The following is a guest contributed post from Matt Joseph, CEO & Founder of Locent
Providers have long faced the challenge of delivering care to many different types of people. Illness is colorblind and its correlated suffering is universal. However, the recent shift towards value-based care implicitly assigns financial penalties to those providers that fail to support underserved and diverse groups.
Among other initiatives, the CMS’ Hospital Readmission Reductions Program (HRRP) penalizes hospitals for readmitting patients for the same illnesses within a preset period. Hospitals must therefore find ways to ensure the recovery of all patients – including low-income and uninsured patients – or literally pay the price. As a result, the stakes are higher than ever to reach discharged patients and guide them actively through recovery.
Choosing the right technologies to account for demographic and economic disparity in patients is difficult, but the implications are significant. As a son and brother to diverse physicians, as well as an advocate for diversity in technology, I’m all too familiar with the impact of bias inside and outside of healthcare. But technology can quickly close the gap between healthcare providers and diverse communities.
On the surface, this is an issue of establishing fair technology standards. However, technology merely reflects the motivations of its creators. Providers must take special care to account for implicit biases in the technologies they implement.
Much of the Technology Already Exists
Healthcare IT is having a moment. With $1.65B invested in healthcare startups in the last year alone and $30B in federal subsidies doled out to promote the adoption of EMR systems, healthcare IT is transforming the practice of medicine. Yet concerns abound that socioeconomic factors will continue to prevent large segments of the population from receiving the care they need. While it seems clear that technology holds the keys to improving population health, healthcare providers struggle to choose from hundreds of thousands of mobile apps, wearable devices and consultancies to address their new mandates.
While emerging technologies like artificial intelligence will play a meaningful role in improving population health in diverse communities, many widely distributed technologies are better positioned for immediate impact. According to a study by the Pew Research Center, smartphone penetration among Blacks and Latinos is 70%, nearly 10 points higher than Whites. Furthermore, these diverse groups are more than 3 times as likely as Whites to be smartphone-dependent, meaning they have few options for going online other than their smartphone. As a result, m-health is critical to reaching diverse populations.
From omnipresent technologies like social media and messaging services, to wearable health trackers for improving information sharing between doctors and diverse patients, these ‘household technologies’ can help healthcare providers engage with diverse patients, and more effectively monitor, analyze and improve their health. Here’s a closer look at how.
Social Network Presence to Increase Trust of Doctors
Research last year from University of Pennsylvania’s Population Studies Center found that diverse groups across the country are less likely than white patients to trust or believe that their doctors care about them. One way healthcare providers can begin addressing this problem in the digital age is to establish connections with diverse groups using social media, where they are particularly active. Facebook has noted, for instance, that Blacks are three times more likely than the general population to make a status update on social media and six times more likely to physically check-in to a location on social media.
Social media allows healthcare professionals to connect with patients personally and distribute relevant content. While providers must be careful to shift any discussion of personal health information to compliant channels, social media networks can establish relevancy with diverse communities online and give patients confidence in their healthcare providers. In addition, opening online profiles to feedback, reviews and ratings can provide transparency to diverse patients with concerns about bias in their care.
Fitbit and HealthKit Ease Sharing Information & Encourage Health Goals
Popular wearable devices are becoming treasure troves for health data, even saving patients’ lives in some cases. They’ve also become powerful fashion statements for style-conscious consumers. As chronic diseases like obesity, hypertension and arrhythmia disproportionately affect diverse communities, physicians must encourage patients suffering from these conditions to take care into their own hands before they present acutely. Wearables like Fitbit can help diverse patients track and share daily health information with physicians as they manage chronic conditions.
While wearables are feasible for some diverse patients, not all can afford the $80 baseline products. For price-sensitive consumers, many smartphones come equipped with health services that allow patients to track health information over time. Services like HealthKit can empower patients looking for alternatives and add-ons to wearables. Furthermore, Samsung’s Galaxy S5 was first mobile phone equipped with heart rate monitor in 2014 and nearly all smartphones released thereafter have built-in health-tracking functionality.
Text-messaging to Increase Adherence to Treatment Regimens
Only 50% of patients adhere to their treatment regimens for chronic conditions and it doesn’t appear to be improving in certain minority communities. A longitudinal study of prescription drug adherence between 2002 and 2010 from researchers at the University of Tennessee Health Science Center (UTHSC) found that African-American and Hispanic patients trailed whites in adherence to common prescription drugs.
Despite its relative age (23), SMS is the most widely used mobile application in the world, outpacing classic mobile services like email, voice, and social networks. According to studies, black patients are the most receptive group to receiving health information via text (Fox and Duggan, 2012). With that in mind, SMS could present a silver bullet of sorts for health care providers seeking solutions to improve diverse patient adherence. And with estimates on healthcare savings from better adherence ranging from $80B to $290B per year, both providers and patients have a tremendous incentive to create better adherence habits outside of the obvious health implications.
