Bringing Digital Health to Those Who Need It Most

by | Jan 29, 2016

Between my current life as an analyst and my former life as a journalist, I’ve sat in a lot of keynote addresses, conference sessions, and presentations touting the latest and greatest consumer healthcare products. No matter whether I’m impressed, puzzled, or bored, I always ask myself, “Would Mom and Dad use this?”

My parents embody the archetype of technology laggards. Their watches are not smart. Their television is not high-definition. Their internet is wireless and high-speed, but only because it was part of a package deal with their cable provider. Their music is stored on CDs, their movies on DVDs, their photos in physical albums and shoeboxes. Their household appliances do not send data to the cloud. If you want to communicate with them, you must use the Phone feature of your handheld mobile device.

In other words, the answer to the question I always pose is inevitably “No.” Many Americans, I reckon, would answer the same way. And that points to digital health’s biggest problem.

Take the recent Consumer Electronics Show. Amid all the pomp and circumstance, very little from CES applied to people like my parents. Under Armour’s $400 Health Box? It’s for athletes with money to burn, not seniors on Medicare collecting Social Security. Fitness-tracking headphones? The next time my parents carry music anywhere will be the first. A tricked-out medication reminder? Maybe – but can someone taking 10 pills afford 10 smart pill bottles? An app-connected pregnancy test or smart baby monitoring kit? Those ships have sailed long ago.

I focus on the needs of my parents for two reasons. First, they and their peers are the immediate present and future of healthcare – more numerous and longer-living than previous generations and, as a result, in need of healthcare services the likes of which the industry is unprepared to accommodate.

Second, study after study has confirmed that those who occupy the top of the healthcare cost pyramid – those with multiple comorbidities or complex chronic conditions – tend to be older, less affluent, and less health literate than the population at large. Yet digital health appeals to the young, the affluent, and the health literate. Instead of targeting Mom and Dad, startups target people like me – and then wonder why, after several months, we abandon the “solutions” and go on with our lives.

I understand the reticence to develop and market technology solutions to a demographic that’s reluctant to embrace tech in its own right, as Gen Xers and Millennials have done. In 2016, it’s a great way to drive a tech business into the ground.

However, as with so many problems plaguing healthcare, the answer to increased adoption among older, needier patients isn’t more tech, more advanced tech, or even different tech. Just as communication is at the heart of successful care coordination, communication – in the form of education and training tailored to the individual needs and wants of each patient – sits at the heart of successful consumer health adoption and use.

So many digital health solutions assume that simply leading users to water will not only convince them to drink – and convince them of the benefits of drinking – but somehow immediately make them proud, confident, and frequent visitors to their watering hole, even though there are thousands of other watering holes, some even crocodile-free or under a shady tree. That doesn’t work. As an Accenture recently reported, a whopping two percent of hospital patients use mHealth solutions that hospitals have wasted millions of dollars developing or acquiring, in large part because patients don’t know how to use them – if they even know they exist at all.

Which begs the question: Have these health systems even worked closely with their staff on how these apps will facilitate clinical workflows, quality metrics, and outcomes? If the clinical staff is not on board in promoting these apps, patients won’t be either.

Healthcare continues to innovate in parallel paths, with the work of small startups and consumer tech brands (who get tech and consumerism) occupying a completely different space than the work of large healthcare organizations (who get patients). The longer that happens, the longer that events such as CES will be filled with innovations that truly don’t matter in a clinical context and are highly unlikely to ever make it into the hands of patients – like my parents – who actually stand to benefit from them.


  1. Jennifer Pearce

    The reality is that large health care organizations don’t “get” patients. They get cost, quality and safety as defined by the system. If you ask a patient what “affordable” or “safe” or “timely” care means, you’ll get a different answer.

    I’d take what you wrote above about health systems even working closely with staff on how these apps will facilitate clinical workflows, quality metrics, and outcomes and expand it to include, “Have health systems asked patients whether an app will improve their hospital experience, the quality of the care they receive and ultimately, how they heal?”.

    • John

      True Jennifer, most HCOs do not ask the patient. Even those that do, via patient advisory boards, are not fully immune to succumbing to the default of what is easiest to implement and least taxing to clinical staff. In my own personal experience, have run into the problem of clinicians being less than supportive of patients using a portal for fear that the patient won’t understand the record. Couple that with a relatively thin and less then engaging portal that most HCOs provide and you are left with what we have today.

  2. Anna-Lisa Silvestre

    Hi, adding to your comments about parents. My mother (in her 80’s back then) was so upset at the phone tree in her physician’s office that she somehow obtained the fax number and simply faxed him with her questions and requests. No doubt he was not thrilled with this approach, but it got the job done for her.
    We confuse the technology with the purpose — by starting with what people need to do, then looking at how they can do this we should end up with simpler solutions. When you start with the technology, e.g., “wearables” you have to find a problem that it solves.
    But of course simpler solutions aren’t likely to result in headlines, large amounts of VC money or “cachet”.
    Remember the Jitterbug phone? My mom loved that too.

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