When Digital Health announces a new application, everyone seems to think it will improve health. not me.
Where I work, in San Francisco's public health system, in a hospital named after a founder Facebook, Digital solutions promising to improve health feel away.
Patients and service providers in our public delivery system are well aware of the real barriers to using technology to improve health. Low-income patients (almost all of whom receive general insurance) and miscellaneous (more than 140 languages are spoken). Many of them manage multiple chronic conditions. Service providers who care about them suffer from fragmented health records and old communication methods, such as Faxes And Callback.
So when companies tell us they will cure diseases, reduce costs, and save lives using the latest technology, I'm often hesitant.
more than Thirty billion dollars have been invested in digital health since 2011. The resulting technological innovations, such as mobile applications, telemedicine and wearable devices, help patients fight diabetes, chronic disease treatment or weight loss, for example.
However, we have Having seen digital health drive significant improvements in health outcomes and reductions in health expenditure. This lack of impact is due to the fact that digital health companies adopt products that often do not exceed the "troubling well" – healthy people who make up a small proportion of health expenditure and are already involved in the health care system.
If we design health applications for those who already have access to health care, nutritious food, fresh air for breathing and stable housing, we lose this point.
It is not surprising that health applications are inadequate to the needs of low-income, diverse and vulnerable patients when these populations are not part of the user's tests. In addition, the science developed by technology developers is created through clinical trials conducted on participants who often do not reflect the diversity of the United States.
More than 80% of participants in clinical trials of whiteMany are young and male. Women, ethnic and ethnic minorities and older persons should be involved in clinical trials to ensure that outcomes – based not only on product development but also on care and clinical policy – are relevant to different population groups.
Research Conducted by my colleagues at UCSF Center for Population at Risk Shows that low-income patients are unable to access many digital health applications. "I'm going to lose patience with this," said one of our patients, who are testing a popular application to manage depression. He expressed concern that "someone too uneducated would be like," Now, what am I doing here? "However, despite these barriers, the majority of study participants (most of them with smart phones) also express their strong interest in using technology to manage Their health.
While the private sector is fantastic for innovation, it will fail to improve health in a meaningful way without real-world evidence being created in partnership with diverse patients. In addition, these profit-making companies face long-term prospects for their shareholders in a fundamental way without knowing how to reach 75 million Medicaid patients (including one out of every three Californians) who benefit from digital health solutions.
There is an answer, which is at hand. To truly improve health outcomes, digital health companies should collaborate with public health experts and patients not only in evidence-based research, but also to build products that meet the needs of all patients.
Along with the compelling business potential of innovation in Medicaid, the infrastructure to support this business is increasing. For example, organizations like HealthTech4Medicaid The arc of innovation is bent towards patients who are most in need through advocacy and key partnerships with policy makers, policy makers, caregivers and technology developers.
To bring about a real revolution in health, let us ask creative and technology-savvy people to include diverse end users early and often. Otherwise, the application "for it" will have them, not all of us.