Health equity in America is a vast topic, and I’m sure there are people much more expert in this area than I am. However, as a Black man, and as the CEO of a healthcare technology company that works with thousands of clinical organizations, I believe it’s my obligation to learn, speak out, and take action.
As healthcare becomes increasingly digital, and as we continue to see billions upon billions of dollars invested in technology that enables these digital interactions, I wonder if we’re putting the cart before the horse. Can effective tools and solutions be designed when the first step in the process isn’t learning about the unique needs of different patient and clinician populations? The “run before we walk” approach with technology has too often created an unbalanced playing field for patients, but it doesn’t have to be this way.
A recent JAMA article focusing on digital health equity stated that digital health has the potential to “address some of the structural challenges for marginalized populations, including lowering access barriers of time and distance and providing tailored communication by language and literacy.” The article cautions that the “digitization of health care can 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 patients with diabetes and starting with the assumption that every patient has—and knows how to use—a smartphone. Smartphones are undeniably popular, but there are still plenty of patients for whom this kind of app-based interaction is just not feasible for one reason or another. These very basic obstacles need to 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 inequalities. They’re on the list, but they’re probably not at the top. In a world where care delivery and patient-to-provider interactions are increasingly facilitated by digital tools, and the makers of those tools count hundreds—even thousands—of healthcare organizations as customers, technology should be a central part of the discussion.
Health equity is a challenge that requires all of us to take many different actions. It can be overwhelming. Here are three common-sense actions I can recommend for anybody in the healthcare IT space who wants to take steps toward having a tangible, positive impact on health equity.
Listen to stakeholders
You probably know this already, but it bears repeating: The customer voice is arguably the most important one. What types of barriers are they seeing in their hospitals and health systems? What is the data showing? As one example, we did a study related to ED 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 English. This kind of feedback and insight is invaluable—it comes directly from people with firsthand experience about persistent challenges in the industry. 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 inequalities by equipping provider organizations with better technology. Because I’m part of just such a leadership team, I’ll say that we should all 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 primary audience!
Who’s building your products?
Diversity is key to understanding blindspots. Within the healthcare system, bias doesn’t just exist among providers—it also exists among the people who build the products they use every day. As such, companies need to evaluate who’s actually building their products. Whether they’re discussing which engineers are coding the products or which strategy teams are putting together the future roadmap, diversity matters. A bias in the engineering ranks may lead to bad 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 if their biases—because we all have them—might create harmful blindspots.
This isn’t about favoring one set of opinions or ideas over another. It’s about filling your table with perspectives that are diverse enough to yield products and decisions that resonate with a broad audience. And it’s not about seeking universal agreement, either, because I firmly believe that healthy disagreement can be good. The first step is opening up a dialog with your team, and in most cases, sincere efforts on this front provide a clearer path ahead for the entire organization.
Location shouldn’t matter
Standards of care are not always uniform, even in multiple facilities within the same health system. I’ve noticed in very real ways that care delivery varies drastically depending on a hospital’s location, and this discrepancy needs to be incorporated into internal processes and decisions about technology solutions to ensure that care is as uniform as possible. Patients should be able to confidently expect the same level of attention whether they’re being admitted in Alabama, California, Maine, or any state in between. It’s important to focus on building products that foster better coordination and engagement so that clinicians in any setting can communicate more effectively and more naturally. This means messages will get to the right person at the right time, care will be delivered more seamlessly, and patients will have a better experience, regardless of who they are and where they’re coming from.
Health equity is good business.
As our society evolves at a breakneck pace, and the healthcare industry along with it, technology and digital health leaders should constantly be thinking about the total potential impact of our products. How can we make the communities we serve stronger? How can these products help to bridge persistent health equity gaps? The first step is having these in-depth—and sometimes difficult—conversations. Talk to your customers to understand their challenges and roadblocks. Talk to your people to surface good opportunities for bringing new voices and perspectives to important discussions.
From there, put what you’ve learned into action. In my case, that means harnessing 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 health equity as a guidepost, you’ll end up with better products that more closely 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, more lucrative business.