The deaths of George Floyd, Breonna Taylor, Ahmaud Arbery and others have lit a powder keg in the U.S. and abroad, leading to nearly two weeks of protests and demonstrations that highlight the pervasive and long-standing issues of racism, racial inequality and police brutality.
As public pressure mounts on those in positions to create change, a number of technology and health organizations have released statements pledging to support racial justice and equality both within and outside their operations.
Within big tech, for instance, Apple replaced its front page with a lengthy post from CEO Tim Cook stressing that the company "must do more" to bring its technology to the underserved and promote internal diversity. Alphabet CEO Sundar Pichai recently shared word of millions of dollars in donations to organizations addressing racial inequities, of an eight minute, 46 second moment of silence and of internal discussions targeting long-term change. Amazon posted a PDF statement on Twitter in the early part of the week stating that the company stands "in solidarity with the Black community ... in the fight against systemic racism and injustice," while Facebook's Mark Zuckerberg announced $10 million in donations, and acknowledged "more work to do to keep people safe and ensure our systems don't amplify bias."
Perhaps unsurprisingly, these statements have come up short for several editorial writers, countless social media commenters, and industry members. Many of these critics highlighted each tech platform's ongoing role in exacerbating these issues, while others were concerned that those statements might be the start and end of an organization's response.
“For folks to put out public statements against racism is great, but there has to be additional steps within the organization to ensure the company’s values against racism align with diversity and inclusion," Kistein Monkhouse, founder and CEO of chronic-patient-empowerment platform Patient Orator, who has spoken out about moving beyond public statements to create change, told MobiHealthNews. "That has to be intentional."
A slew of major healthcare organizations, such as Cedars-Sinai Health System and Brigham Health, have also released statements in support of the protests for racial equality. However, these have generally elicited less pushback from the public. Major professional organizations such as the American Medical Association have also weighed in with a public statement and targeted video discussions of structural racism's impact on health and care provision.
“Physicians on the front line see both the short-term and long-term effects on health of racism and trauma, so we really thought … we really needed to amplify these issues and name these issues so we could really move forward on action,” Dr. Patrice Harris, president of the American Medical Association, said about the organization’s decision to post a statement, during a broadcast interview. "We really have to make sure we are identifying the structural legacy of racism, and also the continued bias – implicit bias and overt bias – that is impacting our health today."
(Editor's note: A statement against racial inequality and injustice from HIMSS, MobiHealthNews' parent company, can be found here.)
Several stakeholders from the health tech industry – something of a middle ground between these two camps – have also announced their support for the demonstrations and their causes over the past week. How are their statements and the commitments they bring being received by those hoping for long-term change?
Addressing the problem at hand
Dozens of digital health startups, front-runners and founders have released public messages that range from a few sentences of support to explicit calls for action – or even health and safety instructions for demonstrators on the streets.
On Twitter, telehealth giant AmWell published a statement highlighting "solidarity with the Black Community" that was accompanied by a quote from Martin Luther King, Jr.
Health chatbot-maker Buoy Health's social media account posted a blacked out image in accordance with the Blackout Tuesday campaign, alongside messages from the brand and its founder that "we want to be 100% clear that Black Lives Matter." Teladoc Health CEO Jason Gorevic penned a LinkedIn post that included a message denouncing workplace intolerance that was sent internally to Teladoc staff.
A handful of supporting messages highlighted monetary gifts to charity organizations.
Fitbit (soon to be part of Google) said on Twitter that it was "joining the fight against racism and police brutality" through donations to Black Lives Matter and the Anti Police-Terror Project, and consumer telehealth brand Hims posted a link to the NAACP Legal Defense Fund's donation page alongside news of their own $50,000 contribution. Connected workout-device-maker Peloton and employee mental health platform Happify Health each paired their donation announcements with unique content offerings – special workout and meditation classes emphasizing the need to speak up for the former, and the development of free injustice-driven stress and trauma programs for the latter.
Among the brands most explicitly endorsing the protests has been consumer-telehealth service Ro, which posted a statement of support and told followers that "if you disagree with this statement or feel it's in any way controversial, don't use our services and unfollow us." This post came alongside a four-part chain of images instructing protesters on how best to protect their health when protesting during a pandemic. Digital and in-person care hybrid One Medical also shared an article on what protesters should do when exposed to tear gas or pepper spray that was written by one of its providers – although the company did not put out a formal supportive statement.
These messages highlighting the issues and promising greater awareness moving forward are a welcome start to addressing inequalities within the digital health industry, health outcomes and the broader society, Monkhouse said. Corporate donation commitments in particular have been well received by supporters of the movement, many of whom have begun replying to public statements lacking a monetary pledge with the phrase "open your purse."
The real challenge for the industry, however, will be transitioning these opening steps toward policies and practices that will last for years to come.
“My impression [of the responses] has been ‘Great! Now let us know what the action steps are going to be’ — it's one thing to have optics around statements and announcements but it's another thing to do the work needed to bring sustainable change," André Blackman, founder and CEO of Onboard Health, an executive recruiting firm dedicated to promoting diversity, wrote in an email to MobiHealthNews. "Take action by hiring more people of color and sending resources directly to the founders. That's it. We've talked at length about diversity 101 (we've seen enough webinars). If companies are really focused on impact, those are the two areas to make it. Internal investment."
Ensuring long-term change
With this in mind, some companies have announced is a greater focus on racial inequality within their own ranks. On Tuesday Anne Wojcicki, CEO and cofounder of 23andMe, wrote a letter to the company's community members calling out 23andMe's Eurocentric product, as well as the flaws in its hiring practices.
“As a leader who really cares, I feel the responsibility to not just talk about Diversity, Equity and Inclusion, but to make meaningful changes and contributions through my own actions and how we operate at 23andMe,” the statement read. “Our management team, Board and employee base must have greater diversity. I am ashamed to say I do not have a single black employee who is at Director level or above.”
This letter was met with mixed response on Twitter. Some commended the company for its honesty. Others called it a “marketing stunt.” However, inclusive hiring practices are a frequent suggestion on how to improve equality within the healthcare industry.
“Does everyone who is on the executive board look the same and from the same background?” Monkhouse said. “That is a problem and a clear indication that there is a lack of diversity and inclusion in the practice. I think in addition to that, every healthcare organization should be thinking about making a conscious effort to increase the diversity of their workforce – and for those that already have a diverse workforce, they should be looking at ways in which they get amplified.”
MedCrypt founder Mike Kijewski took another approach to addressing workplace inequities. Following the protests, he posted a public Twitter message offering up his support to black startup founders seeking a foothold in the industry.
“I don’t know how to [fix] policing. I don’t know much about anything, really. But I have experience in the startup world, raising money from VCs, accelerators, etc. If you’re a black startup founder and think I could help, let’s talk,” he wrote on Twitter.
The venture space has historically had an overwhelming racial imbalance. In fact, according to a 2020 Deloitte report only 3% of all investment professionals are black or African American.
“Systemic racism, inequality, and institutionalized violence are healthcare issues – and more importantly, matters of humanity. Silence and inaction in the face of injustice is simply not an option. It’s past time to get to work,” Rock Health wrote on Twitter.
Some funds have already started to make tracks in this regard, with Softbank announcing its plans to launch a $100 million fund that will invest exclusively in companies led by people of color, Axios reported Wednesday.
Monkhouse said she sees the investor's role as key for helping to shape health equity down the line, in part by helping to support black entrepreneurs.
“What healthcare organizations and investors really need to do is look to engage with diverse innovators and people of color at the community level, because ultimately this is a form of investment in those communities,” Monkhouse said.
The link between providing equitable health services and supporting black innovators is another hot topic. ConsejoSano, a patient-engagement platform that connects health stakeholders and innovators, tweeted about the connection between diversity in the workplace and serving the population.
“The core tenet of ConsejoSano is that every single person has an unalienable human dignity and deserves to be treated with such each and every day of their lives," the company wrote on its Twitter page. "We are proudly led by a Black Founder & CEO, and we are a team deeply rooted in the diversity of our distinct cultures and experiences. We as colleagues and co-builders of the company hold an inviolable belief in the value of human life."
And looking more broadly, diversity in digital health may help bring insights about community needs in regard to the social determinants of health. In the past, innovators have stressed the need to include black voices when creating tools for diverse populations.
“One of the innovations I’ve seen in some organizations is to invite members of the community, particularly vulnerable populations, to the table to add to the discussion,” Duane Elliott Reynolds, founder and CEO of Just Health Collective, said in a recent HIMSS20 webinar specifically discussing the coronavirus’ impact on the African American community. “Sometimes that means doing things like covering the cost of their hourly salary in order to have them be able to leave work, because a lot of these folks in vulnerable populations may have financial difficulties. But the critical aspect is to invite them to the table and allow them to provide their perspective, which allows you to build trust.”
While there is still much to be determined about how exactly these protests will impact the health and technology space in the long run, it has unquestioningly propelled conversations about the pressing need for diversity and inclusion.
“It is a disservice to black and brown people, as well as lower-income communities, when people that are far removed from those populations are the key decision-makers to solving their problems,” Monkhouse said, “whether that be in digital health, related to healthcare access or, on an even more micro level, the way in which a person is treated in a healthcare encounter. In short, everyone benefits when the workforce is diverse.”