Building techquity into the digital healthcare delivery system
Technology is often viewed as a great leveler, opening doors to new opportunities for employment, social connection, and improved quality of life for people from disadvantaged backgrounds.
In many cases, this has been true for healthcare technology. However, as providers rely more heavily on artificial intelligence and patient-facing apps, they must beware of preferential programming that further inequities instead of solving them.
“Techquity” is the strategic development and deployment of technology to advance health equity by carefully considering issues of access, ease of uptake, and sustained engagement with digital solutions.
Achieving true techquity will require developers and providers to understand their populations fully, deeply explore potential barriers to adoption, and actively work with diverse stakeholders to create a digitally-enabled healthcare delivery system that benefits all.
Defining the challenges of equal access to technology
Healthcare has often struggled to offer the same digital experiences available in other industries, acknowledged a panel of experts at ViVE 2022 in Miami Beach.
“During the pandemic, my 82-year-old mother found it easier to order groceries than do a telehealth visit,” commented Dr. Carlos M. Nunez, Chief Medical Officer at ResMed. “Why are Amazon and TikTok so easy and engaging, but healthcare drops the ball? You can buy all the technology you want, but nothing will happen if it’s not designed well.”
Inaccessible technology is “just a waste of time,” agreed Dr. J. Nwando Olayiwola, Chief Health Equity Officer and Senior Vice President at Humana.
“In my previous role at Wexner Medical Center in Ohio, we were very proud to quickly develop telehealth tools for COVID-19. But about 70 percent of low-income patients weren’t using them, either because they didn’t have broadband, there were issues around language, or they weren’t comfortable with it. We weren’t achieving the goals we hoped to because of challenges that went beyond the availability of the technology.”
Addressing hidden biases in an artificially intelligent world
The techquity issue gets even more complicated when considering technologies that inform decision-making. Just a few flaws in an artificial intelligence algorithm can unintentionally disadvantage certain populations, said Nunez.
“My company makes medical devices, including CPAP machines,” he explained. “To design the masks, we have a database of human head shapes that leaned very heavily toward the ‘typical’ CPC patient, which is a white, middle-aged, overweight male.”
“But there are actually a billion people with sleep apnea who need CPAPs, including people of all ages, genders, weights, and races. If we don’t train our algorithms diversely enough, we’re baking inequities into our products.”
The future of healthcare will be largely based on AI, said Olayiwola, rendering it critical to recognize and address these technological blind spots.
“At Humana, we’ve taken the ethical AI pledge to make sure we examine our models with health equity in mind,” she said. “We need to understand the potential places where flaws in code can magnify disparities.”
Incorporating techquity into a long-term vision for health IT
Achieving techquity will require three main ingredients, said U. Michael Currie MPH, MBA, Sr. Vice President & Chief Health Equity Officer for Optum and UnitedHealth Group.
“I like to use the acronym CPR,” he said. “First, we need C-suite alignment and buy-in. Next is persistence in addressing disparities that are very deeply entrenched in our industry and society. Lastly, we need to devote resources to bring this lens of health equity into everything we do.”
Fortunately, techquity is moving in the right direction, he said. “A few years ago, products that actively addressed health disparities were more ‘nice to haves’ than anything else. Now, at Optum and UnitedHealth, we don’t evaluate any product or service without considering its impact on health equity.”
With a concerted effort from all healthcare stakeholders, including patients and caregivers, the industry will continue to move toward equality in technology access, digital accessibility, and data-driven outcomes.
Read more of our ViVE event coverage:
- Aligned incentives, community investment are key for achieving health equity
- Empowering nurses to lead healthcare’s digital revolution
- Bringing the power of the hospital to the home with high-acuity telehealth
- ONC’s 2022 agenda focuses on interoperability to enable the greater
- Maximizing the ROI of investments in healthcare digital transformation tools
- In a COVID-19 world, digital transformation of the workforce goes beyond clinical tools
- How to move beyond cybersecurity compliance in healthcare? Focus on clinician workflows
- Embedding DEI initiatives into healthcare talent recruitment
- Building virtual care infrastructure begins with removal of perceived barriers
- Sutter Health staying agile to improve patient experience with digital automation
- Mayo Clinic is using AI to solve the unstructured data problem for all
Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry. Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.