It’s a new day in healthcare. Access to mobile apps on smartphones can change outcomes in diabetes, obesity, depression, anxiety and numerous other conditions that require behavior change.
Billions of dollars in capital are pouring into the digital health sector in anticipation of hockey-stick growth curves. While we’re on our way to tackling diseases in groundbreaking ways, we can’t create a world in which digital health is a privilege for the tech-savvy, wealthy and educated.
With chronic conditions already disproportionately prevalent in Black, Hispanic, low-income and elderly populations, we can’t afford to create new types of inequity. Today, 97% of Americans own a cellphone and 85% own a smartphone. While this data implies everyone has access to mobile phones, we have work to do.
According to a recent National Poll on Healthy Aging from the University of Michigan Institute for Healthcare Policy and Innovation, just 44% of older Americans ages 50 to 80 have ever used a health app. Those in poor health are least likely to have done so. However, those with higher incomes and education are much more likely to have used health apps.
As we embrace breakthroughs in digital health, let’s not cut, paste and proliferate the health equity issues of the offline world. We can only claim success when we measure who’s engaging, who’s not and why. Let’s create and reward a digital health ecosystem that is responsible for tackling socioeconomic barriers, by design. While no company has the silver bullet, we can get beyond “check-the-box” answers and deliver equitable care through digital health.
It starts with awareness
Information about new virtual care benefits typically arrives in emails or a company newsletter at work. Just click on the link to download an app and get started — easy, right? What about workers who don’t sit at a desk? What about single moms working two different jobs who don’t check their email every day?
How do we reach the elderly with multiple chronic conditions who don’t have an email address at all? The range of technology access issues is vast, and we need to meet members where they are — in the community, at clinics, by phone, on billboards, on social media, at work and at home. “Surround sound” means we understand the various offline and online environments applicable to diverse populations and we meet them there.
Crossing the tech literacy chasm
When reaching out to socioeconomically diverse populations, trust matters and we’re responsible for earning that trust. When seeking engagement in new tech-based benefits to improve health, we run into various tech literacy issues: “I don’t download apps,” “I don’t remember my App Store password” or “I’ve never used a smartphone.”
If we pay attention, we can overcome these barriers. One virtual chronic care company built a service center entirely focused on enrollment support. This walked patients through the app setup process step-by-step, providing a hands-on tour of all the features in the app, and even helping them with resetting their App Store passwords when necessary.
In addition to its mobile app, the company offers a web-based version of their chronic care programs as an alternative for those without smartphones. Paying attention to tech literacy at the beginning of the process enables caregivers in the app to support and encourage patients.
The hidden truths about the hard-to-reach
Tackling tech literacy alone isn’t enough. If we take the time to look more beyond the top layer, we discover deeper human issues. “I’ve had these conditions forever, nothing is going to change.” “I’m overwhelmed, I can’t start something new.”We can’t transform healthcare until we overcome the deeper issues — feelings of hopelessness, isolation, food insecurity and affordability.
For digital health solutions, this starts with uncovering the truth about each individual. If a person is “off the grid” because of various health and life realities, AI and bots alone aren’t going to help. Human connection matters, and care team members who are trained appropriately in motivational interviewing can empower people to take charge of their health, even in difficult circumstances.
Human providers can think out of the box when they learn that their patient’s closest grocery store supplying vegetables is 30 miles away (and that they’re getting frozen vegetables from the local Dollar Store instead). Technology and data can find the most affordable alternatives for medications, but it’s the human connection with a provider that makes the biggest difference. The best digital health companies combine the human element of connection with the power of technology to deliver outcomes.
“Speak my language, please”
Connecting with ethnically diverse populations goes way beyond using Google Translate to change a lesson from English to another language. An Indian patient with a heart condition seeks out an Indian doctor because they think the doctor will understand why rotis, rice and lentils are central to eating patterns. It requires truly understanding a person’s customs, food, language and community.
Technology can shine on this dimension. Machine learning can be used to personalize content according to ethnicity and member preferences. App-based nutrition guidance can recognize the difference between plantains and bananas and modify portions of arroz con pollo to reduce carbs. App-based peer groups can pull together Latin community members trying to manage stress, lose weight or manage diabetes.
We can create equitable health care through digital health, and these are just a few ideas to start. If we sow the seeds of social consciousness as we innovate, we can break down socioeconomic barriers to health.
Photo: PeterPencil, Getty Images
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