population-level outcomes and also has beneficial effects on the larger economy. Over the past century, improvements in global health have contributed to about one-third of all economic growth in advanced economies. To sustain this growth rate, digital health solutions must be tailored to reach previously excluded or underrepresented groups.
There is an increase in the interest in digital health, and investors in digital health solutions are starting to take note. In 2021, venture funding for digital health companies rose to $29.1 billion, with more than $0.5 billion targeting social determinants of health and underserved populations. Additionally, investors incorporate social, environmental, and governance criteria into their decision-making, making it plausible for health equity to become a core principle in planning for maximum social impact.
Bridging Equity Gaps
Digital tools are critical in the effort to bridge the equity gap, as they can increase healthcare access, address unmet needs and personalize care for patients, and evaluate the historical context within the communities they serve. Digital health innovators, learning from start-ups and established leaders in the field, can envision how their products will address health equity.
In a bid to make a meaningful difference, digital health innovators aiming to develop and scale their products need to understand these three areas of opportunity.
1. Improve Access to Healthcare
There are two main access constraints: availability and affordability. While digital technology can narrow the equity gap by streamlining medical bureaucracy processes that are difficult to navigate and eliminating travel and transportation factors from healthcare access, limited insurance coverage and high treatment costs are well-known barriers to care. For instance, fertility treatments like in-vitro fertilization are poorly covered, making these procedures too expensive for many patients. Univfy, a digital health start-up, seeks to break this barrier by developing an AI-based platform that predicts a patient’s probability of success and by partnering with clinics to offer refunds in case the IVF efforts fail.
For patients in rural areas, there are several barriers to care, including the limited availability of providers and the costs associated with travel and time away from work. However, the covid pandemic stimulated a rapid and notable increase in telemedicine and improved access for those who were not reliably able to attend in-person consultations.
To combat inaccessibility to medical equipment, portable diagnostic and medical devices are being developed with the aim of transforming care by reducing costs and expanding the availability of diagnostic services beyond traditional healthcare settings.
2. Address Unmet Needs
In the health care practice, it is not unusual to have variations in physician knowledge and varying responses to treatments. This can affect patient management and complicate rare disease diagnosis and treatment, leading to a diagnostic odyssey that could last several years. An algorithmic population screening of electronic health records could help reduce the time it takes to diagnose rare diseases and connect patients with the appropriate providers.
Social determinants of health, such as access to clean water, good food, safe housing, and transportation, affect patients’ ability to maintain good health and seek care when needed. Combining unmet social needs and lack of access to quality care creates a feedback loop in which each erodes the other. This cycle can be broken by considering patients’ social determinants of health and specific medical needs in product development.
3. Consider the Historical Event
The health-seeking behavior of individuals also depends can also be influenced by the historical experiences between the medical establishment and the community to which the individuals belong. For example, according to a report from the Commonwealth Fund, the past forced sterilizations and the Tuskegee syphilis study contribute to Black Americans’ mistrust of the medical community. In the presence of other structural factors, this mistrust is associated with fewer preventive health interventions, delayed diagnosis, and worse patient outcomes.
Digital health companies must consider how past experiences influence the patient’s perception of a product or service and find creative ways to establish trust and understanding.
What To Do
In the scheme of improving health equity, digital solutions are a critical first step. Digital innovators can increase their likelihood of success by building a diverse and inclusive team, embedding equity in product development, and collaborating with the patients and the communities in developing products in order to meet their peculiar needs.
Considering patients’ backgrounds can also improve their overall experience with and the efficacy of a digital product. While many digital tools incorporate various language options, they fail to address cultural context, and that remains a barrier to adoption. Reducing cultural, linguistic, and educational barriers helps to ensure that patients can complete annual wellness checks, satisfy urgent care needs, fulfil their social needs, and manage chronic conditions.
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