Health Tech for the Underserved: Is IT Ready? Are We?

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California Lt. Governor Gavin Newsom speaking at HTF

On paper, The Health Technology Forum’s (HTF) Innovation Conference this month looked like a barnburner. California Lieutenant Governor Gavin Newsom, a theme addressing the issue of access for the globally underserved, and a free breakfast? What more does a conference need? For HTF, the answer was focus.

From CEO panels, to supporting individuals with complex needs, to a keynote about leadership, the pieces just didn’t quite fit in the context of “Platforms for the Underserved.” In the end though (literally the end of the day), one of the venture capital panelists eloquently synthesized the problem. She said that public and global health benefits of digital health technologies remain secondary to revenue generation when it comes to investing. Full stop.

It was nice to hear someone actually say it. The comment effectively pulled into focus the fact that the disjointedness of the conference might have just been a reflection of the disjointedness of the space; an indication that digital health technology for the underserved hasn’t quite arrived.

That’s not to say a lot of smart people aren’t trying to figure it out. Indeed, the conference showcased a considerable amount of brainpower dedicated to looking at what technologies might be useful for the underserved and how to design, deploy, and fund them.

For example, one panel examined the success of telehealth with veteran and mentally ill populations, implicitly hinting at similar possibilities for expanding global access to care. Another speaker, Jessica Evert, MD, executive director of Child Family Health International (CFHI), focused on the cultural competencies involved in transmitting knowledge across boundaries. Evert’s perspective added another valuable piece to the puzzle, drawing attention to issues surrounding the effective implementation of technology. However, the big takeaway came earlier in the day and was slightly counterintuitive.

One of the first sessions at the conference was a CEO panel with John de Souza of MedHelp, Dean Stephens of Healthline, and Darren Schulte, MD, of Apixio. A variety of on-trend topics were discussed during a question and answer session. The first person to ask a question did not waste time: how do we cross the chasm of digital health in the developing world?

The CEOs’ answers were startling. Not for their groundbreaking insight, but for their simplicity: technology is not the answer. Technology is a tool to understand, measure, and intervene with, but technology-enabled service is what will ultimately improve outcomes and expand care. Not new information, not radical thinking.

But isn’t it easy to forget? In a world where there’s an app for everything, the healing power of human touch, of the right person in the right place at the right time — that will never go away. When’s the last time you tried to use a health app with a serious head cold and couldn’t think straight? Do we expect the seriously ill, elderly, and homeless to access these tools when they are in much worse states? (Full disclosure: I stole this thought exercise from the conference and I struggle to use health apps in perfect health!)

Newsom advised attendees to ask a better question if ever we encountered an answer that wasn’t to our satisfaction. HTF showed that we are asking the right question. If we weren’t, how would we have arrived at the success of organizations like CFHI and AMCANI, or innovations like Medic Mobile’s texting to increase immunizations and IDEO’s and Unilever’s portable toilet system in Ghana?

But Newsom, ever the source of inspirational one-liners, also challenged us not to play in the margins. It is in this spirit that we need to shift our attention to the next question. After all, it is this next question, carefully crafted, that will allow us to arrive at the answer we all so desire: that the dynamic Health 2.0 technologies and tools we’ve been watching develop here are ready to feasibly and effectively enable services that will improve health outcomes and access to care for the globally underserved.

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