Migrants’ access to health care – Is there an app for that? (F7)

2015, Germany. Accusations are spreading on social media, heating up an already heated discussion on asylum seekers: “They can’t be that poor if they have smart phones!!!!” Meanwhile, a teacher gives his students a shopping bag each and asks: “Imagine your house is being bombed. You are in a rush and running for your life. All you can take is this bag. What would you pack?”

Unsurprisingly, every student packs a mobile phone. Having a mobile phone while fleeing can be both a live saver and a lifeline to relatives at home. Google Maps, Google Translate, Facebook and Skype, all of them indispensable tools for survival.

What does the fact that refugees today are much more digitally-connected than in the past mean for the provision of health care to this underserved community? The forum ‘Digital and Access to care for all’ organised on Thursday afternoon by MSD, IOM and the European Digital Therapeutics Partnership tried to find answers by bringing together representatives of ICT companies, start-ups, national health systems and international organisations.

“Digital health has the potential to revolutionise migrants’ access to health, because it is patient-centred.” Michele Pastore, Samsung & Chair of Digitaleurope’s Working Group on eHealth

Digital solutions can provide migrants with information and services that were previously not accessible to them, and they already do, but there are also significant challenges in using digital innovations to improve migrant health.

Digital literacy, language barriers, data protection, the risk to increase existing health inequalities and the trust of patients, that using those services and providing information will not compromise their migration path, were extensively discussed during the workshop.

However, what kept me thinking after the session is the question:

Is digital innovation the most effective way to improve migrants’ health?

The greatest focus of the discussion was placed to online health records for migrants. Several presentations have illustrated well why, in the particular situation that refugees face in camps or in transit, electronic records can make the retention of health information and their sharing across borders significantly easier. However, electronic records are not really an ICT solution only useful for the migrants. They are not migrants-specific and would be useful for all patients, which makes providing them to migrants only politically difficult to justify. Is it possible to develop digital tools geared particularly towards migrants? Is that even necessary, or does it make more sense to use universal tools, such as electronic patient files?

Soorej Jose Puthoopparambil, WHO Europe, rightly pointed out in his opening presentation that migrants are an enormously heterogeneous group with different backgrounds. In particular, a person’s legal status determines how much access they have to the health systems on their way or in their host countries. In fact, the terms “migrant” and “refugee” should not have been used interchangeably – both in the session as well as in this article – because of their difference in meaning and connotation.

Can digital solutions be developed that are useful for all migrants? And if not, is it worth investing public money in solutions that potentially only serve a small group of migrant patients (for potentially a limited amount of time)? These questions are particularly important taking into account that the aim should always be to integrate migrants into the local health care system and not to create a parallel system, as both Marianne Takki, DG SANTE, and Agis Terzidis, Greek Ministry of Health, rightly pointed out.

The last question that remains open is also whether we can expect innovation from the private sector and whether it is profitable for start-up companies, such as the ones that were represented during the session, to develop ICT for health tools for (groups of) migrants. Targeting the poor and marginalised does not seem any easy way to make money.

I hope that I am too sceptical or maybe ignorant to all the innovation that has already happened and provides migrants with better access to health care already today. Ultimately, however, this debate should not distract the attention from the need to improve European health care systems in general to be universally accessible.

 This Blog was written by the YoungGasteiner Wiebke Seeman

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