It’s easy to get swept up in the "magic" of modern medicine. We hear about AI diagnosing diseases in seconds, doctors performing surgery from thousands of miles away, and watches that track every heartbeat. But there’s a quiet, critical question we often forget to ask:
Who is this actually for?
If a life-saving health app requires the latest iPhone and a high-speed fiber connection, it isn’t a universal solution—it’s a luxury.
As Gustavo Monnerat, Deputy Editor at The Lancet, recently highlighted, we have to stop treating equity like a "bonus feature." If we want digital health to actually work, we have to build it for the person who doesn’t have the latest tech, the person who doesn’t trust the system, and the person living in a digital desert.
More Than Just "Logins" and "Laptops"
Drawing from a framework published in npj Digital Medicine, we can see that "digital health" isn't just about software. It’s a complex web of human experiences.
- The Individual Struggle: It’s not just about "access"; it’s about confidence. If a patient feels intimidated by a screen or doesn't trust how their data is used, they won't use the tool. We have to meet people where their literacy and comfort levels actually are.
- The "Shared" Reality: In many homes, a tablet isn't "personal"—it's shared between three generations. The framework points out that interdependence (how families use tech together) and the patient-clinician relationship matter more than the code itself.
- The Neighborhood Effect: You can’t run a telehealth clinic in a neighborhood where the "community tech norms" don't support it or the broadband is spotty. Digital health is only as strong as the local infrastructure.
- The Big Picture: On a societal level, we have to fight algorithmic bias. If the AI is trained on data from only one type of person, it will fail everyone else.
Why "Equity First" is the Only Way Forward
We often think that if we just build great tech, the benefits will eventually "trickle down" to everyone. But history shows us that doesn't happen. Instead, the gap just gets wider.
Gustavo Monnerat puts it bluntly:
"If AI, remote monitoring, telehealth, and digital therapeutics are to truly improve global health, equity cannot be an afterthought... digital health must be designed to reduce existing inequalities."
In another reflection on the scaling of AI, Monnerat reminded us that tech without a soul is dangerous:
"Scale requires governance, accountability, equity, and explainability. Without that, don’t scale it."
The Bottom Line
Digital health shouldn't be about replacing the human touch; it should be about extending it to those who have been out of reach for too long. Innovation is only "innovative" if it reaches the people who need it most.
Reference:
https://www.linkedin.com/feed/update/urn:li:activity:7416899099024789504/
