Guest posting by Charles Ho
A major conversation in the field of digital health revolves around the “digital divide”, which is the notion that certain groups of people are segregated due to their different habits of technological use. One particular topic in this overarching subject is the development of mobile healthcare technologies that are tailored to meet the needs of a population not typically associated with innovative technology, namely those who are elderly or low-income. Unfortunately, many new mobile applications and “wearable” technology are not geared towards those with chronic health conditions, which represents a great deal of health issues in the aforementioned populations1.
The Center for Health Care Strategies is currently holding a competition which challenges software developers to create a digital health solution which targets the needs and backgrounds of “low-income, high-need” individuals2. I find this to be very worthwhile effort, since it raises awareness that some of the seemingly simple things in life, such as nutrition and other social determinants of health, can be a platform for digital health interventions.
Although many people do not expect low-income individuals to be major consumers of mobile technologies, such usage is becoming increasingly prevalent. The “digital divide” less reflects the difference in access to such technology but rather the disparity in effective engagement with these digital technologies. For instance, a study has shown that a majority of those who are homeless have smartphones.3 Thus, digital health represents a huge opportunity to implement an impactful intervention for their well-being, if such as solutions are designed the right way.
Potential solutions that are worth pursuing need not be strictly associated with the patient’s health. There are numerous other factors that impact a person’s health, such as transportation access to a clinic. Perhaps it would be beneficial to develop an app that provides the most optimal public transportation route for a patient to access the nearest clinic they are eligible to be seen at. It can be interactive and real time, taking into account the patient’s specific needs as well as real-time tracking of buses and trains. This could also be used to gather location data and allow public health officials to better target mobile health campaigns. Such a digital health tool may help the low-income population access healthcare in a more convenient manner.
These types of technological solutions, which nowadays appear seemingly ordinary, can make a much larger impact on population health than some of the more popular health apps, which address fitness and tracking personal health data. Before jumping on board, these solutions targeting the low-income population need to ensure that they know how to operate these devices and if their wireless connections are reliable, such as ensuring they have a sufficient data plan on their smartphones. This is just one complication that needs to be addressed. That said, designing effective software applications for the low-income population can be an impactful component for addressing healthcare disparities.
REFERENCES
[1] Wired. “Wearables are totally failing the people who need them most”. <http://www.wired.com/2014/11/where-fitness-trackers-fail/>
[2] Center for Health Care Strategies. “Digital Health Developer Challenge Targets Low-Income, High-Need, High-Cost Population” http://www.chcs.org/news/digital-health-developer-challenge-targets-low-income-high-need-high-cost-population/
[3] Johns, M. “The US homeless turn to smartphones and iPads to survive”. Business to Community.
http://www.business2community.com/tech-gadgets/the-us-homeless-turn-to-smartphones-and-ipads-to-survive-0375464
[4] iHealthBeat. “Low-income patients interested in digital health communication”
<http://www.ihealthbeat.org/articles/2013/2/27/lowincome-patients-interested-in-digital-health-communication>