Health equity in America is a broad topic, and I’m sure there are people with more expertise than me in this field. However, as a black person, as the CEO of a medical technology company that works with thousands of clinical organizations, I believe I have an obligation to learn, speak up, and act.
As healthcare becomes increasingly digital, and as we continue to see billions of dollars invested in the technologies that support these digital interactions, I wonder if we’re putting the cart before the horse. If the first step in the process is not understanding the unique needs of different patient and clinician groups, can effective tools and solutions be designed? The “run-before-the-run” approach to technology often creates an uneven playing field for patients, but it doesn’t have to be.
recent JAMA article Focusing on Digital Health Equity states that digital health has the potential to “address some of the structural challenges of marginalized populations, including lowering barriers to access over time and distance, as well as providing tailored communication through language and literacy.” The article warns, “If this digital ecosystem moves forward without active participation, planning, and implementation, the digitization of healthcare can also compromise health equity.” It’s like designing an app for people with diabetes and assuming that every patient is Own – and know how to use – a smartphone. Smartphones are undeniably popular, but there are still many patients who, for one reason or another, don’t think this app-based interaction is feasible. These very basic barriers need to be part of every conversation and decision before a digital health product can be brought to market.
It’s also true that digital health companies may not traditionally be seen as part of the “spearhead” when it comes to addressing health inequalities. They are on the list, but they may not be at the top. In a world where digital tools increasingly facilitate healthcare delivery and interactions between patients and providers, and the makers of these tools count hundreds or even thousands of healthcare organizations as customers, technology should be a central part of the discussion.
Health equity is a challenge that requires many different actions from all of us. It can be overwhelming. Here are three common-sense actions I can recommend to anyone in healthcare IT who wants to take steps to make a real, positive impact on health equity.
Hear from stakeholders
You probably already know this, but it needs to be repeated: the voice of the customer is arguably the most important. What types of barriers do they see in hospitals and health systems? What does the data show? For example, we conducted a study related to ED wait times with a large health system client in the Northeast, and the data showed that patients whose first language was not English had four times longer wait times. This feedback and insight is invaluable – it comes directly from someone who has firsthand experience with the challenges that persist in the industry. It also allows digital health company leadership teams to develop corporate strategies that alleviate some of these pain points and inequalities by equipping provider organizations with better technology. Since I’m just part of such a leadership team, I’d say we should all take this feedback to heart and take the time to think about how to build products that positively address healthcare inequities and care disparities. Listen to your key audience!
Who is building your product?
Diversity is key to understanding blind spots. In the healthcare system, bias exists not only among providers, but also among the people who make the products they use every day. Therefore, companies need to assess who is actually building their products. Whether they’re discussing which engineers are coding the product or which strategy teams are developing a roadmap for the future, diversity matters. Bias in the engineering workforce can lead to bad or ineffective products that don’t work for everyone. Companies can address this by taking some time to think about who should be on the team, why they should be on the team, what their perspectives are, and whether their biases (because we are all biased) create harmful blind spots.
It’s not about favoring one set of opinions or ideas over another. It’s about filling your table with enough diverse viewpoints to produce products and decisions that resonate with a wide audience. Nor is it seeking general consensus, as I firmly believe that healthy disagreements can be good. The first step is to start a dialogue with your team, and in most cases a sincere effort in this area will provide a clearer path forward for the entire organization.
Location shouldn’t matter
Even across multiple facilities within the same health system, standards of care are not always uniform. I’ve noticed in a very real way that care delivery varies by hospital location, and this difference needs to be factored into internal processes and decisions about technology solutions to ensure care is as uniform as possible. Whether in Alabama, California, Maine, or anywhere in between, patients should be able to confidently expect the same level of attention. It’s important to focus on building products that foster better coordination and engagement so clinicians can communicate more effectively and naturally in any setting. This means messages will be sent to the right people at the right time, care will be delivered more seamlessly, and patients will have a better experience, no matter who they are and where they come from.
Health equity is good business.
As our society evolves at breakneck speed, and so does the healthcare industry, technology and digital health leaders should constantly think about the overall potential impact of our products. How do we make the communities we serve stronger? How can these products help bridge the persistent health equity gap? The first step is to have these deep — and sometimes difficult — conversations. Talk to your customers to understand their challenges and obstacles. Talk to your staff to discover great opportunities to bring new voices and perspectives to important discussions.
From there, put what you’ve learned into action. For me, that means leveraging these courses in a way that helps my team build tools that improve patient access and engagement, while making it easier for clinicians to coordinate care. That’s the beauty of it all – when you use health equity as a roadmap, you end up with better products that better meet the needs of your customers and the patients they serve. It turns out that doing the right things can be the foundation of a stronger, more profitable business.
