During a presentation this past Friday as part of HIMSS Global Health Equity Week, a public health expert from the UN offered his thoughts on some of the challenges and opportunities for worldwide digital health improvement.
In the discussion, Health Equity: A Global Perspective, Ahmed El Saeed, thematic lead in health at the United Nations Technology Innovation Labs Programme (UNTIL), spoke with HIMSS CEO Hal Wolf.
They described impressive and quickly scaled advances in healthcare technologies since the start of the COVID-19 crisis – but decried the fact that an array of social factors also often conspires to keep vulnerable populations from experiencing their benefit.
“On one hand, we have a lot of innovation being thrown against the wall, a lot of people scrambling for more information and utilizing it in effectively just-in-time capture,” said Wolf. “But then we look up and we see this disproportionate impact of COVID-19. Are we fundamentally looking at a widening of a digital divide in such a situation?”
He added: “The geographic disparities, the inability to gain access, is not just a rural area and it’s not just a situation in countries with limited resources,” said Wolf. “Often there are people living in the shadows of amazing hospitals that do not have access to those facilities.”
Unfortunately, in the U.S. and around the world, a person’s income level, gender and ethnicity still have an outsized influences on their health and their access to care.
Part of the challenge, specifically with regard to the tools developed to help combat the pandemic, is the speed with which they were created and rolled out.
“We’ve seen this rapid digital transformation happen in healthcare systems and healthcare delivery systems across the world,” said El Saeed. “And it was not really something that was planned, obviously. It was something that happened as a rapid response to a health emergency.”
And in cases of rapid responses to health emergencies, “it’s very difficult sometimes to look at the different elements and factors that could potentially be propagated or affected by that type of response.”
The pressure to roll out some of these solutions very quickly, said El Saeed, may have often been to the detriment of the “key principles that we usually advocate for when we are developing similar solutions – which is the importance of designing for the user, listening to the beneficiaries more, trying to contextualize the solution, to really speak to the needs of the communities that are being served.”
For that reason, he said, “unfortunately, there has been, I think, a widening of the digital divide.”
The digital divide is not a new concept, of course. Oftentimes it’s used to describe the situations where underserved populations lack access to the broadband connections that would enable them to take full advantage of telehealth, for example.
But the global gap that El Saeed describes is “not limited to communities that have issues with connectivity,” he said.
“When we talked maybe about [the] digital divide in the past, it was primarily about connectivity issues, looking at places where access to data services was a challenge, and hence many of the smart solutions that were available were not accessible to too many people. Now we’re also looking at issues related to capacity. So if the community or the city or country lacks the capacity to be able to operate such solutions, then it will be a big issue to deliver services.
“We’re also looking at issues related to costs: If data has large costs, no matter how good – if a program is designed to deliver certain messages about COVID-19 with very well-illustrated videos, for example – there will be very low uptake because of how much it will cost the beneficiaries to actually view these illustration videos or health promotion material.”
El Saeed noted that there are “reports coming from very advanced countries who have no issue with connectivity or access to data saying that there is a digital divide happening across age groups. So a certain age group may not have access to certain solutions to be able to use certain solutions compared to others.”
When the pandemic hit, “we were caught obviously off guard on these things,” he said.
Thankfully, now there are a lot of efforts “looking at how we can close this digital divide, and how we can actually utilize some of these advances and technologies to accelerate delivery on some of the important health gaps.”
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