“In my capacity as a member of the research and design team, I sought to imbue this work with critical reflection about the kinds of issues important to STPP: supporting the Center's efforts to build on the knowledge and experiences of the patient communities with whom we were working; an understanding of the values and assumptions informing the design of innovative digital health technologies; and the role of policy in shaping the drive to innovate digital health technologies in the first place.”
Beza Merid was a faculty affiliate with STPP when he became a research fellow in cardiology at Michigan Medicine. Now at Arizona State University, he appreciates how influencing innovation policy can create better health outcomes for underserved populations.
What does your work in science, technology, innovation, and racial justice involve? How does racial justice factor into science and technology policy?
My work examines the social, cultural, and political dimensions of illness and innovation in the world of digital health. In particular, I’m interested in understanding how digital health technologies are used to address complex problems like chronic illness, the need for remote patient monitoring during the ongoing pandemic, and the provision of care for patients in medically underserved communities. That means paying attention to how these technologies are designed and deployed, and also thinking about the values that inform these processes.
My focus is on cardiovascular care, and I spend time thinking about the role of technology and policy in managing high blood pressure as a means to prevent heart disease. My work makes the argument that when it comes to addressing the persistence of problems like racial disparities in access to health care and health outcomes, innovative technologies can be a part of how we pursue ideals like equity and justice, but they cannot be the entirety of how we intervene. We need policy solutions to address the underlying conditions that enable these disparities to exist and persist over time.
So, for example, if we want to take an approach to reducing disparities in heart disease risk that centers racial justice as a core value, I argue that we have to think about inequitable access to high quality medical care, the unaffordability of health insurance, environmental barriers to health, the design of context-specific digital health technologies, users’ capacity or willingness to use these technologies, and the pursuit of policy solutions informed by patients’ experiences in our patchwork health care system altogether in order to make lasting and effective change.
How did participating in STPP at U-M help you in achieving your academic goals? How did it compliment your work at Michigan Medicine and the Wired-L Center?
During my time as a faculty affiliate in the STPP program, I had the opportunity to meet with students in the certificate program and to present some of my research and discuss shared interests in the world of health insurance policy reform. This was vital because it gave me a chance to think collaboratively about the importance of bringing together different kinds of expertise—including the lived expertise of patients and caregivers and the credentialed expertise of researchers and policymakers—in addressing the difficulties patients face in navigating our health care and health insurance systems.
This focus on science and technology policy was also an important complement to my research at Michigan Medicine, where I later worked to help design a mobile health (mHealth) app for patients with high blood pressure. The research center where I worked employs community-based participatory research to design an app that could help patients get more exercise and eat a healthier diet as a means to lower their blood pressure.
In my capacity as a member of the research and design team, I sought to imbue this work with critical reflection about the kinds of issues important to STPP: supporting the Center's efforts to build on the knowledge and experiences of the patient communities with whom we were working; an understanding of the values and assumptions informing the design of innovative digital health technologies; and the role of policy in shaping the drive to innovate digital health technologies in the first place.
At Michigan Medicine, I was working with other non-cardiologists as well - information studies scholars, a biostatistician, and community partners.
I have since left this position to begin work at ASU as a tenure track assistant professor in the School for the Future of Innovation in Society (SFIS), but the work of the WIRED-L Center continues on.
Your research "examines the design and use of digital health technologies, and the role that patients and their family caregivers play in these processes." What are the policy aspects of promoting the use of, and access to, those technologies?
There are a range of policy concerns that shape the world of digital health, and that ought to shape our digital health futures. As health care providers and researchers, policymakers, and patient communities work to build and improve these tools, they must focus on policy approaches to managing the cost of health care and health insurance (including issues of insurance coverage and reimbursement for health technologies), the regulation of innovative technologies that may bring about novel data privacy concerns, the role these technologies may play in national and global health strategies and action plans, and the prominence of these technologies in our ongoing efforts to survive the COVID-19 pandemic. When we think about all of the ways that digital health technologies can improve our lives and possibly transform how we deliver care, we must also pay close attention to the structural barriers, the inequities, and the people who are left out, as well as the work we can all do to build more just futures that equitably distribute the benefits of these technologies.
What I am most concerned with as we tackle these problems is what justice-based solutions would look like given these structural constraints. What does justice mean here, and who gets to decide what it means? To the extent that justice involves innovation in digital health, we have to think reflexively about how the innovations we design and deploy actually function in society.