Health care equity in America is a vast topic, and I’m sure there are people far more expert in this area than I am. However, as a black man and as the CEO of a health technology company that works with thousands of clinical organizations, I believe it is my duty to learn, speak up and take action.
As healthcare becomes increasingly digital, and as we continue to see billions and billions of dollars invested in technology that enables these digital interactions, I wonder if we are putting the cart before the horse. Can effective tools and solutions be designed when the first step in the process is not learning the unique needs of different patient and clinician populations? The “run before we walk” approach to technology has too often created an unbalanced playing field for patients, but it doesn’t have to be that way.
Recently JAMA article focusing on equity in digital health, stated that digital health has the potential to “address some of the structural challenges for marginalized populations, including reducing access barriers of time and distance and enabling personalized communication through language and literacy” . The article warns that “the digitization of health care may also harm health equity if this digitally enabled ecosystem moves forward without proactive engagement, planning, and implementation.” It would be like designing an app for diabetic patients and starting with the assumption that every patient has and knows how to use a smartphone. Smartphones are undeniably popular, but there are still many patients for whom this kind of app-based interaction is simply not possible for one reason or another. These very basic obstacles must be part of every conversation and decision before digital health products are brought to market.
It’s also true that digital health companies may not traditionally be considered part of the “tip of the spear” when it comes to moving the needle on health care disparities. They are on the list, but probably not at the top. In a world where care delivery and patient-provider interactions are increasingly facilitated by digital tools, and the creators of those tools count hundreds—if not thousands—of healthcare organizations as customers, technology must 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 the healthcare IT space who wants to take steps toward making a tangible, positive impact on healthcare equity.
Listen to stakeholders
You probably already know this, but it’s worth repeating: The voice of the customer is perhaps the most important. What types of barriers do they see in their hospitals and health systems? What does the data show? As one example, we did a study related to emergency medical wait times with one of our large health system clients in the Northeast, and the data revealed that wait times were four times higher for patients whose first language was not is english This kind of feedback and insight is invaluable—it comes directly from people with first-hand experience of the industry’s constant challenges. It also allows leadership teams for digital health companies to shape company strategy in a way that can alleviate some of these pain points and inequities by equipping provider organizations with better technology. Being part of just such a leadership team, I will say that we all need to take this feedback to heart and spend time thinking about how to build products that actively address healthcare inequities and gaps in care. Listen to your core audience!
Who builds your products?
Diversity is the key to understanding blind spots. In the health care system, bias doesn’t just exist among providers—it also exists among the people who create the products they use every day. Because of this, companies need to evaluate who actually builds their products. Whether they’re discussing which engineers are coding the products or which strategic teams are building the future roadmap, diversity matters. Bias in the engineering ranks can lead to poor or ineffective products that don’t work well for everyone. Companies can navigate this by spending some time thinking about who should be on the team, why they should be on the team, what their perspectives are, and whether their biases—because we all have them—could create harmful blind spots.
This is not about favoring one set of opinions or ideas over another. It’s about filling your table with perspectives that are diverse enough to lead to products and solutions that resonate with a broad audience. And it’s not about looking for universal agreement, because I firmly believe that healthy disagreement can be good. The first step is to start a dialogue with your team, and in most cases, a sincere effort on this front provides a clearer way forward for the entire organization.
Location shouldn’t matter
Standards of care are not always the same, even across multiple facilities within the same health system. I have seen in very real ways that care delivery varies dramatically by hospital location, and this disparity must be incorporated into internal processes and decisions about technology solutions to ensure that care is as consistent as possible. Patients should be able to confidently expect the same level of care whether they are admitted in Alabama, California, Maine, or any state in between. It is important to focus on building products that promote better coordination and engagement so that clinicians in any environment can communicate more effectively and more naturally. This means messages will reach the right person at the right time, care will be delivered more seamlessly and patients will have a better experience, no matter who they are or where they come from.
Health capital is good business.
As our society evolves at breakneck speed and the healthcare industry along with it, technology and digital healthcare leaders must constantly think about the overall potential impact of our products. How can we make the communities we serve stronger? How can these products help address persistent gaps in health equity? The first step is having these deep and sometimes difficult conversations. Talk to your customers to understand their challenges and obstacles. Talk to your people to find good opportunities to bring new voices and perspectives to important discussions.
From there, put what you’ve learned into action. In my case, that means using these lessons in a way that helps my team build tools that improve patient access and engagement while making it easier for clinicians to coordinate care. And that’s the beauty of it all—when you use equity in healthcare as a guide, you end up with better products that more accurately meet the needs of your customers and the patients they serve. As it turns out, doing the right thing can be the foundation of a stronger and more profitable business.