The most common question that any member of The Medical Futurist group has to answer is this: Can digital health tools solve health inequity? You don't need to read long articles. Here is the quick answer: They might. But not now, and not clearly.
Two trends can be seen based on the growing amount of quality data available on the subject. Digital health tools can be used to bridge gaps and provide opportunities for leapfrogging in certain cases. A great example of this is Ghana's use drones to deliver blood or vaccines. Another example is the steady rise in adoption of digital health tools by women of color in the US. This could be due to the poorer than average health outcomes that they have in traditional healthcare.
These are just a few examples of data that show a dire picture. Figures show that the underrepresented and/or disabled (poor, rural minority, women, LGBTQ, etc.) have less access to cutting-edge digital health solutions. The gap isn't closing but it's actually growing.
What is digital health literacy? What does that mean?
These definitions are crucial to understand what digital health can and cannot do.
Health literacy. Individuals' ability to understand, find and use information and services in order to make informed decisions about their health and those of others.
Digital literacy. The concept is the same but online tools and resources make it easier. Officially, it is “the ability to search, find, understand and appraise health information from online sources and to apply the knowledge to solving or addressing a health problem.”
Health equity. When everyone is able to achieve their full potential in health and well-being, then that's called Health Equity.
Why is this important? There are many reasons why this is important. It is important to know how to proceed if someone experiences worrying new symptoms. This will affect how quickly they find the relevant information and whether they are able to distinguish between reliable and subpar sources that offer different treatment options.
These skills are necessary to understand health management, the benefits and limitations of wearables, and how they can provide data, and how telehealth apps may be used to manage chronic conditions. It all comes down to structural inequalities. If I lack basic literacy and financial resources, I won't be a target customer of an expensive and complex smartwatch that collects my health data and offers bespoke monthly subscriptions with access first-tier specialists who analyse my data.
You will see the point. A digital tool for digital health is just that. It does nothing on its own. Advanced arrhythmia screening is theoretically possible, but it will not have any tangible health benefits unless people have access to the tool as well as a better understanding of its benefits.
No arms, no chocolate
Digital health tools today, despite their potential to provide care to people without access to it – in practice they deliver the best for those who are least in need. Urbanites, wealthy, and well-educated patients can buy the gadgets and accompanying services. They can also do their research. Surveys show that digital health is helping those who have access to the best healthcare through all channels.
The most important thing to do in order to harness the potential of digital health tools is to help people use them. Helping others use them is the most important factor. It can be done by healthcare professionals and centralised initiatives that aim to mentor peers.
Train the patients, and train the trainers
Healthcare professionals who are dedicated enough to patient care should first identify patients with low digital literacy. Experts recommend a list of questions that can be used to identify patients with low digital health literacy. It is possible to determine if a patient can be reached via e-mail and if they have broadband internet access.
Patients who are “flagged”, meaning they don't use e-mail, can benefit the most from personalized and hands-on advice from practitioners. Instead of suggesting that they download this or that app, a practitioner can show them how to download the app and how to use it. This will increase engagement and adherence.
Instead of telling them about the possibility of scheduling visits online, it is better to walk them through the process. It will be much more effective to suggest specific information sources that they can trust, rather than suggesting they read more about their special diets.
We can't all provide a full-time mentor in professional health. Here is where the train the trainers’ models shine.
We can train other members of the community, who will then be able to (and willing to) pass on their knowledge to their peers. My husband will appreciate the online scheduling system if I know how to use it. I can show my diabetic neighbour if I am aware of an app that helps manage the condition. If I knew more about smartwatches and how they can monitor cardiac parameters, I could explain to my colleague with high blood pressure why he may want one. I also know what to look out for when using them.
These are just a few of the many interesting initiatives. The NHS has launched a program to train digital mentors. However, this is geared towards healthcare professionals. Peer-to-peer mentoring has been shown to be a positive method for helping diabetes patients.
Disruptive technologies tend to open up gaps before they close them.
It is difficult to predict how quickly digital health will become a reality for everyone. However, if we look back at the past examples of disruptive technologies that spread – and no one called them that – we can see that they tend not to close the gap immediately but to increase it later.
Electricity to washing machines, polio vaccines and mobile phones – each benefit was not available to everyone at first. But eventually, they became the norm.
The post Will Digital Health Widen or Close the Health Inequity Gap The Medical Futurist first published this article.
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By: Andrea Koncz
Title: Will Digital Health Widen Or Close The Health Inequity Gap?
Sourced From: medicalfuturist.com/will-digital-health-widen-or-close-the-health-inequity-gap
Published Date: Tue, 14 Jun 2022 08:00:00 +0000
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