Tech can address, but not solve, stigmatized public health crises

At Health 2.0, experts and technologists explored tools for fighting physician suicide, opioid addiction, and eating disorders.
By Jonah Comstock
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Kristina Saffran tells the audience about her own eating disorder story and her work with Project Heal.

Health 2.0’s Fall Conference this week in Santa Clara, California served to highlight all the things technology can do, but it also took some time to highlight some of the biggest problems in healthcare technology alone can’t solve. Opioid abuse, physician suicide, and eating disorders were three topics discussed during the Unacceptables panel, and while encouraging technology was shown off, the problems ultimately called for deeper systemic fixes.

“There is a movement to address the issue [of physician suicide],” Robin Symon, a documentarian who previewed her feature, “Do No Harm”, at the conference, said. “There are a lot of wellness, resiliency programs. But it focuses on the individual. It’s victim blaming. We have to remember that the problem is the system. Yes, we want our physicians to be more resilient because we have to function in our managed care system. But we have to remember that the system has to change.”
 

During the panel three technologies were shown off to address these problems: Meru Health, a digital intervention for physician depression, was demoed by VP Emily Hine; Aime, an AI-powered chatbot designed to predict and prevent opioid addiction was demoed by cofounder Ray Christian; and Recovery Record, an app that helps eating disorder patients monitor meals, connect with therapists and mentors, and receive in-app coaching, was demoed by CEO Jenna Tregarthen.

These interventions are impressive and even well-vetted: Both Meru Health and Recovery Record are in active use and are backed by data, with more studies under way. And there’s common lessons to be learned from all three.

One thing the three issues have in common is immense social stigma that keeps people from seeking the help they need.

“Fifty percent of people who need help are not getting help because of stigma and shame and lack of access to discreet care,” Hine said. “So our engineers and entrepreneurs created a discrete solution that’s accessible from your smartphone that you can access from the privacy of your own home or work.”

And both Meru Health and Recovery Record leverage peer support to keep people from feeling alone.

“We now support an international community of over 100,000 patients and families,” Kristina Saffran, CEO and cofounder of Project Heal, an organization that works with Recovery Road, among many other initiatives, to fight eating disorders. “In 2017 we asked that community ‘What made the biggest difference in your recovery?’ And they answered loud and clear: Other people who had been there.”

But ultimately systems need to change. Doctors need to be allowed and encouraged to seek help, Rymon said, rather than having to fill out a questionnaire about their mental illness history in order to maintain their license and being encouraged to work unhealthily long hours, as many often are. Eating disorders and opioid addiction both need to be described in the public discourse as diseases, rather than, as they often are, personal failings.

And while technology can offer some relief, it can also make things worse if its deployed without consideration. Tregarthen described an encounter with Apple CEO Tim Cook where she addressed that concern.

“To people with eating disorders, the hard-set, built-in step counters, energy trackers, calorie counters that are a feature of Apple and Android devices and are readily available and in our faces, actually are a trigger and they are a race to the bottom,” she said. “We hear people saying ‘Today was a win. I deleted MyFitnessPal and installed Recovery Record.’ So there really is this jostle between technologies that make an eating disorder worse and technologies that make it better. It’s just a consideration when we think about ‘Do no harm’.”

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