Blair Hirst, Founder, Digital Health Review
Inspired by the challenges their family faced with the healthcare system, Blair Hirst has deployed their degrees in engineering and technology to bring equity to the rapidly growing field of digital health. Blair's company, the Digital Health Review, educates, informs, and creates community among consumers, providers, and the companies that are building digital health products. Blair shares with us their story and their passion for building a more equitable healthcare system.
Q: You are a technologist and an evangelist for health equity, and you work at the intersection of those two fields. What do you see as the benefits and the risks of the digital revolution in healthcare?
Blair: The primary and most important benefit of the digital revolution in healthcare is increased access. Where you are located can determine the quality of your healthcare. Are you located in an area that has providers and the healthcare infrastructure you and your family need? Are you located in a rural community or marginalized community – places we think of as a healthcare desert? With the digital health revolution, you can access healthcare through your phone or through a laptop. That allows people who are not living within developed healthcare infrastructures or hubs to access healthcare. In addition to access, digital healthcare facilitates culturally competent care by connecting providers with a particular skill set or cultural background with diverse populations throughout the country. And, finally, digital tools can help us collect and track data around certain diseases and issues that affect minority communities, and that will help deliver better-quality care to the general population.
I also see some risks inherent in the digital health revolution, particularly the way technology may inadvertently perpetuate existing structural inequities if left unchecked. While digital health in theory expands access, it doesn't help people without a phone or laptop or who don't have access to stable Internet. Alternatively, take Covid-19 and the kind of healthcare needed by multi-generational households. What does it mean to quarantine when there is no room or option to isolate? Are the same methods of treatment viable for someone with a different home or community makeup? We need to think preemptively about how we're building the digital health revolution and who needs it the most, so that we're not leaving out those communities that have been overlooked because of historical inequities.
Q: Before starting your company, you spent your career in healthcare, including at Memorial Sloan Kettering. What drives your passion to work towards equity in the healthcare system and how do you think about health equity?
Blair: It's very personal. I'm originally from Baton Rouge, Louisiana. While the state has great people and great food, it lacks good healthcare. In my family, we have a history of sickle cell anemia. My sister had sickle cell anemia, and I have family members who have had diabetes and HIV. So, growing up, I experienced the healthcare system through that lens. I've seen firsthand what it means when someone does not have adequate healthcare and how destructive it can be to their lives and livelihood.
Because of inadequate care in Baton Rouge, my single mother moved us from Louisiana to Maryland so that my sister could be treated at Johns Hopkins. My mother went to great lengths to obtain competent healthcare for my sister and that got me thinking at a young age about healthcare access. So, instead of pursuing a career as a biomedical engineer, which is the field in which I got my undergraduate degree, I built a career in healthcare technology. It quickly became clear to me that how technology was being built and who was at the table while it was being built had a direct trickle-down effect on patient care and outcomes. For example, when building patient engagement or patient-facing solutions, you need to ask the questions: Who is the patient population for this? Are they English speaking? Can they hear? Can they interact with the technology or do they perhaps have a neuropathy that prevents them from physically handling the tool? If these kinds of questions are ignored when building health technology, the products will perpetuate some of the access inequities that already exist in healthcare.
As a technologist in healthcare, I believe it is incumbent on me to embed health equity into all the work I am doing. But I also believe that health equity should be top of mind for technologists in other sectors, such as real estate, food and beverage, and even transportation. While most people think about healthcare as the interaction between a person and a provider, social determinants of health – the components that contribute to a person's health and wellbeing – encompass much more. Access to housing, transportation, education, and healthy food all have an impact on population health. We know that people who have stable housing, consistent transportation, and good local food options will have better health outcomes. So, I encourage startups and innovators who are building in these spaces to think about health equity as part of their mission and values.
Q: Tell us about your company – Digital Health Review – and how the company's mission addresses the issues we've been discussing.
Blair: Digital Health Review is a community platform that brings together consumers, builders, and providers in healthcare to improve literacy around digital health and improve access to the tools being developed. Consumers interested in using digital health tools and providers prescribing them for their patients use our platform. We provide content to help educate, inform, and share data around digital health. We also provide data on consumer digital health products across categories such as women's health, men's health, fertility, genomics, elder tech, baby tech, and more. We help consumers take ownership of their health by providing information about these products, including eligibility for insurance or FSA/HSA funds, compliance with HIPAA, and the clinical research backing the products – ultimately with the goal of garnering trust and use of these tools. Lastly, we have created a community on our platform who are passionate about digital health. This allows us to break down the silos among consumers, the innovators who are building these tools, and the providers who are recommending the tools to patients. By creating community among these stakeholders, they can talk together, learn from each other, and build better products for the community.
Q: As we celebrate Pride Month, we can't help noting that the LGBTQ community has historically been overlooked and underserved by the traditional healthcare system. Have you seen progress in bringing health equity to this community?
Blair: I have experienced the healthcare system as a Black, non-binary, queer woman. And the fact is, the queer community has been marginalized and unrepresented in healthcare for quite some time. Culturally competent care requires queer-friendly spaces in healthcare and providers who have proper training. We know that if someone doesn't feel they are in a safe space, they are less likely to go back to a provider or to get care, and that has lots of downstream effects. That's another reason it is extremely important that, as we're building digital health tools, we think about the identity of the patients and develop educational materials and create ads and marketing campaigns that speak to them.
Q: How can digital health innovators promote health equity within our communities?
Blair: I'd like to challenge companies in the digital health sector to build their business with health equity in mind. In some ways, it's like the 15% pledge made by large retailers that have committed 15% of their shelf space to products sold by Black-owned businesses. I'm hoping the Digital Health Review will become the go-to resource for companies in the space and that every company on the platform will commit to embedding health equity in their products.
Learn more about digital health here: Digital Health Review