Crossing The Digital Divide with Connected Health

Often when I speak about connected health, I am asked ‘What are you doing to provide these services to communities with health disparities?’ For many years, connected health advocates took it on the chin when this important topic was brought up.  We relied heavily on home computers and home Internet access to achieve the power of our programs.  Yet, underserved populations had fewer home computers and less Internet access.  We were left to half-heartedly mention that access was improving and of course folks could always go to the library if needed. It was a lame response.

Something happened in the last couple of years.  As the connected health industry migrated more and more to mobile health, we began to see more and more opportunity to extend our solutions into underserved communities. After all, according to date from Nielson published at the beginning of 2011, smartphone use among various ethnic groups is high: Asian/Pacific Islanders (45%), Hispanics (45%) and African-Americans (33%). About a year ago, our friends at the Pew Internet project published data showing that the mobile Internet was more popular than the fixed line Internet for minority users.

This has been both gratifying and exciting for we connected health evangelists, enabling us to both conceive of and offer programs to underserved populations.  At the Center for Connected Health we have a number of examples of such programs.  They are among the most fulfilling and rewarding efforts we’ve undertaken over the years.

This past Friday, I had the honor of attending a celebration at one of the Boston Public Schools in a poorer section of Dorchester.  Since February, the Center, in collaboration with Partners Community Benefits and Dotwell has supported a program (Step It Up) in two Boston elementary schools to teach the children about the benefits of increased activity.  Individual students are provided with a smart, wireless pedometer that enables their steps to be passively uploaded when they are in proximity to their school.  Each class is a team, their combined steps serving as the basis for competing in a race to walk across the U.S.

We had an update on Friday.  It was among the most moving events I’ve been a part of during my 15 years as the Center’s Director.  At one point, each teacher stood up and talked about how many steps the class had taken to date, how that translated into distance on the map of the US (“We have walked as far as Pittsburgh”) and set a goal for the remainder of the school year (“If we each take 500 steps more per day we’ll have enough steps to get to Cleveland”).  The juxtaposition of the quantification of a health behavior and the use of that to educate the students in math and geography was stunning.  Also, the illustration of how quantified health information can be used to motivate teams to improve health is compelling.  The enthusiasm of the kids was truly inspiring.

And all of this in a resource constrained environment.

My second example of how we are crossing the connected health divide involves our use of SMS text messaging to engage with underserved patients in two important categories (young expectant mothers and individuals suffering from opiate addiction) to enable them to keep their healthcare top of mind and improve their adherence to care plan as a result.  This work has been done in collaboration with the Lynn Community Health Center, just north of Boston and our friends (again!) at Partners Community Benefits.  In these two programs, participants received customized text messages several times a week to remind them of a variety of health related tasks and tips. Examples include reminders for doctor’s appointments and educational messages.  84% of young expectant mothers said they felt better cared for by this intervention as did 100% of addicts.  We are in the process of expanding this program further.

Connected health is a powerful toolset and it should be available to individuals from all walks of life.  Happily, the penetration of mobile phones in all ethnic and socio-economic populations has allowed us to begin to achieve this vision.