To examine how commercial digital health technologies contribute to inequity in healthcare and propose an accountability model for their lifecycle, focusing on the mechanisms of inequity.
Approach:
Proposed Accountability Model: An accountability model is proposed that covers the entire commercial digital health lifecycle, emphasizing the need for evidence of equitable performance before procurement and implementation, including monitoring and evaluation processes.
Key Findings:
Digital health technologies do not perform consistently across different patient populations, leading to clinical consequences.
Algorithmic bias and inequity are influenced by commercial incentives, procurement choices, and patterns of digital exclusion.
Existing frameworks primarily focus on algorithm development and performance, neglecting the broader commercial context.
Interpretation:
Equity considerations must be integrated into the design, procurement, and monitoring of digital health technologies.
Limitations:
The article does not provide empirical data to support the proposed accountability model.
The focus is primarily on commercial digital health, potentially overlooking the role of non-commercial technologies.
Conclusion:
The need for equitable performance in digital health technologies should be treated as a fundamental requirement for trustworthy health innovation.
