Innovation in digital health technologies hampered by inequities

Persistent differences exist in access to, use of and engagement with digital health technologies between communities and areas across Europe, finds a new paper, co-authored by Public Health Wales and WHO/Europe. 

Telephone or video consultations, electronic patient portals, and utilising electronic health records are all examples of how digital technologies can improve health care for patients. But the data shows there is currently lower reported use among those with poorer underlying health. 

Patterns in access, use and levels of engagement with digital technology vary across populations, with consistent evidence of higher use of digital health technologies in urban areas and in individuals of white ethnic origin and English speakers compared to those from ethnic minorities and those with language barriers.  

People with higher education levels and higher economic status used these technologies more, and younger persons tended to use them more than older adults. No clear evidence on inequalities in the engagement with digital health technologies was found despite these being likely to be variable between population groups.  

Alisha Davies, Head of Research and Evaluation at Public Health Wales, said: 

“A more equitable future for digital health requires an understanding of access to, use of and engagement with digital health technologies. 

“This is one of the most comprehensive scoping reviews of equity in digital health technologies. The findings highlight important evidence gaps across 10 domains of equity, and the importance of embedding equity into the development and integration of digital technology in health, to ensure benefits are maximised and unintended consequences are prevented.   

David Novillo-Ortiz, Regional Adviser on Data and Digital Health at WHO/Europe, said: 

“Greater understanding of the role of inequity in people’s ability to access, use and engage with digital health is needed so that a more equitable future for digital health can be developed, ensuring no one is left behind.”  

While many healthcare providers are increasingly using digital health technologies (DHT) to enable patients and the public to manage their health and engage with healthcare systems, a focus on these technologies “may inadvertently widen existing inequities in health, if known inequalities in access, use and engagement with digital technology are not considered and addressed,” the paper notes.  

The authors identify key areas for future work, including a common framework to monitor engagement with digital technology for health across equity domains, mapping inequities in digital infrastructure and addressing barriers to access digital health, finding the most effective approaches to build digital skills for those most in need; and addressing usability for those with disabilities or language barriers.  

The uptake and development of digital health systems have the potential for widespread benefits through more efficient and targeted healthcare, and equitable patient-centred approaches are at the centre of WHO/Europe’s Regional digital health action plan. 

WHO/Europe encourages its Member States to build repositories of good practices, strengthen health equity approaches and gender equality, and develop integrated solutions to monitor and evaluate digital health policies and interventions. 

‘Equity within digital health technology within the WHO European Region: a scoping review’ summarises the evidence from 22 reviews from 2016 to 2022 on inequity in access, use and engagement with digital healthcare technologies. 

Equity within digital health technology within the WHO European Region: a scoping review