How can connected care increase healthcare equity | #Philipschat

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Melanie Kilgore Hill

Aug 02, 2018 - reading time 7 mins

By FHI editorial team

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From providing access to healthcare in rural and remote areas through to streamlining obsolete health data systems, connected care may be one solution to increase equity in developing economies.

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From providing access to healthcare in rural and remote areas through to streamlining obsolete health data systems, connected care may be one solution to increase equity in developing economies. A global topic with many different factors to consider, our latest #Philipschat once again brought the experts together to give their perspectives.


Joining us on our latest chat,  Dr Githiniji Gitahi, CEO of  AmrefHealth Africa, Healthcare Geographer, Cláudia Costa, Vanessa Carter, founder of hcsmAfrica and Jan Kimpen, Philips Chief Medical Officer – as well as other medical professionals from around the world.

What is the role for connected care to play in improving health equity in developing economies?

Faced with a number of societal, cultural and economic challenges, developing economies often struggle to provide quality healthcare for a population that may be unable to afford or travel to desired clinics. Vanessa Carter began the discussion by reflecting the consensus, saying “I think connected technology in a community setting can help open the doors for patients who have very low health literacy”, supported by Simon Spurr, who agreed, stating “Connected care can bridge the geographic divide between patients and providers, particularly in rural areas”.


With the floor open, Jan Kimpen shared “Mobile technologies also have huge potential in emerging markets. For example, Mobile Obstetrics Monitoring in Indonesia to increase mother and child healthcare “– further illustrated by the ‘Monitoring pregnancies using mobile solutions’ case study.


However, Cláudia Costa highlighted the other side of the argument, warning that “Having connected care technology without information how to use it to prevent illness it’s like buying a Ferrari without having a driving license. Health literacy and specific information about the technology are extremely important.”

What needs to happen for equal access to healthcare tools to become a reality?

Although the technology may exist, there are still a number of barriers that still contribute towards inequity – all of which may be unique at a community level. Claudia Costa highlights that in order for healthcare to success, other areas of society must be improved as well: “If we aim to prevent illness and tackle inequalities we cannot just look at the areas of healthcare. Education, Employment, Built & Physical Environment, Security & Health behavior are also, or even more, important.


She does, however, highlight the power of mobile technology, stating “The connected market will expand, no doubt. Looking at the growth on Social Media / Smartphones etc. in South Africa”, which was followed by an article going deeper into South Africa’s readiness for future health.


Putting a different lens on the sentiment, Dr. Gitahi speculated that having more phones was not a strong indication of better connected care potential, pointing out that “We must not take smartphone penetration at face value in Africa. High cost and low quality of data means the smartphones are often just handheld cameras”. For him, governments need “to achieve Universal Health Coverage and with it quality access and affordability otherwise they remain donor funded or for only those who can afford.


Other replies included:

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Where are the areas of greatest healthcare inequity when it comes to mature economies?

Future Health Index research showed that in mature economies, the general population in urban are more likely to agree that they trust the healthcare system in their country than those in rural areas (59% vs. 56%). However, this isn’t to say that mature markets have it all figured out. Starting the discussion on this question, Jan Kimpen said “Chronic disease and patients living with multi-moralities is a major issue in mature and developing markets. Where there is poverty there are huge pressures on health systems. Telehealth offers huge potential” before linking to an article publishing the results of a three-year telehealth study.


Taking a more philosophical approach, Dr. Gitahi pointed out that sometimes it’s the implementation that can cause problems, saying “We see too many technologies which are being forced like a square peg in a round hole and not adaptive enough. Adoption depends on adaptability”. His solution? “Governments are megatrucks running down a road with poor brakes and manual steering. Best way to influence their adoption is to jump on the truck and do your work on it rather than to develop and then try stop the truck” to which Mojca Cargo replied “We’ve been talking for years about Ecosystem collaboration. Some started talking also about industry collaboration. That said MORE needs to happen. Collaboration is needed to move ‘big trucks.”


Other replies included:

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In mature economies, what role can digital technology play in reducing healthcare inequity?

With large scale data collection in mature markets, health systems can now use technology to predict health trends, achieve first time right diagnosis and provide personalized treatment plans. For our participants, this angle was a chance to dig a little deeper into the roles of digital health technology in mature economies.


Cláudia Costa began by touching upon the importance of trust, saying “The awareness about the availability of connected care technologies by the general population will improve their trust and utilization”. Looking at things from a more fundamental view, Dr. Gitahi highlights that “Technology solutions for healthcare must be built bottom up and offline first otherwise they become ‘technology for technology’s sake” and that “We see too much ‘technology driven solutions’ rather than ‘human-centred solutions! And the innovators then try to force the technology solutions into the system.


Other replies included:


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How does urbanization in both developing and mature economies pose challenges for health equity?

The final question explored the impact of urbanization and growing populations – with more than 65% of the world’s population estimated to be living in cities by 2050. For Anne-Marie Bagnall Associate Director Centre for Health Promotion Research at Leeds Beckett University, the modern age “can lead to greater access to unhealthy food, alcohol etc, reduced opportunities for safe physical activity, inequitable access to good healthcare”. In reply, Jan Kimpen agreed, but pointed out that “it can also do the opposite, promoting healthy living. Valencia created a wonderful park throughout the city where large crowds are exercising, when put in front of the necessity to divert a river!


Vanessa Carter then joined in the discussion with insight into South Africa, stating “Increased demand for government services with no additional investment to improve them is a major problem”, following up with a possible solution where “Startups are emerging to try to close these gaps in the public health system”.


Putting forward another example of urban centres adapting to healthcare, Jan Kimpen then posted “@DHA_Dubai have an innovate approach to integrated care pathways for more productive, personalized care in urban environments. e.g. the Dubai Heart Safe City program connect lifestyles, emergency and acute and rehabilitation”, together with a link to the article.


It was then that the conversation had to come to an end – one of our most lively yet! As always, Jan Kimpen had final words of inspiration to share with the participants and followers, stating “Improving access to primary care is one of the most profound challenges for the near future. Nobody can do innovation in healthcare alone. So also if we have to make care inclusive we have to work together, mainly with the people directly involved.” A sentiment we can all agree on.


Cover photo by Arif Wahid on Unsplash

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