There has been an incredible rise in technological advancements in the world of healthcare recently due to our sudden need for everything to be digital when COVID hit. While the cases of COVID have gone down and we’ve settled into a new normal, that isn’t the only crisis that we need a tech fix too. We need to start searching for how we can use technology, new or old, to fix health inequality and discrimination.
We reached out to our beautiful Healthcare IT Today Community to get their insights on the role technology can play in working towards health equity. The following is what they had to say and be sure to check out our previous look at Data’s Role in Health Equity.
Gary Hamilton, CEO at InteliChart
To make meaningful progress on health equity, hospitals and health systems will first need to identify existing barriers to care that impact their own patient populations. New legislation will require organizations to document how they screen patients for social determinants of health, analyze patient data, and address healthcare disparities. When selecting patient-facing digital tools, health systems should evaluate platforms on their ability to engage all patient populations. Well-designed technology should enable access to all individuals, regardless of their location, socioeconomic status, native language, or internet connectivity. Remote monitoring tools that encourage shared decision-making and goal-centered patient engagement in the care delivery process can counterbalance the health disparities experienced by socially and economically disadvantaged populations. With greater knowledge of each patient’s challenges, risks, and motivations, providers can more easily address barriers to care and support the best possible outcomes for every patient.
Ophir Tanz, Founder and CEO at Pearl
Any time you’re talking about a more equitable future in healthcare, AI has to be part of the conversation. Objective, consistent and quantitatively-driven diagnosis, treatment planning and outcomes are the foundations of a universal standard of care. AI will enable us both to establish that standard and to expand broad access to it. As healthcare leaders and the general public increase their AI literacy, they can apply their learnings to improve equity in healthcare with investment in AI-driven medical and telehealth systems. And, as we’ve seen with the diagnostic tools coming online across the medical landscape, AI brings ancillary benefits that extend beyond their fundamental clinical utility. In dentistry, for example, AI is rapidly improving doctor-patient communication, increasing patient trust and compliance with recommended care––delivering a subtle but impactful boost to healthcare equity by reducing disparities in how individuals perceive the dental healthcare system and, in turn, manage their own dental health.
Josh Klein, CEO at Emerest Connect
We often overlook the factors of social determinants of health. The reality is our surroundings and environments, including income levels, educational background, access to healthcare, and social and community contexts are strong indicators for health outcomes. Many of the issues are systemic and impact people differently based on race, gender, age, and more. When used correctly, technology can help bridge gaps that currently exist in healthcare because simply speaking, it provides more insights. Whereas a traditional visit to the doctor can analyze one’s physical health in a fixed time, technology can gather data throughout a patient’s lived experiences, helping healthcare professionals understand patient backgrounds, experiences, and personal preferences on a deeper level.
Ben Zaniello, MD, MPH, Chief Medical Officer at PointClickCare and Practicing Infectious Disease Doctor
A lot of time and energy in healthcare technology today goes toward what is often called “high class” problems. Whether it is integrating Apple Watch data, shortening emergency department wait times or providing better concierge care, these interventions can be helpful, or even great. (We do need to automate data collection, who wants to sit in an ER? And many of us can’t get into our primary care doctors, either). But if you look at the real cost of care, where quality collapses, and we act more like a developing nation than the one spending the most on healthcare, there is less innovation. Health equity—ensuring that those struggling to find safe shelter and their next meal, not the next Apple product—receive good–I’ll even settle for adequate care. In order to improve care outcomes, here is where we need new devices, new algorithms, better technology overall. Ironically, gaps in our safety net may be some of the easiest to fill. Our uninsured and Medicaid populations receive some of the most fragmented care due to the difficulty in finding consistent primary care and available specialists. So, let’s make coordination between providers easier, make telehealth more accessible, and ensure everyone has access to not just basic care but informed and connected care.
Alex Rothberg, Co-Founder and CTO at Intus Care
One of the most interesting and significant changes in healthcare right now is the shift towards value-based care. For too long, payers and providers have lived in different worlds, and have met only to butt heads in the arenas of prior authorization, denial of coverage, and claims adjudication. What value-based care (VBC) brings to the table is financial alignment between the people that provide care and the people that pay for it, with a joint goal of providing high quality efficient care, to the great benefit of the patients who are served. Aligning incentives sounds great, but it ultimately results in minimal change without layering in technology and data to provide proactive care at scale.
Preventative care is the holy grail of healthcare because catching a problem early saves money for the payer, leads to better health outcomes for the patient, and removes burden from the healthcare system, which is already facing a staffing crisis. The easiest way to think about preventative care from an economic perspective is as a deadweight loss, and often the greatest opportunity exists in populations that are the most overlooked and whose health is frequently more heavily impacted by the Social Determinants of Health (SDOH) than the clinical health determinants.
Take, for example, a community that lives in a food desert and is unable to reliably access high-nutrition food, or lacks the time to shop and prepare nutritious food. With technology, we can run studies and find that maybe it costs less money to provide nutritional meal kits free of charge than it does to pay for the effects of a low- nutrition diet across a covered population. This creates a great benefit where low-income individuals are able to receive free or subsidized healthy meals, and the insurance company ultimately saves money by covering a healthier population.
The need for VBC is that for interventions that are more clinical in nature, allowing clinicians to take part in the upside of preventative care creates the opportunity for healthcare data vendors to find more powerful opportunities for intervention beyond “unskilled” preventative care like meal prep into more clinically-complex preventative care that addresses a wider variety of SDOH.
Bronwyn Spira, Founder & CEO at Force Therapeutics
There are various multifaceted–and sometimes intersectional–reasons behind health and healthcare disparities, from physical limitations, financial challenges, lack of technology to language barriers and health literacy gaps. For individuals facing these issues, we consistently see lower rates of healthcare utilization and referral as well as higher readmission and complication rates. This can lead to higher levels of functional impairment, worsening comorbidities, and overall health decline. Thoughtfully designed technology that enables remote care can help overcome some of the health equity and access barriers by empowering all patients to access quality care. Such technology can include multiple languages, strong offline access, SMS capabilities for those lacking internet access, and easily digestible education materials, making it possible for more patients to participate in the same evidence-based care at home as they would in person.
Vikie Spulak, Executive Vice President, Strategic Accounts at Carenet Health
As the healthcare industry evolves and introduces new technology, the role of the healthcare consumer continues to expand as they can be in control of all aspects of their care journey. Although technology can be revolutionary, providers still need to educate consumers on what to look for when booking appointments, finding specialists, negotiating medical bills, and more, to ensure proper patient engagement. The healthcare system is broken, and while technology is bringing care into the consumer’s home and tackling accessibility, affordability is still a deciding factor for most consumers when choosing to delay or pursue care. While technology innovations are chipping away at access and convenience, the costliness still remains. Healthcare providers have the responsibility to inform consumers when and how they need to take action in their care. It is imperative to focus on diverse populations, including those on Medicaid receiving necessary treatment, and especially those that lack access to the internet or new technologies.
Andrew Kobylinski, CEO at Primary.Health
Technology rapidly scales scientific learning for the benefit of all, not just the privileged, such as by improving air quality in schools and automating disease management to reduce sickness without disrupting daily life. Affordable and accessible technology can empower local leaders with healthcare expertise, ultimately stopping the spread of infectious diseases and reducing illness severity.
Tanja Dowe, CEO of Debiopharm Innovation Fund S.A. at Debiopharm
Access to the highest level of care is a prevalent issue within the healthcare system. Technology continues to play a large role in healthcare, expediting and reducing the costs associated with the drug development process. The implementation of AI has been instrumental in significantly cutting down the drug development timeline and creating viable drug targets in a more timely and cost-efficient manner. As the geographical and economical barriers that prevent access to lifesaving treatments continue to diminish, healthcare professionals will be able to reach more and more patients in need of care.
Meesha Dogan, Co-Founder and CEO at Cardio Diagnostics Holdings Inc.
Health differences between different groups of people, be it the number of people that get certain diseases or the number of people dying from diseases can be attributed to environmental, social and economic factors such as geography, income, ethnicity, race, level of education, immigration status and sex/gender. Technology can be leveraged to help improve health outcomes for everyone by improving access through remote care and monitoring technologies such as telemedicine and wearable devices to reach those in remote and underserved areas, improve and foster education through mobile health apps that provide health education is multiple languages, and provide tailored health solutions through AI-driven technologies that can aid in the prevention, detection and treatment of highly preventable chronic diseases such as heart disease.
Lindsay Zimmerman, PhD, MPH, Vice President, Bartosch Patient Activation Institute at Upfront Healthcare
Research shows that health outcomes are driven by an array of factors, including underlying genetics, health behaviors, social and environmental factors, and health care. While there is currently no consensus in the research on the magnitude of the relative contributions of each of these factors to health, studies suggest that health behaviors, such as smoking, diet, and exercise, and SDOH factors like social and economic circumstances are key contributors to individuals’ health behaviors and the primary drivers of health outcomes. Technology is well poised to improve health for everyone and shrink equity gaps in that it is multi-fold and can offer higher quality care delivery at a lower cost. But what is especially impactful when technology is introduced is that can offer an improved and more equitable patient experience by engaging all patients in their care in a way that addresses their individual health needs and preferences.
Melissa Urrea, Senior Executive Medical Director at naviHealth
One of the areas where technology and research can improve healthcare is in the area of genomics. The Human Genome Project opened new areas of research and technology and we’ve just begun to understand that different people respond to different medications based on their genetics. This is an area that can fundamentally change how we treat patients and can potentially improve outcomes.
We currently base our treatment of hypertension, in general terms, on race. We’ve observed that African Americans, in general, respond better to calcium channel blockers and diuretics. But imagine how much more specific and effective treatments could be if we designed medications based on a patient’s genetics and not just race. Or better yet, we could prevent diseases from even occurring by modifying the genes that cause them in the first place.
We have to approach medicine with great humility because there is so much more that we don’t know than what we actually do know. Additionally, as the great 19th-century physician Sir William Osler said, “It is more important to know what sort of patient has a disease than what sort of a disease a patient has.” Those words are still true today.
So much to consider here! Thank you to everyone that submitted a quote to us and thank you to all of you for reading! Comment down below or on social media to let us know your thoughts on technology’s role in achieving health equity.
This article was originally published on Healthcare IT Today on May 5, 2023. You can view the article here.