Healthtech has already seen incredible innovation over the past five years: Doctors are recommending an Apple Watch for patients who previously would have gotten a prescription for a heart monitor. Primary care physicians can diagnose their patients with common illnesses through telemedicine solutions. Consumers can get preventative and maintenance prescription medication through mobile applications without a visit to their doctor.
While these are all convenient for patients and expand the reach of physicians, these benefits are primarily available to individuals who already have access to quality care and the luxury of choice. Now that digital solutions are becoming more mainstream in healthcare, it is time to focus innovation on healthtech for those who need it most.
The Social Divide
Patients in large, urban areas have easy access to care, right? Not necessarily. Individual resources are a much larger determinant of access than address. Having easy access to a vehicle makes a dramatic difference in a patient’s ability to seek out quality care.
Patients who rely on public transportation are limited to care providers who are along the path of bus or train systems, and it’s not uncommon for public transportation tracks to not facilitate an easy trek between a residence and a primary care physician or specialist’s office. Even though their residence may only be a couple of miles from their care provider, public transportation may force them to travel to the city center and back out another spoke of the wheel on the transit line map. The time and cost associated with the commute makes it more expensive and difficult to access care.
Rural residents fight a similar battle for healthcare access. With the continued closure of rural hospitals, patients who already lived at a hefty distance to their care providers are finding themselves even more isolated. Specialists tend to be clustered in densely populated areas where they are more likely to find enough patients to maintain a practice. This leaves rural residents to decide whether they can afford to take the majority of a workday to commute to a county or two away to see a specialist. As a result, rural patients are seeing far more chronic conditions and higher morbidity than their suburban and urban counterparts.
Innovating for Chronic Conditions
Technology is already making strides in offering mobile solutions to support those with chronic conditions. From the Birmingham-based digital health coach Pack Health to New York’s Upside Health, one of the consistently proven ways to improve outcomes for chronic conditions is to frequently engage the patient. Upside Health’s mobile app, Ouchie, connects pain management patients with their doctors and a supportive community to better control pain.
“By offering patients insights into their daily updates regarding their condition, helping them set functional treatment milestones and then delivering this regularly to providers, clinicians and staff are increasing patient accountability, engagement and experience. Numerous studies have drawn a strong correlation between compliant, engaged patients with chronic illnesses and better outcomes,” Upside Health founder Rachel Trobman said.
When these patients live in rural communities or rely on public transportation, chronic conditions are more likely to be left untreated or not monitored as closely simply due to the challenge of connecting with a care provider. Expanding technology solutions to engage these patients can make measurable improvements on quality of life.
Preventing chronic conditions from worsening is at the heart of Kustom Kinetics, which uses their mobile app to provide free durable medical equipment (DME) to nursing home patients to prevent hospitalizations, backed by Medicare’s I-SNP program.
Access to quality care is challenging enough when the only influencing factors are geographic location and socioeconomic status. Add consideration for disabilities, and access becomes even more difficult. Visible and invisible disabilities alike can drastically lower an individual’s opportunity to attend a doctor’s appointment in person. Transportation can be challenging, the process of waiting can be anxiety-inducing, and the exposure to the environment of healthcare facilities can be overwhelming.
Telemedicine allows individuals with disabilities to avoid the stress and time of commuting to a healthcare facility. Patients can meet with a healthcare provider in the safety and comfort of a familiar setting through a mobile device or computer. This is especially valuable for children with developmental disabilities.
App2Talk has been providing a low-cost augmentative and alternative communication (AAC) solution for families for six years. Traditional AAC devices are expensive and can be difficult to get covered by insurance. App2Talk’s innovative approach to providing software solutions to those who need it most are giving a voice to non-verbal children with autism in their homes and schools.
Even if patients can physically visit a doctor’s office, it doesn’t mean they will. Groups that still face stereotypes to this day, such as LGBTQIA+ individuals seeking sexual health testing and counseling, have the additional challenge of overcoming stigma to seek the healthcare they need.
“There is a persistent and unmet need to reach underserved populations in ways that these groups deem as acceptable. For example, I work with youth who are sexual and gender minorities. Due to stigma in healthcare settings, they may prefer accessing care via telemedicine with in-home laboratory services,” Dr. Henna Budhwani, medical sociologist at the University of Alabama at Birmingham, said.
“From my vantage, we need to apply innovative technological interventions and strategies to improve care and in medical education, such as the use of virtual reality for simulations to address severe maternal morbidity in rural communities or using text reminders with personal digital monitoring to improve medication adherence for those with chronic conditions.”
Innovation that allows individuals to access the quality care they need without facing the risk of third-party harassment or threats is key to keeping communities healthy. This requires easy, non-intrusive user experiences that allow patients to feel safe, both physically and socially, while actively monitoring their health.
Healthtech hinges on the availability of patient data, whether it’s manually input by the patient, collected by a connected health device, or shared by their doctor. Because of the heavy regulations on protection of healthcare data, new players in the field can face immense challenges to get access to the right data and approve the flow of that data between involved parties. Privacy is still essential, but not to the point that the patient’s health suffers.
The COVID-19 pandemic forced innovative thinking to move even faster, resulting in Apple and Google’s partnership for exposure notification. GuideSafe, Alabama’s exposure notification mobile app, leverages this anonymous key exchange to allow a technology solution without revealing health data from patients or doctors.
An overwhelming majority of US adults are in strong favor of increasing their own access to their health data. Making this data more accessible through connected health systems enables innovators to move faster and improve outcomes for more patients. Empowering clinics to make their own choices about what software systems to adopt also speeds the process, rather than relying strictly on hospital system decisions for all clinics and practices under the umbrella.
Transitioning the insurance industry to accept multipurpose connected health devices instead of single-function hardware is also a crucial step toward improving patient access to quality care. For example, while a heart monitor or pedometer is easily categorized as a prescribed device by a doctor, the number of measurements that can be collected through an Apple Watch are far more comprehensive in painting a picture of the patient’s health as a whole and can better inform a physician regarding treatment plans.
Healthcare innovation has made great strides over the past decade, but it’s nowhere near completion. Now is the time to focus new applications on increasing access to care for all patients, regardless of socioeconomic status, geographic location, or disability. The health of our future society hinges on it.