The acceleration of digital health services during the pandemic has been accompanied by growing concerns about the ‘digital divide’ in global healthcare. The growth in virtual care has been predominantly in more affluent, urban populations.
Rural communities across low- and middle-income countries have found themselves even more isolated from health support during lockdowns. Vaccine drives have also been hindered by digital barriers, such as in India where poor rural communities lack information on how to register and the internet access to book through the online system.
3.7 billion people live in regions in the world without internet connectivity, and so many digital health services just don’t work for these populations. This is a huge barrier to achieving Universal Health Coverage for all and missed opportunity for healthcare businesses unable to reach emerging markets for their services and products. These are three priorities for building digital health services that work for everyone on the planet.
Design for the Real Patient Experience
User-centred design is essential to digital health solutions, and number 1 of the ‘Digital Principles for Development’. Unfortunately, digital health services aren’t designed around the real needs of patients in the rural communities we operate in across low- and middle-income countries.
Households have mobile phones, but often only the younger members of the family rather than the older patients who most need health support but aren’t used to technology. The phones are basic, running on older mobile operating systems that many health apps don’t work on. Internet connectivity is very patchy, and you can only get a signal at certain locations in the communities.
You need to design with and for this user. For example, our mobile health apps are designed ‘offline-first’, so community health workers can use them to provide education, screening, and e-commerce services even in low connectivity regions and sync when back online (including peer to peer syncing). They work on basic versions of Android, with only the simple functionality that communities need.
Focusing on the real needs of communities drives the innovation needed to overcome access to healthcare barriers. Essential diagnostics are too expensive and complex for many rural populations in low- and middle-income countries. Mx Labs is one company turning the smartphone into diagnostics tools. Their Heart Monitor app visualizes blood flow in real-time, helping to recognize early symptoms of hypertension, a leading preventable risk factor for cardiovascular diseases.
Bridge the Data Divide
The ‘data divide’ and ‘digital divide’ go hand in hand. Data underpins effective digital health services, but only if it’s relevant to the populations the services are for. Similarly, AI-powered applications can make healthcare more predictive, efficient and accessible for everyone, but only if the data inputted into the algorithms is representative of everyone. As Clive Humby once commented “Data is the new oil. It’s valuable, but if unrefined it cannot really be used”.
The fundamental issue is making sure we’re collecting representative data for all relevant populations. This is challenging in communities where health systems are often still paper-based, so needs investment and innovation. Investment in better staff training, computer systems, and power sources at rural health centres. Innovation in new ways to collect data in hard-to-reach populations, such as roaming community health workers with “offline-first” apps or through health chatbot services on low data versions of instant messaging platforms.
Regulation must play a role with policy makers, regulators and governments ensuring that digital health solutions are always based on representative data and can be leveraged to benefit all populations.
Accelerate Digital Literacy
Digital literacy levels are not being developed rapidly enough in the parts of the world most in need of digital health services. Recently, we integrated Facebook groups and tools into a new health service for Non-communicable Diseases in rural Philippines, but usage was initially low compared with the in-person health sessions. However, we found that involving the more digitally literate, younger family members in their older relatives’ care could help to drive greater adoption of the digital channels.
This highlights the need to harness more tech savvy, community members to accelerate the digital literacy of rural communities. In Odisha India, the Centre for Youth and Social Development (CYSD), collaborated with the Foundation for Rural Entrepreneurship Development (FREND) to implement a digital literacy campaign supported by Google.
Community women were equipped with how to use smart phones, instant messaging platforms and YouTube for video content. Using these enhanced digital skills, they were able to support the fight against Covid-19 in their communities, such as sharing information and advice through WhatsApp
Digital health has the potential to make healthcare accessible to all, but only if the digital technologies are available to everyone. The pandemic has reinforced the benefits of these health technologies but also the barriers that exist for billions across the world. It must be used as a catalyst for rapid action, ensuring digital health services are put within reach of everyone on the planet.
By Rich Bryson, Chief Strategy & Marketing Officer, reach52
Digital Health is indeed the future, but it first needs to work for everyone in the planet for it to be useful!
Insightful read! Digital health just might be our ticket to UHC but not if digital health only reaches high-connectivity areas.
Indeed, digital health is the way to go but must address its gaps in today’s world especially in light of the pandemic. Great read to remind us of the work that still needs to be done!
The pandemic drastically changed the landscape of healthcare systems in our rural communities. Such an insightful read! Glad there are digital healthcare companies willing to step up to the challenge and help bridge the gap to make healthcare accessible for all!
Achieving the Universal Health Coverage in countries like Philippines is really challenging primarily because aside from financial constraints there are other factors like its archipelagic set up. To achieve such end, government needs to employ strategies and innovations to reach rural areas in implementing the UHC. This article clearly shows that one of the best strategy the government could employ is through digital health services. This is a new hope for people in far places to have acess in free and affordable health services timely as they need and practical than going into far health facilities.