Technology Addressing Health Inequality
Last year, The Department of Health published data showing that those living in the poorest areas of the UK still run a greater risk of premature death, presenting to A&E as an emergency case, or seeing a child die soon after birth, compared to their wealthier counterparts. This is despite the continual government pledges to address such inequalities.
“For the poorest in the country this is a double whammy of early death and poorer health while still alive. They are going to die younger and are facing 20 more years of life spent in poor health relative to the richest. This should be a wake-up call to ministers.” David Buck, a Senior Fellow at The Kings Fund
Because of these statistics I still think that health technology today is one of the most exciting places to work. By recognising and embracing the importance of technology in the populations world and incorporating it into patients ecosystem of support, we could begin to reduce and potentially eliminate the UK’s health inequality.
46.4 million people in the UK now own a smartphone and this number is predicted to rise to 53.96 million by 2022. This is not just localised to the UK. A similar rate of adoption is seen across the EU. Like never before the UK population has access to information, via their smartphone about not only healthcare issues in general but their own wellness. However, having access to this information does not necessarily mean that populations access this information or indeed, understand it when they do. This is especially true of populations in lower socio-economic backgrounds.
Health literacy can be defined as ‘the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health’
Health information in its current form is written at too complex a level for 43% of working adults, rising to 61% if the information includes numerical values2. Lower levels of health literacy impact clinical outcomes and mortality generally caused by lower educational levels and as a result; unhealthy lifestyles.
“Health literacy is a social determinant of health and is strongly linked with other social determinants such as poverty, unemployment and membership of a minority ethnic group3.” World Health Organisation.
Understanding populations through social channels, generalised pre-determinate behaviour, demographics, geo-location and engagement with their smartphone, we can increase awareness of information, tools and services that could help support populations with interventions that lead to a change in behaviour, mitigating long-term chronic conditions and improving overall engagement.
Smartphones are providing greater access to healthcare services. For example, Babylon now provides FaceTime appointments to not only GP’s and primary care services but also specialist care such as Dieticians, Endocrinologists and Gastroenterologists. It can also triage patients upfront, in natural language, with a chat bot making it easier for patients to see the right people quickly, and explain symptoms using language that makes sense to them, humanising the experience.
Other specialised applications are also providing support, such as Betterhelp: providing users with real-time access to therapists and Health Tap, which allows users to ‘build their own care team’ and using AI find answers to symptoms, as well as setting personal health goals and getting checklists for coaching from specialists, to achieve these goals. Previously this type of intervention and care would have been restricted to more affluent populations as the employment of these specialists would have cost substantial amounts of money.
Finally there is Echo, linking patients with their primary care centres and enabling the, to have their repeat prescriptions sent straight to an address that is convenient for them. This means the patient has less missed repeat prescriptions, and GP surgeries (potentially) have more available appointments as patients no longer need to continually go to the doctors to get repeat prescriptions approved.
These applications are available on smartphones to everyone.
Intervention and Support
Smartphones are continually tracking all kinds of information about us. From our activity, sleep and movement down to interactions, usage and engagement with applications. This level of information, once contextualised can be one of the most powerful tools an individual has at their fingertips to enable them to take ownership of their healthcare.
Generally people do not want to be continually reminded that they have a condition, but they do want to be informed if something is going wrong, or something could affect them, so that they can take action.
Overlaying data that is being collected via the smartphone, and even from wearables, gives us the opportunity to contextualise this information with additional information about their condition without (in some cases) the patient even having to enter anything.
This level of interventional care could mean that patients seek help sooner, mitigating worsening issues later on down the track. It also means that patients can get earlier access to support systems and appropriate treatments through the earlier identification of issues and tracking of worsening or changing symptoms.
Technology would previously have been a barrier to some patients prescribed medications or diagnosed with diseases that have complimentary patient support programmes. However, smartphone usage now outstrips computer usage with some households not owning computers and instead opting for tablets or smartphones only. This means that technology is not only mainstream but is providing people with diagnostic support and interventional care, as well as support once diagnosed and on medication. The smartphone is improving adherence and engagement through access to information and services previously out of reach to lower socio-economic populations.
Levelling the Playing Field
The economic diversification of the smartphone market has enabled greater access to broader demographic populations and the potential to level out the playing field across different socio-economic groups is huge.
The smartphone enables an increased understanding of users through engagement data, access to information and resources that resonate with diverse populations through user understanding, applications and services that increase access to diagnostic information, interventional care and support services, and its potential to bridge the gap between the rich and the poor is massive.