Among the inequalities that exist in America, one of the most outstanding is the health equity gap. This disparity, defined as “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage,” affects millions of people worldwide and is the reason for differences in longevity and quality of health, health insurance coverage, lack of access to care, and quality of care.
At the root of it all are the Social Determinants of Health, or the social and physical environments that affect our health. For many, access to healthy food, housing, and reliable transportation—generally influenced by factors such as socioeconomic status and race—have an immense impact on overall health. If a person is unable to eat healthy due to the cost of nutritious food, or unable to reach their doctor’s appointment due to lack of transportation, their health can suffer. They may be missing out on the care they need to prevent or manage chronic illnesses through a healthy diet, exercise, interventive care, medications, care plans and more. These factors may be long-lasting and impossible to control for those affected.
Closing the health equity gap, therefore, must start with the healthcare system as a whole. And technology may be a great influencer.
Technology in healthcare today
Technology today is dominated by the smartphone. In fact, as of 2021, 15% of U.S. adults use the internet solely via their smartphone as opposed to home broadband services. This is even more prominent in low-income populations, where the amount of those with incomes below $30,000 who depend on smartphones for accessing the internet has roughly doubled since 2013.
With smartphone use increasing, especially among the underserved, our approach to treating patients needs to change along with it. This isn’t limited to smartphones; other advanced technologies such as remote patient monitoring, wearables and medication management systems need to be considered as well, as these are powerful tools to combat the health equity gap. They are also growing in usage. It’s estimated that 30 million US patients—about 11.2% of the population—will use remote patient monitoring devices by 2024. This is a 28.2% growth from 23.4 million in 2020.
Remote patient monitoring, or RPM, tracks stats such as insulin levels and heart rate on wearable devices and transmits the information to a smartphone or tablet. In many cases, this information is shared with a medical provider and used to inform the treatment of the patient. In other cases, the use of mobile health solutions can also prevent an in-office visit, which can be costly and potentially life-threatening—especially when the COVID-19 pandemic continues to send people to hospitals.
The significance of technology for the underserved
Technology in the healthcare arena is even more important for the underserved. Access to care for low-income individuals, for instance, can be improved if they have monitoring devices to tell them and their healthcare provider if their blood pressure is too high, their insulin levels are low or their heart rate is irregular. At-home health interventions such as these prevent a costly—and sometimes impossible—doctor’s visit. In the long-term, these devices help keep patients at home and out of the hospital, saving them money and improving their health outcomes. This is due, in large part, to the low cost of the devices compared to a hospital stay, and the fact that remote patient monitoring is covered by Medicare and 23 state Medicaid programs. They also alert medical providers to a possible health issue before it becomes serious-—crucial for the underserved population, where negative health effects can include higher mortality rates, higher risk of infection and a higher likelihood of hospitalizations.
Health apps and other wearables track more day-to-day data, such as weight, exercise level, food consumption and even mental health. Keeping tabs on these numbers help patients proactively monitor and control their health. Wearables that track steps and sync with a mobile app, for example, can provide insight into daily activity levels that may have gone unknown previously. The result is encouraging more exercise and improving quality of life. Overall, these devices help fight the negative effects of the social determinants of health, encourage healthy habits, and may prevent hospitalizations.
Nothing will change overnight. However, these technological advances could spell the difference between a positive and negative health outcome for the underserved, and, over time, narrow the health equity gap.
While access to and quality of healthcare is an ongoing battle that affects health equity, technology is an important tool that can combat these factors and help eliminate some barriers to care.
Payers and providers should prioritize technology and use it as a tool to improve the lives of their most underserved populations, which allows more people to benefit from the rise of technology in healthcare. For the underserved, however, technology may be the missing ingredient to living a healthier life and closing the health equity gap.