Health Technology for All: An Equity-Based Paradigm Shift Opportunity
Executive Overview
The health of the U.S. population faces significant challenges, particularly for people of color, due to structural racism. Current health care policies and practices prioritize cost and efficiency over equity, exacerbating marginalization and disparities. Health-relevant technologies have followed patterns of structural discrimination, resulting in poorer information and resources for marginalized communities. A paradigm shift centering on equity is necessary to counter these disparities.
Prioritizing What Matters: A Call to Action
America’s innovation ecosystem tracks and measures individuals extensively, but organizational culture, behaviors, and health outcomes lack similar scrutiny. A shift is needed in measurement practices, data analysis, and technology design to prioritize equity and safeguard civil and human rights. The 1998 Salzburg meeting envisioned a person-empowered future of health care, emphasizing technology design and person-centeredness. Initiatives like OpenNotes and Patient and Family Advisory Councils have made progress, but more is needed.
Using a Lens of Equity and Inclusion
Major stakeholders must consider whether issues are resource problems or equity problems. Equity metrics should drive solutions toward marginalized communities. Community wisdom should inform intervention design and implementation. Leaders have an ethical imperative to create accountability for health equity and empowerment.
Opportunities to Lead
- Integrate responsibility for achieving equity into every organizational unit.
- Listen to and amplify underrepresented voices.
- Refocus on equity as the central goal of health and technology innovation.
- Prioritize measuring equity and inclusion.
- Invest in culturally responsive measurement and evaluation.
Why It Matters
Centuries after W.E.B. Du Bois highlighted structural racism’s impact on health outcomes, the U.S. continues to face significant disparities. The COVID-19 pandemic and racial justice movements have brought these issues to the forefront. A bold reset is needed to address historical inequities and achieve financial and business efficiency.
Understanding a Century’s Journey Toward Valuing Health Equity
Racial disparities in health outcomes persist due to structural racism. Historical figures like Du Bois have documented these inequities. Recent efforts, such as President Biden’s Executive Order on Advancing Racial Equity, acknowledge the importance of health equity.
Moving Toward a Person-Centered Health Information Ecosystem
A personalized health information ecosystem should prioritize patient needs and empowerment. This requires coordinated action from policy makers, academic institutions, funding organizations, health system leaders, technology companies, and individuals.
Realizing That Our Data Are Inequitable
Race-based prejudices impact care and compassion within and beyond the health care system. Health innovation depends on individual-level data, which can perpetuate disparities if not addressed. Data governance must evolve to include equity and privacy considerations.
Restarting the System
Efforts like the Quintuple Aim and ‘value-based care’ have not explicitly addressed anti-racism and structural inequity. A fundamental reset is needed to center equity in health technology and care.
Advancing Toward a Rights-Based Regulatory Framework
Thoughtful regulations on health-relevant data are necessary. A rights-based approach should integrate equity, privacy, and transparency. Regulations like HIPAA are insufficient for the digital age, and new frameworks are needed to protect health data.
Conclusion
Health innovation must prioritize equity before cost and efficiency goals. A multisector call to action is needed to redefine concepts of value and progress. All stakeholders must work together to create a more equitable and healthy future.
