How digital equality could boost heart health

Our online world is revelatory - and not just because of what we post, like and share. The era of digital everything is shining a light on glaring gaps and inequality, especially in the health sphere.

Whether it's via m-health, e-health, telemedicine, or the all-encompassing digital healthcare, the option to get seen, diagnosed and treated without the need for an in-person visit is more important than ever. It has taken a pandemic to emphasise that digital connectivity, access and telemedicine are great tools, but also that a lack thereof can sometimes mean the difference between life and death.

Digital support for heart health

Most people have become very familiar with social distancing due to COVID-19, but doctor distancing has also increased in these unprecedented times. And while digital healthcare is growing, so are incidences of cardiovascular or heart disease (CVD). It now causes 17.9 million deaths each year, according to the World Health Organisation, with more than 75% of CVD deaths occurring in low- to middle-income countries (LMICs).

Luckily, the heart is likely to be a prime focus of digital healthcare development, given the many non-invasive tools available for cardiovascular medicine. Current applications can help monitor patients remotely and in non-invasive ways. Digital platforms can connect pharmacies and enable pharmacists to up-skill to provide patient counselling, for example. In addition to remote consultations, wearable devices such as smartwatches can read the wearer’s data from embedded microchips and sensors. More sophisticated examples include hand-held or chest-applied electrocardiogram (ECG) devices that can be attached to smartphones to record heart rhythms and help diagnose irregular heartbeats caused by atrial fibrillation.

Expanding digital inclusion to support heart health

The digital health revolution is a critical tool in our arsenal to fight heart disease, but we must ask ourselves where and for whom it is taking place? Evolving healthcare presents a wealth of opportunities, but new technology typically comes with a caveat - missed or mishandled opportunities can result in a heavier burden and a greater gap in access, affordability and equitability.

Many patients who succumb to heart disease live in low-resource settings that are often excluded from digital access or digital healthcare options. Patients living in rural areas, far from the first available clinic, for example, are often not covered by any healthcare options. Older patients in these areas may also have less experience using digital solutions.

Mobile broadband technology offers a unique opportunity to countries and areas without fixed-line communications networks. Still, according to recent data, 72% of internet-connected households are in urban settings, compared to 37% in rural areas. In the world’s least developed countries (LDCs), 17% of the rural population have no mobile coverage, while 19% only have access to a 2G network. Even in the USA, nearly 30 million Americans do not have access to a high-speed, fixed internet service.

There are also gender equality issues to address. The Mobile Gender Gap Report 2021 states that women in LMICs are 7% less likely than men to own a mobile phone, while 234 million fewer women than men have access to a mobile internet device.

Geography, gender, income level and age must not impact equitable access to healthcare. The future of healthcare will be judged by our ability to address these artificial barriers. So, how can we do this?

Playing catchup

The healthcare sector was among the first to harness the opportunities of digital technology, although it trails sectors such as banking and transportation. The growth in wearable devices and the informed use of data will help yield health returns in wealthier countries. Across Europe, health information sought online more than doubled in a decade.

Digital technology is already changing the landscape in LMICs and continues to grow. It is imperative that these countries’ most vulnerable communities also have access to continuous care through a robust, digital connection to medical services.

What are some of the key pillars of success in digital healthcare? Leveraging technology successfully will require investment, infrastructure, education, and data protection to help build public trust. Weaving digital literacy into overall education efforts will increase the comfort levels of those who are not used to technology as a health resource, including some healthcare workers.

Heart health equity is a key building block of a thriving society, but optimising healthcare is a multi-sectoral challenge. Policymakers, economists, civil society, academia and the private sector must all be involved in planning and implementation. All healthcare approaches – whether digital or traditional – must be accessible to the most vulnerable.