Ensuring eHealth Equity From Enrollment to Outcomes
At ZeroDivide, our work in the health field focuses on leveraging eHealth tools (electronic health resources and health care delivery tools) to decrease the persistent disparities in health outcomes for low-income communities, communities of color and other underserved groups. eHealth tools are powerful and in many instances, game-changing. They can lower costs, increase efficiency, enhance patient experience, improve care coordination and medication adherence... but employed indiscriminately, these promising tools can also widen existing health gaps.
eHealth equity encompasses the requirement that health information technologies be both widely available and affordable, but also developed with diverse and disadvantaged end users in mind. This means eHealth tools should be culturally relevant, linguistically and literacy-level appropriate, universally designed and accessible to users with a range of needs and abilities. eHealth tools that are informed by people’s lived experience, built around the assets and needs of underserved communities and supportive of both patient and provider engagement can be used to transform the health and well-being of underserved communities.
The Affordable Care Act’s health insurance marketplaces and expanded Medicaid programs are unique opportunities to introduce eHealth tools to millions of previously uninsured and underserved people. At the same time, the federal government is investing in health IT, with $28 billion in payments over ten years to providers who adopt electronic health records. The time has never been more critical for advocates, philanthropists and policymakers to join with the technology sector and push for the development and dissemination of thoughtfully designed eHealth tools. If a projected 25 million people can couple their new coverage with affordable, accessible, easy-to-use and relevant technologies, they can be empowered to manage their own health and the health of their families in ways that were previously unimaginable—and providers will have a new set of tools to care for and communicate with their patients.
“Enrollment to Outcomes” is ZeroDivide’s framework for our eHealth equity work. We believe that adoption and use of eHealth tools at any single point in the delivery of health services is not sufficient to increase health equity. To improve the overall health and well-being of medically underserved people, they must first be fully engaged in the healthcare delivery system from “enrollment to outcomes.” eHealth tools can then be introduced as a means by which patients can more meaningfully participate in their own health management, together with their providers and caregivers. This process includes the use of traditional and social media for health care outreach and education, online enrollment in health insurance marketplaces and the use of patient portals, mobile apps and other digital tools to access personal health records, manage health and wellness activities, participate in preventative care and communicate with doctors and other care providers.
With intentionally designed eHealth tools, a young mother can access her and her baby’s electronic medical records on her laptop (or on a secure site within her community if she does not have home Internet access), and share them with the baby’s new pediatrician. She could sign up to receive appointment and medicine compliance reminders through text messages, and she can talk about her baby’s health with other new moms by joining an online community. With a mobile app, she can track her daily wellness choices to make sure she is making healthy choices for herself and her family, and when her father is sick, she can use a mobile app to translate his health concerns from Mandarin into English to share with his physician.
Increasing access to and use of eHealth tools by medically underserved populations will be key mechanisms to increase health care equity. By putting the power of information into the hands of health care consumers, we can demystify the health care system, increase transparency and enable data-driven decision making for individuals who have thus far been unable to meaningfully participate in the management of their own health.
Tessie Guillermo is president and CEO of ZeroDivide. Follow her at @tmguillermo on Twitter.