While here is a growing understanding of the barriers that prevent people from using health technology, trust, a fundamental factor, is often overlooked. In this article, we will explore the importance of trust and discuss ways we can nurture it to acclerate technology adoption.
If you have 5 minutes to spare, have a watch of this video produced by the ‘Techquity for Health’ Coalition launched by the HLTH Foundation a non-profit organisation working to promote equity, inclusion, and opportunity in healthcare. The video features interviews with individuals, including those from rural communities, non-English speaking families, and formerly incarcerated individuals, who share their experiences with using technology and concerns about privacy and the use of personal health data. It highlights powerfully the disconnect between the development of health tech and the expectations of the actual patients who are supposed to use it.
Why Trust Matters
Trust plays a critical role in health tech adoption. Lack of trust can create significant barriers to its use, stemming from personal, institutional, and technological factors. As highlighted in the video, concerns about the security and privacy of personal health information are common. News reports of bias in AI algorithms and misuses of personal health data, are unfortunatley all too common and will only serve to undermine trust.
Many individuals rightly worry about the risk of data breaches or unauthorized access to their health data. According to recent research conducted by Accenture, consumer trust in the responsible and ethical usage of personal health information remains low. In one survey only 20% of respondants expressed "very confident" levels of trust in the way their data is used and handled in their best interest. This lack of confidence in data usage will pose a risk to the adoption of many useful digital health technologies such as the scaling of virtual care services. Consent isn’t given in the absence of trust.
Transparency and communication are crucial in building trust in health technology. Governments have a role to play in effectively communicating to the public the advantages and opportunities of securely connecting and sharing health data. However, past failures in transparency, such as the UK's Care.data initiative in 2014 and subsequent failure in 2021, which resulted in millions opting out of data sharing, has repercussions on data ownership, and highlight the need for better transparency practices to nurture the public's trust.
Trust in health technology is also influenced by trust in the wider health system. Research on the use of the UK's COVID-19 digital contact tracing app, found that trust influenced its' adoption. Trust and subsequent use was higher among those who had trust in the government and the National Health Service (NHS). Transparency, support, and recommendations from healthcare providers, such as the use of digital prescriptions, were shown to improve trust and influence adoption.
Many individuals lack understanding of how technology works and what it can do, leading to hesitancy in trusting and using it. Digital literacy is a global challenge, and addressing it will help build trust in health technology. The Good Things Foundation are doing some great work in this space building digital social change programmes, to improve the digital skills in local communities.
Language is another factor that influences trust. Many health apps use complex language and are predominantly in English, which can be a barrier for non-English speakers. Global issues like low health literacy, which affects a significant percentage of the population, is another issue. Basic or below basic health literacy levels are prevalent in around 47% of the European population, which underscores the need for health information to be accessible and understandable to diverse populations. Addressing language and communication barriers by providing translations, using recommended reading levels, and incorporating audio-visual functionality can improve understanding and accessibility of health technology and improve trust.
Fear of change is another barrier. Patients may be resistant to new technologies if they are familiar with traditional methods of healthcare delivery and worry that technology will replace human interaction, resulting in lower quality care. Striking a balance between technology and human interaction is essential to build trust in health services and technology.
Trust is not just a barrier to technology adoption, but it can also affect the effectiveness of healthcare services. Patients who trust their healthcare providers are more likely to engage in preventative care, follow treatment plans, and share accurate health information, leading to better health outcomes.
Despite these trust-related barriers to adoption, healthcare providers and technology developers can take steps to build trust with patients.
To drive digital health adoption, healthcare providers play a crucial role, when in actively endorse and recommend the use of health technology, patients are more likely to trust and adopt it. An Accenture survey found that over half of respondants (55%) would be motivated by "trusted healthcare professionals" to take a more active role in their health management using technology. However, only 11% reported receiving such recommendations regarding the use of digital tools for managing their health.
We need to improve the information that is provided to patients about how their health data is collected, stored, and used, and communicating the benefits of health technology in an honest and transparent manner, addressing head on any concerns related to privacy, security, and data usage. Also important is explaining to patients how technology works and how it can benefit them, how patients will receive personal value from the technology and the information collected, what data is being shared and why it's important, where and for how long it will be stored, and how it will be protected. Answering these questions can improve patient confidence and trust.
Clinicians have a role to play to promote digital engagement and awareness, to educate their patients about the benefits and safety of health technology, and address any misconceptions or fears. However this requires clear reimbursement models. In this regard, Germany is leading the way through its Digital Healthcare Act, the first legislation in Europe to provide national reimbursement of digital technologies, enabling patients to receive prescriptions for health apps.
One initiative working to build trust is OpenNotes who are advocating for greater transparency in healthcare and the sharing of information to build trust and promote the benefits of transparent communication throughout healthcare. One of their initiatives saw patients and clinicians co-creating clinical records has delivered positive impact.
Another initiative is the Epic MyChart® Bedside, an application that allows patients to view their EHR data in real time during their inpatient stay, designed to improve inpatient education and engagement and strengthen patients' relationship with their care team. The technology improved patients' relationship with their clinicians and helped them to better understand their medications.
Ensuring that health technology is user-friendly and accessible to diverse populations, including those with low digital literacy or language barriers, is needed to improve trust. Having diverse representation in health technology development and implementation can help ensure that its inclusive, relevant, and trusted by all populations, and help mitigate issues related to language, cultural, and societal differences.
Finally, it's important to recognize the limitations of health technology and the value of human interaction to foster trust in healthcare services. While technology can offer many benefits, it's crucial to incorporate it in a way that maintains individualised care that comes from human interaction. Striking the right balance between the tech and human connection will help to build trust among patients.
Comments