While the powers of healthcare IT to radically transform the health of a patient population are widely lauded, one thing that isn't discussed as much are the areas where the technology could do the most good but doesn't often reach to. Take Washington, D.C., for example: One of the richest, most tech-savvy cities in the nation, it also has remarkably low rates of obesity. Almost. Taking a closer look reveals that the 8th Ward, a predominantly lower income section of the city populated by minorities has a high level of obesity, skewing the district's numbers.
Ivor Horn, MD, associate professor of pediatrics at Children's National Medical Center and George Washington University School of Medicine says that there is a wide variety of health IT out there that can help tackle and manage the health crisis of obesity, but that much of it is not reaching the population groups where it can do the most good: minorities.
At a talk at the recent Healthcare Experience Design conference in Boston, Horn was optimistic about the inroads health IT can make in these populations, and provided some key insights on how health IT can benefit minority populations and how to reach them. She spotlighted some issues affecting healthcare technology's ability to make inroads in minority community – and offered some tips on doing it right.
1. Are there big factors holding developers back? One of the problems in getting health IT to reach underserved populations is that there is a lack of developers working to create applications for those groups. "There's no real personal connection to the populations that are the most underserved," says Horn. She says that the first big step to take is to connect with the underserved populations and to begin to understand the communities and their needs. "People need to build those bridges so they can take the amazing things they're doing that are so creative and make them useful to those who really need it," she says. Partnering with local organizations can be a way to break the ice and get input on how best to reach people. One that Horn says is inspiring to her is Black Girls Code, a nonprofit that reaches out to African American girls and teaches them programming skills. Horn says the program "inspires me to say we can work now with what we have and where we are and if we educate, there will be this great population who's able to continue to do it moving in the future."
2. Concerns around cost. The cost of health IT is often seen as a factor that holds it back from underserved populations. Horn doesn't think this is the case. "My patients have a playlist just like you do because it's at a price point that's made it available to them," she says, using the example of Apple to illustrate how competitive pricing can put technology in to a wide range of hands. Still, that money has to come from somewhere. Horn notes that "for my patient population, the government often pays for them through Medicaid or Medicare." Because health problems such as obesity can be so damaging but can also be targeted by health technology, Horn thinks that it is a smart investment to target underserved populations, as it can greatly improve the standard of health for all. "If we design things that are for populations that often times have the worst disparities ... but also produce some of the highest costs, then we have an opportunity to reduce costs in healthcare," she says.
3. Go local first, then scale up. Launching an initiative aimed at underserved populations can be a daunting task. Horn says that many minority groups are simply not understood well enough to have an effective health technology partnership. Starting with a focus on a particular local group and partnering with a community is one way to create a lasting, scalable model for success, she says. "We can do this together. That's the key thing," says Horn. Even if a community group isn't particularly tech- or healthcare-centric, they still are a valuable partner who understands the populace and can help communicate and engage with people. Once a local project begins to take off, those lessons can be scaled up. "You're going to learn some basic principles in worthing with local organizations that you can apply on a national level," she says.
4. Communicate. Collaborate. Because minorities are often misunderstood or underrepresented, developers are not often willing to jump in to uncharted territory. Horn says this is partly because "people aren't always ready to ask the tough questions or hear the tough answers. For communities, you're going to hear the tough answers." What matters in launching a project designed to target health matters in underserved communities is an open and effective line of communication. "Taking the time to build relationships, and not jumping in and jumping out, I think are the key things," says Horn. She says that designers have a responsibility to listen to their audience and try to work with them to develop the product, but that it's also their mandate to know what to include and what not to include. This all needs to be part of the communication process. "Being up front from the beginning, to tell people... 'when we work together we'll have a good result,'" is a basic template for an effective line of communication, she says.