If you keep company with early adopter tech types, it might seem commonplace to book doctors’ appointments online or track activity with any of several new wearable sensors. But while digital health is gaining ground, it still has a ways to go before its most innovative applications hit mass adoption. And as bleeding edge individuals and companies embrace new ways of receiving and delivering healthcare, it’s critical to consider how new health technology can reach people in all communities – not just the country’s elite pockets.
That point was driven home yesterday during a Social Media Week panel I moderated on How Behavior and Patients Can Fix Health Care. I was chatting with three health tech entrepreneurs, Dr. Jay Parkinson, co-founder of Sherpaa; Unity Stoakes, co-founder of Startup Health; and Derek Flanzraich, founder of Greatist, about how they and their organizations are changing health care, when one of the audience members commented that the conversation felt too “self-referential” and asked how to close the behavior gap in health technology. (You can see the whole discussion here.)
It was an entirely fair question – and one that I hope all health technologists ask themselves regularly. While technology, especially mobile devices, is more ubiquitous than ever, there are still disparities in broadband access, availability of digital tools and information about new services. The Pew Internet & American Life Project, for example, reports that Latinos (55 percent) and African-Americans (58 percent) are less likely than Whites (75 percent) to have a home Internet connection. Not surprisingly, Pew also says that those with more education and higher incomes are also more likely to go online for health care information – 78 percent of those who earn more than $75,000 vs. 45 percent of those who earn less than $30,000.Keep early adopters happy, let them help spread the word
On the panel, Dr. Parkinson said that Sherpaa, which works through employers to provide 24/7 access to doctors via email and phone, targets companies like Tumblr and General Assembly because “you have to start with people that get it.”
“If Facebook or the iPhone started marketing to my parents first they wouldn’t have taken off,” he said. The economics of healthcare is slow (especially relative to the pace of technology) because it’s defined by the government, but by keeping early adopters happy and buzzing about their experiences with Sherpaa, he said he hopes they can gradually educate more and change the system.
Another way to bring the masses into the new health movement is by making it more accessible and relatable through trusted brands, said Flanzraich. In the last year, Greatist, a health and fitness content site that’s part Buzzfeed, part fitness magazine and part health journal, has nearly doubled traffic to just under two million unique visitors. And he said those users, who are mostly from outside early adopter hubs New York and San Francisco, are drawn in because the site connects important health news to pop culture and other topics people already want to read about.
I also added that employers play an important role in bringing health technology to a wider audience. Using Fitbits and Nike Fuelbands that track activity and calories burned may seem like naval-gazing to non-techies, but they could start to mean more if employers reward people for activities logged on those devices, for example, with health insurance discounts or FSA (flexible spending account) credits. At first, it may be the more tech-forward employers that see the value in programs like this. But if companies like employee wellness startup Keas can show employers cost savings, devices that motivate behavior change could matter to even more populations.Report: Better data collection could pinpoint and address disparities
As technology proliferates, innovation is also spreading organically into different corners of the world, noted Stoakes who cited SMS-based efforts that enabled drug authentication in Africa and boosted immunization rates in India.
However, in the U.S., even though early adopter patients and doctors will lead the way, health innovators and policymakers can do more to bridge knowledge and behavior gaps. (At GigaOM’s Structure:Data conference in March, I’ll be speaking with Aetna’s head of innovation about how big data can improve patient care and lower costs.) A report presented at a White House Summit on “ehealth equity” this week outlines a few ways to do that. Written by consumer groups The Asian & Pacific Islander American Health Forum, California Pan-Ethnic Health Network, the Consumer Union and the National Council of La Raza, it offers several recommendations on how health information technology could reduce imbalances in care, particularly in communities of color, limited English proficient groups and immigrants and mixed-status families.
For example, it suggests capitalizing on mobile technology, designing web sites that consider differences in culture and health literacy and developing outreach strategies specifically targeting the underserved.
One area in health IT that could lead to particularly positive improvements is data collection and analysis, the report says. Although it emphasized security to prevent the misuse of data, the report says better demographic information could help identify disparities and lead to services that more appropriately consider linguistic or other cultural needs.
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