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Health Equity Unlocked: How Digital Innovations are Overcoming Barriers to Inclusion and Access

Author: Dr. Shikha Anand, MD, MPH

Published: August 22, 2023

Access to quality healthcare remains a significant challenge for many individuals and communities, particularly those facing a socioeconomic disadvantage such as geographical barriers, or discrimination based on race, ethnicity, or gender. Remote technologies have the ability to help close access gaps by allowing patients to receive care from the comfort of their homes.

I spent the first 15 years of my career as a primary care provider in federally qualified health centers, and continue to practice as a hospitalist in Lowell, a city where 17% of people live below the poverty line. Through my clinical practice, I have worked to help patients navigate the access challenges in healthcare. I have also worked with, and in, communities to design programs that serve their individual health needs. Through this process, I have learned two things above all else:

  1. People across demographics want access to convenient, high-quality, tech-enabled care
  2. They want this care to be appropriate for their contexts

The pandemic highlighted the inequities in access to technology experienced by underserved communities and necessitated infrastructure improvements. Structural challenges remain, with smartphone and broadband access decreasing with education and a socioeconomically disadvantaged status, but we are seeing an uptick in progress towards health equity.  

Societally, we are more in tune to health equity than ever before. There are more programs addressing social determinants of health and more funding to decrease health inequity.  Moreover, within the medical community, more individuals with varied and diverse lived experience are stepping into leadership roles, which will ultimately lead to more understanding and access. However, the number of leaders who have lived or service experience with marginalized communities is still relatively small in health technology. And, many of the programs are limited to those who are medically underserved, lacking the power of true scale.

Incentives for startups often focus on willingness to pay, which leads to design that can exacerbate inequities. To truly address health inequities at scale, marginalized communities must routinely be a part of the design of health technologies that are powered to scale. The idea that these innovations can simply be scaled to other communities, without their inclusion in the design process, has led to many health-promoting applications that are not relevant to underserved communities. Part of why I got into health tech was so I could use my experience working with, and designing for, historically marginalized communities to help build health equity into scaled solutions. Throughout my career, I have worked to support health literacy gaps, communication preferences, and non-English language at scale.

The Heart Seat®

As Casana’s first Chief Medical Officer, I intend to continue the focus on health equity.  Casana’s smart toilet seat, the Heart Seat, already has features that will be helpful across contexts. It doesn’t require much work for the user – it’s effortless. 

A traditional blood pressure cuff feels like a game of twister. It’s hard to get on your arm and use correctly for many people. The values can be difficult to understand with low health literacy, and anxiety-provoking for many. The Heart Seat requires no skill to use, and does not display the data at the time of measurement, allowing people to control when and how they see their data. We will build upon this ease of use as we build our condition management solutions, bearing in mind and designing with marginalized groups including older adults, ethnic minorities, and those with intellectual, developmental, and physical disabilities.

Overcoming barriers and achieving true equity in healthcare will remain an ongoing battle, however it’s solutions like the Heart Seat that inspire me to continue to be part of the larger mission to make inclusion routine in our industry.

The FDA cleared Heart Seat® captures heart rate and blood oxygenation. The medical device will become commercially available upon future clearance of non-invasive blood pressure.