Hacking for the Underserved

What comes first: the problems, or the tools to solve them?

It seems at times as if the newest technology on the block has become more important than creating actual solutions to healthcare problems. In the digital health landscape, hackathons have run counter to the tools-first tenet. Over a two to three day period, hackathons bring together patients, computer programmers, designers, clinicians and investors to create scalable technology solutions for healthcare’s most pressing problems. Health hackathons start with the problems. No other populations present more challenging problems than under-served populations. So how can we use technology to tackle these problems head on? For underserved populations, the problem first, tools later approach of hackathons may hold the answer.

The first step of a hackathon is the problem pitch. MIT Hacking Medicine encourages participants with the following guidance:

“Tell a story about it. What is the problem? Who is suffering because of it? Why is it important?. Don’t tell us about the solution yet. Just focus on painting a picture of the problem.”
—MIT Hacking Medicine Handbook

Don’t jump to the solution—sounds easy enough, right? However, in its current state, digital health too easily jumps to the technology solution without understanding the problem first. For underserved populations, the strain of limited resources makes understanding the problem critical to finding appropriate applications for technology. No one understands the problems better than patients. Through creating community-based health hackathons that directly encourage patients to paint a picture of their problem, technology can offer value to populations often disenfranchised by the healthcare system.

Pitching a technology solution without understanding the problem risks depleting already scarce resources. We have seen the tools-first approach fail before. Patient portals have struggled to engage underserved populations. In using newer technologies such as apps, wearables, telehealth, OpenNotes and artificial intelligence, we must collaborate with underserved patients to understand the problems we are trying to solve. The pitch isn’t that you can count your steps, you can see your doctor using your computer or your can read your doctor’s notes. The pitch should include ‘We have low levels of exercise, we have trouble seeing our clinicians, or we struggle to understand our health.’

Problems first, tools second.

This post also appeared on Tincture Magazine on June 1st, 2016.