Our online world is revelatory, and not just because of what we post, like, and share. “Digital-everything” is shining a light on glaring gaps and inequality, and no less so in the health sphere.
It has taken a pandemic to emphasise that digital connectivity, access, and telemedicine are great tools, but also that the lack of these can mean the difference between life and death. And whether we call it m-health, e-health, telemedicine, or the all-encompassing digital healthcare, the option to get seen, diagnosed, and treated without the need for an in-person visit is at stake more than ever. Indeed, efficient “doctor-distancing” has increased in these unprecedented times, but not yet for everyone.
Digital healthcare is growing and so is the incidence of cardiovascular disease (CVD) that now surpasses 18 million deaths each year, many of them in low- to middle-income countries (LMICs). Because many non-invasive tools are available in cardiovascular medicine, the heart is likely to be a prime area of development in digital healthcare.
Digital healthcare can help monitor patients remotely and in non-invasive ways. Digital platforms can connect pharmacies and enable pharmacists to be up-skilled in providing patient counselling.
Adding to remote consultations are wearable devices that include smartwatches and more sophisticated devices that read the wearer’s data from embedded microchips and sensors. Other examples include handheld or chest-applied electrocardiogram (ECG) devices attached to smartphones that can record heart rhythm and help diagnose irregular heartbeat when it involves atrial fibrillation.
Expansion must address inclusion
As a critical tool in our arsenal to fight heart disease, we must ask ourselves where and for whom is the digital health revolution taking place? Evolving healthcare is a well of opportunity, and with burgeoning technology comes a caveat. If missed or mishandled, the opportunity can portend a heavier burden and a greater gap in access, affordability, and equitability.
Many patients with heart disease who succumb to it live in low-resource settings that are often excluded from digital access or digital health. In addition, patients living in rural areas, far from the first available clinic, are not covered by any healthcare instruments, and an older population might be less used to the idea of solutions via digital channels.
Geography, gender, and income level must not impact equitable access to healthcare. The future of healthcare will also be judged by our ability to address these artificial barriers. The Mobile Gender Gap Report 2021 states that women in low- to middle-income countries are 7 percent less likely than men to own a mobile phone, with still 234 million fewer women than men accessing mobile internet. Mobile broadband technology has offered a unique opportunity to countries and areas where fixed lines networks were nonexistent.
Still, according to recent data, internet-connected households are mostly in urban settings — 72 percent, compared to 37 percent in rural areas. In least developed countries, 17 percent of the rural population has no mobile coverage. Even in the United States, nearly 30 million people cannot fully benefit from the digital age.
Playing catchup
The healthcare sector was among the first to harness the opportunities of digital technology, though it trails sectors like banking and transportation. The growth in wearable devices and the informed use of data will help yield health returns in wealthier countries.
Across Europe, health information sought online more than doubled in a decade. Digital technology is already changing the landscape in LMICs and continues to grow. It is imperative that these countries’ most vulnerable communities have access to continuous care through connection to medical services.
What are some key pillars of success in digital healthcare? Leveraging technology must be anchored by investment, infrastructure, education, and data protection that help build public trust. Weaving digital literacy into overall education efforts will increase comfort levels for many who are not used to technology as a health resource, including those in the health workforce.
Heart health equity is the building block of a thriving society, and optimizing healthcare is a multi-sectoral challenge. Policymakers, economists, civil society, academia, and the private sector must be at the planning and implementation deck. All healthcare approaches — digital and traditional — must be accessible to the most vulnerable.