Study highlights inequalities in how digital health services are being developed

Ada Lovelace Institute and Health Foundation think tank have published new research warning of inequalities in how digital health services are being designed, developed and delivered.  

The research identifies several challenges in the development of the NHS apps and other digital health services that risk fuelling the digital divide, including digital exclusion and access to healthcare, poor data quality and unclear metrics for monitoring inequalities in data-driven systems. 

A lack of public confidence in data use and fragmented communication between different actors in the health data ecosystem are also disrupting the way data is being used to build health systems, limiting the ability of the health system to respond to emerging or existing inequalities in data-driven systems, the study says. 

In light of these findings, it provides a series of recommendations, aimed at NHS commissioners, policymakers in local and national governments and tech teams, that encourage a more inclusive approach to digital healthcare.

A non-digital option for accessing healthcare should be provided to all patients to avoid widening the digital divide, the study recommends. Additionally, agencies like the DHSC, devolved health departments and the NHS should fund local authorities and voluntary, community and social enterprise organisations to undertake digital inclusion initiatives. 

Organisations involved in designing and developing the NHS app and other patient-facing digital health apps should embed public participation research and co-design in the development and deployment of new features - particularly those that are more likely to be digitally excluded or less represented in data, the study says. 

More contextual information is needed to understand the complexities of people’s healthcare needs, therefore data teams should make sure to adopt data standards that flag potential inequalities or biases in datasets used for health technology and AI projects, the study finds. 

Similarly, project managers and team leads should enable better communication and knowledge sharing between different roles, departments and organisations in the data pipeline  to enable feedback on functionality for monitoring inequalities. 

Organisations should also be collaborating a lot more with GPs and local health providers to help clinicians, patients and carers understand how to use the apps, the study says.