The digital health revolution, spearheaded by AI and remote healthtech, is redefining our approach to clinical trials, patient engagement, and overall healthcare management. However, clinicians are still struggling when seeking individuals with rare diseases and are significantly hampered by geographical limitations and the socioeconomic status of participants. Martin Sandhu, CEO and founder at NUOM, a digital health transformation agency based in the UK, explains why incorporating the patient experience and diversity in clinical trial design and implementation is paramount to obtaining positive outcomes.
Using the latest tech for better patient engagement
The voice of the patient should be at the core of your service offering if you want to have access to a truly diverse pool of individuals that are reflective of a broad spectrum of subjects. The good news is that now we have access to smart, predictive models that can pinpoint the ideal geographies and communities for patient recruitment.
What’s more, patient check-ups can be conducted through digital platforms supported by telemedicine, which further enhance the chances of including more people from minority and underprivileged backgrounds. This means that it is not just patients who have access to a vehicle or can afford to travel will benefit from the trials. Individuals located in remote locations or who encounter mobility issues can also participate, which gives clinicians access to a more representative segment of the patient population.
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Cultural awareness and competence
In most industry sectors, organisations deliver regular training sessions that enable employees to become culturally aware and integrate seamlessly in international business environments. These types of activities subscribe to organisational cultures that aim to promote diversity and inclusivity and embrace the benefits of a multicultural workforce.
In the healthcare sector however, the focus remains on the what – as in what kind of treatment solutions we should deliver – rather than the how. How we communicate with patients, the ways in which we meet them half-way and understand the beliefs that underpin their motivations, may change the outcome of the service we provide. Simply put, cultural competence goes a long way in delivering a human-centred healthcare service.
Cultural competence in healthcare means delivering effective, quality care to patients who have diverse beliefs, attitudes, values, and behaviours. This practice requires systems that can personalise healthcare according to cultural and linguistic differences. For example, at nuom we have created Hepatitis C testing resources and applications that covered a multitude of minority languages spoken in the UK. This meant that our app could capture data from underprivileged, non-English speaking groups who were a lot more likely to be affected by the virus. As a result of this approach, we predict that by 2025 Hepatitis C will be eliminated from the UK.
Fundamentally, whilst cultural competence in healthcare initially referred to meeting the needs of people from distinctive ethnic and racial groups, it now also refers to meeting the needs of people with disabilities, those from diverse socioeconomic backgrounds, and members of the LGBTQ community.
This idea can be summarised through the concept of intersectionality, which is essential in clinical trials, and it can only be achieved by applying it to trial candidates, which should in theory be as diverse as possible. Diverse participation in clinical trials leads to more generalisable results, better-informed healthcare decisions, and improved patient outcomes across different demographics.
Empowering women in healthcare
Medicine has historically focused on male patients, with the male patient being the norm and the female patient being the abstraction from said norm. Women live longer and have more unhealthy years than their male counterparts. This is mainly because socio-cultural aspects vary between the genders and have a different impact on health, well-being and many diseases. We still have a long way to go to achieve gender equality and equal rights for women worldwide.
Researchers are now starting to understand that there is a dire need for specifically addressing the importance of including women in clinical trials. Physiological differences and hormonal variations can significantly impact how diseases manifest and how treatments affect individuals. Women’s health deserves dedicated attention and that research outcomes must be applicable to both genders in equal manner.
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Building trust and overcoming scepticism
Factors such as distrust, cultural nuances, and socioeconomic barriers have contributed to underrepresentation of certain groups in clinical trials or even equal access to healthcare. In establishing trust, healthcare providers play a crucial role by prioritising personal connection and transparency in medical decisions. Patients need to feel heard and understood, and healthcare providers can foster trust by demonstrating empathy and showing genuine care for their patients’ well-being.
More recently, we have seen ethical considerations in digital health that go beyond trust in AI. They also encompass issues such as data security, consent, and the potential for discrimination or bias in algorithmic decision-making. It is essential for healthcare providers to prioritise patient well-being, maintain high ethical standards, and foster an environment of trust and transparency. And it goes without saying that overcoming these hurdles requires a thoughtful and intentional approach.
Conclusion
The transformative potential of embracing diversity through human-centric design in the digital health era should be the focus of healthcare providers.
Prioritising the patient experience is not only ethically-sound, but also essential for advancing healthcare in a more inclusive and effective manner.
Historically, clinical trials have often lacked representation from these groups, leading to skewed results that may not accurately reflect the broader population. So today the imperative to include diverse groups, minorities, and women in clinical trials is a cornerstone of human-centric design in the digital health revolution.Â
Martin Sandhu is the Founder of digital healthcare specialist agency, NUOM.
