Health Techequity: Opportunities for Digital Health Innovations to Improve Equity and Diversity in Cardiovascular Care

Abstract

Purpose of Review In this review, we define health equity, disparities, and social determinants of health; the different components of digital health; the barriers to digital health equity; and cardiovascular digital health trials and possible solutions to improve health equity through digital health. Recent Findings Digital health interventions show incredible potential to improve cardiovascular diseases by obtaining longitudinal, continuous, and actionable patient data; increasing access to care; and by decreasing delivery barriers and cost. However, certain populations have experienced decreased access to digital health innovations and decreased representation in cardiovascular digital health trials. Summary Special efforts will need to be made to expand access to the different elements of digital health, ensuring that the digital divide does not exacerbate health disparities. As the expansion of digital health technologies continues, it is vital to increase representation of minoritized groups in all stages of the process: product development (needs findings and screening, concept generation, product creation, and testing), clinical research (pilot studies, feasibility studies, and randomized control trials), and finally health services deployment.

Telemedicine, e-Health, and Digital Health Equity: A Scoping Review

“…The papers have been mainly editorials [ 21 , 22 ], commentaries [ 27 , 36 , 38 , 46 ], or viewpoint papers [ 14 , 23 , 29 , 39 ], and only a few research articles have focused on the themes of this scoping review [ 12 , 17 , 24 , 25 , 41 , 44 ]. According to the digital e-environments or e-platforms considered, even if all the papers refer to Telemedicine and/or e-Health, some other fields are considered, like Telehealth [ 13 , 14 , 17 , 22 , 24 , 25 , 34 , 36 , 42 ] and mobile health [ 14 , 21 , 26 , 37 ]. Some authors have focused their attention on health data and described the role of electronic health records [ 28 , 31 , 43 ], electronic medical records [ 28 ], personal health records [ 43 ], and patient-generated health data [ 43 ] in promoting DHE.…”

“…It is, therefore, quite clear that the diffusion of Telemedicine tools can increase the general possibilities of treatment for all people, and some advantages are well known to be strongly linked to the possibility of creating and maintaining certain conditions necessary to guarantee equity of access and use, also by virtue of the aforementioned acceleration of the diffusion process of Telemedicine during the COVID-19 pandemic, which has allowed its widespread diffusion in both primary and special care [ 8 - 15 ]. Some authors have also highlighted that the diffusion of Telemedicine can be considered as a sort of double-edged sword; on the one hand, Telemedicine can increase the possibility of accessing treatment, but on the other hand, the most vulnerable populations from both a socio-economic and health point of view, who could benefit the most from Telemedicine, could be those less ready to use it [ 29 , 47 ], and this raises reflections on the potential inequalities of access that could result from the massive use of Telemedicine [ 26 , 44 ], with reference to the so-called “inverse care law” [ 48 ].…”

A cardiovascular risk model validated in Japan applied to an Italian cohort: Procedere con prudenza

“…12 Steps to improve DEI may invoke health technology including mathematical modeling among disparate cohorts as in the present study as well as machine learning or telemedicine. 13 As the authors noted, the J-ACCESS score validated among Japanese patients did not perform particularly well when applied to a dataset derived from an Italian registry. In order to ensure just access to medical care for all, research studies must diversify according to racial, gender, economic, and other demographic variables.…”

Digital Health Interventions for Heart Failure Management in Underserved Rural Areas of the United States: A Systematic Review of Randomized Trials

“… 5 , 6 These tools have the potential to connect underserved rural populations to their care team, regardless of their physical location, allowing for regular monitoring and timely intervention. Although digital health interventions have shown potential benefits for patients with HF in underrepresented groups such as women, 7 older age, 8 and racial and ethnic minority groups, 9 there is insufficient evidence to support their effectiveness for underserved rural areas. Compared with their urban counterparts, patients residing in underserved rural areas of the United States experience a range of socioeconomic challenges such as lower income, lower educational attainment, reduced health literacy, varying health insurance coverage, and limited availability of broadband Internet access.…”