Research by Vrije Universiteit Amsterdam and Amsterdam UMC reveals a major gap in Dutch healthcare policy: the current focus on digitalising healthcare often blinds politicians and policymakers to its negative impact on health inequalities.
Reducing health disparities based on socioeconomic status is one of the key priorities of Dutch mission-driven innovation policy. However, the hype surrounding the benefits of digitalisation, particularly in addressing labor shortages, has pushed the associated risks out of sight. VU Amsterdam researchers, Jessica Coetzer, Teun Zuiderent-Jerak, and Tjerk Jan Schuitmaker-Warnaar, and Amsterdam UMC researchers, Nicole Goedhart and Christine Dedding, published on this topic in Health Policy and Technology. The study is part of the project Doing eHealth Right, within the NWA research programme ‘Health Inequalities’.
Key themes are considered separate
"Current healthcare policy does focus on reducing health inequalities. People in the lowest socioeconomic position live, on average, 24 years longer in poor health than those in high socioeconomic positions. This difference is not acceptable. At the same time, there is also considerable attention for innovation and digitalisation. Unfortunately, these themes are still treated as separate issues," Jessica Coetzer explains.
In discussions about health inequalities, digitalisation is rarely mentioned as a contributing factor; societal concerns about digitalisation tend to be limited to issues of privacy and data protection. When digital inequalities are addressed, the focus is often on improving users’ digital skills. Concerns about limited access to the internet and devices, technology that is not connected to users, or justified distrust in digital systems are absent from healthcare policy. By focusing on rapid digitalization without considering those who are excluded, current policy risks exacerbating existing health disparities.
Researchers sound the alarm
On 21 October, The Great Health Debate (Het Grote Zorgdebat) will take place. The current government has heavily promoted AI and digitalisation as solutions to the workforce shortages in healthcare. The editors of Health Policy and Technology consider the researchers’ article an important wake-up call and a much-needed counterbalance to this hype, particularly in times of national and international challenges within healthcare systems. In an editorial dedicated entirely to this article, they underline the global relevance of challenging “technological solutionism”: the belief that technology can solve problems without recognising the new ones it creates, such as increased health inequalities.
“As this study and the accompanying editorial demonstrate, our belief in the digitalisation hype gives us the worst of both worlds: less accessible care for those who need it most, and more work for healthcare professionals who must guide patients through the digital maze. Policy on digitalisation in healthcare must place justice and health equity at its core. That is the foundation for truly inclusive and labour-saving innovation,” says Teun Zuiderent-Jerak.
The researchers therefore recommend developing policies that actively link digital inclusion with the reduction of health inequalities.