Accessibility in health applications and telemonitoring devices.

The COVID-19 pandemic has highlighted the value of telemonitoring applications, insofar as they have enabled remote care and the monitoring of patients’ clinical parameters remotely, avoiding unnecessary trips to both primary care centres and hospitals. However, it has also revealed significant barriers in terms of accessibility. 

This is one of the conclusions of the study  “’Accesibilidad en las aplicaciones y dispositivos de telemonitorización de la salud. Un acercamiento a la realidad‘, published by Fundación ONCE as part of its ICT Accessibility Observatory of Discapnet for Cooperation and Social Inclusion of People with Disabilities.

The report highlights that Spain has the conditions and trends in which telemedicine and telemonitoring can offer a personalised, equitable and sustainable healthcare response: high life expectancy, with the consequent increase in chronic diseases; rural areas with a dispersed population, together with high Internet connectivity and the use of mobile devices.

Despite the high penetration of devices such as smartphones, tablets, computers and broadband Internet, a digital divide persists, i.e. inequality in access to equipment and, above all, in the skills and qualified use of the Internet and ICTs. A turning point is detected in the momentum of the digital transformation in health, together with risks of exclusion of both the elderly and people with disabilities, insofar as some of them make differentiated use of ICT (use of support products such as screen readers, voice recognition software, font Zoom, etc.), other needs to apply high-contrast investment, and in general, the need for intuitive interfaces, which incorporate ease of use and understanding. 

In addition, training of health workers is also a challenge in the implementation of the most advanced technologies in health care (WHO, 2020). Article 9 of the Convention on the Rights of Persons with Disabilities (UN, 2006), signed by Spain and incorporated into our legal system, refers to universal accessibility stating: 

To enable persons with disabilities to live independently and participate fully in all aspects of life, States Parties shall take appropriate measures to ensure to persons with disabilities access, on an equal basis with others, to the physical environment, to transportation, to information and communications, including information and communications technologies and systems, and to other facilities and services open or provided to the public, both in urban and in rural areas. 

It specifically mentions “Promoting access for persons with disabilities to new information and communication technologies and systems, including the Internet”. For its part, telemonitoring can contribute to goal 3 of the Sustainable Development Goals of the United Nations 2030 Agenda, “Ensure healthy lives and promote well-being for all at all ages“, through the efficient use of resources and aimed at achieving the best health outcomes, taking into account particularly vulnerable groups such as people with disabilities and the elderly.

The aforementioned study proposes an approach to the panorama of web/mobile applications for active telemonitoring, remote monitoring of patients within the Spanish public health system, as well as devices for taking biometric measurements, such as pulse or blood pressure, taking into account the chronic diseases that have been pioneers in telemonitoring, such as heart failure, arterial hypertension, COPD or diabetes. 

This scenario reinforces our conviction of the need to incorporate users in the application design process, applying models such as the quadruple helix or the promotion of Living Lab in health, especially for particularly vulnerable groups, such as the elderly or the disabled. 

SOURCE: Fundación ONCE.

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