Industry Voices—Why redesigning healthcare requires a human-centered approach

COVID-19 was a watershed moment for digital health. With telehealth volume peaking at 78 times the pre-pandemic rate, investor interest surged, signaling the effectiveness of digital tools and the industry’s readiness to embrace them. Funding for U.S.-based digital health startups topped $29 billion in 2021—nearly doubling the total from 2020—while the number of funding deals soared 50%, according to Rock Health.

But the pandemic also illuminated the shortcomings of a digital-only approach to healthcare. Technology is a valuable tool for improving efficiency, convenience and reach—and it works best when it augments, rather than replaces, human connections.  We’re already seeing this awareness temper telehealth utilization, which now accounts for less than 5% of all commercial claims.

So, where do we go from here? Digital health is certainly here to stay. But efforts to improve outcomes and lower care costs must also embrace an approach that maintains the humanity of providing care. That’s why we believe the next wave of healthcare transformation will be all about blending digital tools with a human touch. 

Healthcare is inherently human

During the pandemic, technology brought us connection at scale. Digital health apps answered questions, tracked biometrics and symptoms, and provided information. But healthcare delivery, at its core, is about providing care and building emotional connections that enable complex problem-solving. Apps cannot capture the nuance of a person’s life context or build an empathetic connection, both of which can provide clues to underlying or unexpressed health needs.

The structure behind digital tools can be limiting and, in some cases, even a barrier to care. Digital health requires access to a reliable internet connection, affordable digital devices and service plans, patient readiness and willingness to engage, and a common understanding of health needs and goals. This often puts the digital solution furthest from those who would benefit most. For example, FCC data shows digitally isolated communities (those with low access to broadband) also have the highest disease burden. These communities experience 25% higher rates of obesity and 41% higher rates of diabetes than digitally connected areas.

But the problem goes beyond broadband access. The digital divide also extends to issues of digital literacy, language, and even emotional barriers and motivation. For example, the “chronically well” are often first to reach for digital solutions. Research shows older adults in good health are more likely to use health apps than their peers in fair or poor health.

And engagement is just the first step: Achieving long-term use remains a challenge across all patient populations. One survey shows that less than 60% of Americans have downloaded a digital health app, and nearly 46% of those individuals have stopped using them. The motivations for stopping aren’t complicated, either: Apps require too much manual data entry, can feel like homework, come with hidden costs, or users simply lose interest. Nor does it help that most apps aren’t integrated with patient portals or other clinical systems that patients typically use to engage with their providers.

The structure behind technology is ideal for well-defined health issues, like weight loss or A1c tracking. However, a person’s health is often complex, nuanced and unstructured. A caregiver may seek help understanding his wife’s health insurance coverage for dementia treatment. While an app could provide information on plan benefits, a chatbot wouldn’t pick up on the caregiver’s exhaustion the same way a person would. It would miss the caregiver’s need for respite care, emotional support, and support to address their own rising blood pressure. The root causes of a patient's health challenges may not immediately emerge from their interactions with digital tools, or from an analysis of clinical records or claims data, which is why digital health needs a human touch. 

Above all, healthcare is inherently human. Accenture reports that fewer than 40% of people are comfortable using apps or virtual care to manage their health, and they’re 30% less likely to trust a diagnosis or treatment decision that’s supported by artificial intelligence. Humans are better at listening, adjusting and responding—especially when it comes to treating the whole patient and addressing their health challenges at the source.  

Build emotional connections—and then support them with tech

The industry should be striving for a human-centered, tech-enabled approach to care and service delivery. The goal of human-centered design is to take the best of what technology and humanity has to offer. It’s important to distinguish human-centered from human-only, which can be equal parts inefficient, inconsistent and expensive. Human-centered design starts with building emotional connections with an expert—a physician, nurse or care advocate. Leveraging techniques such as motivational interviewing and active listening, these professionals are in a position to understand what’s happening with a patient and family and navigate the options for addressing the issue. These connections make it possible to get to the heart of issues in ways that apps alone cannot.

Then, digital health can enhance this experience. Digital experiences can replace repetitive tasks for care professionals. They can be woven throughout a care experience. They can provide meaningful information within the context of a user’s everyday life and health goals. They can also provide integrated experiences for multiple caregivers—siblings, children, or other loved ones—who are coordinating the clinical and social needs of the same individual. These digital engagements then offer a feedback loop—additional insight in a user’s behavior, informing future conversations and making them more efficient.

There are several clear advantages to starting with connection before introducing digital tools in healthcare. First, a live connection engages the patient and family right away, ensuring they don’t walk away with another to-do on their list. Second, the connection establishes that the patient isn’t alone; they have trusted allies working alongside them. Lastly, with this earned trust comes the opportunity to do far more than just address the expressed needs that come up in initial help-seeking. The patient or family member trusts that the healthcare organization can actually help them problem-solve within their complex lives—and they trust that the digital health app is an effective tool for supporting their healthcare journey.

Human-centered design, digitally integrated

A digital-only approach to designing new healthcare experiences creates a divide between those who are comfortable using technology to manage their health and those who aren’t—and as a result, risks widening gaps in health equity and access to care. A human-only approach cannot expand to meet the demand for additional necessary services without significant investment in personnel.

Meanwhile, a digitally integrated, human-centered approach gives us the best of both worlds: The emotional connections of human interactions and the scalability and efficiency of digital health tools. This allows providers, payers, and employers to support patients and those who care for them with the interventions they need, when and where they need them.

Shara Cohen is the CEO of Carallel.