Tech won’t save health without equity

On 27 November 2025, over 40 professionals from across the health and care sector came together for a Health Innovation Network Innovation Insights webinar, where the focus was on the Equity Charter. In this blog, Ayesha Rahim, Co-Founder of the Equity Charter, explores why equity must be at the heart of digital health transformation and shares highlights from an engaging and thought-provoking discussion with webinar participants.

When we mention “digital equity” to most people, often the initial assumption is that this is about providing digital hardware to those at the margins of society. Whilst equality of access to health and care services through increasingly digitalised channels is of course important, there are myriad other ways in which a less than thoughtful approach to digital innovation and adoption allows inequity to creep in.

In 2014, Apple introduced the much-anticipated HealthKit app to great fanfare, designed to help users monitor various aspects of their health, including vital signs, nutrition and activity levels. However, the app did not include a feature to track menstrual cycles (NBC News 2014), a glaring omission affecting 50% of the population. How could such a mistake happen? While we may never know the exact reason, lack of diversity, such as a lack of women, within digital teams and throughout the product design process can be a cause of such errors.

Another more recent example that many will remember from the Covid-19 pandemic was the acknowledgment that pulse oximeters (measuring oxygen levels in the blood via fingertip sensors) over-read O2 levels in black patients. Evidence showed that black patients were three times more likely to have undetected low blood oxygen levels (New England Journal of Medicine, 2020). What assurance do we have that those medical devices were clinically effective for a broad demographic of patients?

AI-based health technologies can amplify bias due to training data sets comprising data from predominantly white male subjects. A 2022 study found that image-based dermatology diagnostic tools showed significantly poorer diagnostic accuracy for black patients (17%) (Imperial College London, 2022). Genomic studies are also mostly based on data from white subjects, impeding the ability to translate findings to non-white patients, such as for precision medicine interventions like pharmacogenetics (Cell, 2019).

The potential for digital inequity is threaded through our industry. But the point of this isn’t simply the moral case: it’s that inequity in our digital health structures exacerbates existing health inequalities.

Most innovators in this space do what they do because they see an opportunity to improve health outcomes using tech as an enabler. Interestingly, the populations who have the worst health outcomes map on very closely to those most digitally excluded (Good Things Foundation 2024). But unless we really get under the skin of the structures that cater to the majority, technology innovation cannot hope to address the health outcomes gap – and indeed we may worsen it.

What gets in the way of equity in digital health?

We asked participants of the webinar “What gets in the way of equity in digital health?”. Key themes included:

Lack of awareness and priority – Equity is often overlooked or deprioritised due to limited understanding and competing deadlines.

Insufficient inclusion and representation – Marginalised communities are rarely engaged early or meaningfully, leading to tokenistic or late co-production.

Systemic and cultural challenges – Stakeholder buy-in is weak, stigma persists, and responsibility for equity is unclear.

Process and resource constraints – Limited resources, funding, and expertise, combined with jargon and complexity, hinder equitable design.

Technical and data issues – Bias in AI and datasets, along with poor access to representative data, perpetuate inequity.

Practical barriers – Late involvement in procurement, inadequate Equality Impact Assessments, and siloed collaboration undermine inclusive solutions.

The Equity Charter

The Equity Charter is a social movement and framework that was founded in March 2024 to help embed equity in any organisation connected with digital health. It consists of 10 principles for digital equity:

1. Each of us commits to standing up for equity
2. Leaders, teams & organisations champion equity
3. Equity embedded into policy & practice
4. Equity at the centre of digital strategy & transformation
5. Digital teams represent the wider workforce & communities they serve
6. Equity embedded in research & innovation
7. Digital products & services are designed equitably
8. Ethical procurement & contracting promotes equity
9. Equity in use of data & design of algorithms
10. Equitable health & wellbeing outcomes for underserved communities

Each of these principles has a set of associated actions to help organisations put these principles into practice – these can be found on our website: www.equitycharter.digital.

Both the actions and the principles themselves were developed by the digital health community, with support from Subject Matter Experts from the worlds of technology, EDI, procurement, legal, and of course patient groups. This has culminated in an initiative which we feel is grounded in the challenges and opportunities of improving care through technology, whilst understanding the evidence for how to effect change in relation to reducing inequity. The charter is also endorsed by key organisational stakeholders: NHS Providers, techUK, Digital Health and AXREM.

Our fifth partner, the Health Innovation Network (HIN), leads on principle 6: “Equity embedded in research & innovation”. We collaborate closely with Health Innovation Kent Surrey Sussex, whose Ten principles of health equity for innovators complement the Equity Charter’s focus on digital health. Together, these provide a strong and practical framework for addressing health inequalities through technology innovation.

So, what can you do next?

At the end of the webinar, we asked the participants what practical step they could you take tomorrow to embed equity. The participants committed to embedding equity through practical actions such as fostering inclusive leadership and active listening, valuing lived experiences, and challenging tokenism. Many emphasised co-design and co-production with underserved groups, aligning equity principles with digital strategies, and refining approaches to patient and public involvement. Others planned to implement or enhance Equity Impact Assessments, explore partnerships for EDI-focused initiatives, and start future workshops with equity as a core principle. Overall, the focus was on collaboration, breaking down silos, and ensuring equity is embedded in both mindset and practice.

Here are five ways you can start to embed digital health equity in your work:

1. Watch the recording of the webinar to learn how inclusive design, data-driven strategies, and community engagement can help make digital products and services more accessible and impactful
2. Sign up to our mailing list to receive updates, news and details of events
3. Join our Community of Practice, for individuals who want to take a more active role in making digital equity a reality
4. Think about how you could adopt the Equity Charter in your team and share your progress with us at hello@equitycharter.digital – we want to hear from you!
5. Tell three people about the Equity Charter

Choose equity now.

The views expressed are the author’s own and do not necessarily represent those of Health Innovation KSS. Content is for general information only and not medical advice; references do not imply endorsement. Information was accurate at publication and may change; Health Innovation KSS is not responsible for external links.