How Organizations Shape Medical Device Use

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New medical technologies have the potential to support longer and healthier lives, but technologies can also exacerbate health inequities. This study examines how different organizations (e.g., medical clinics, tech companies, schools) influence access to and use of medical devices for youth with diabetes and how these relationships shape health inequities. The project sheds light on the steps that organizations and policymakers can take to ensure that rapidly-emerging healthcare technologies—and the substantial public and private investments involved in their development—more equitably support a healthier population.Focusing on youth with diabetes and the technologies available to manage this increasingly common illness, this two-phased project interrogates how specialty medical clinics, primary care providers (PCPs), medical technology companies, and schools shape inequities in access to and use of continuous glucose monitoring (CGM) devices and insulin pumps. The first completed phase of the project focused on specialty clinics that differed in how equitably they prescribed devices, finding that how clinics understand technologies and their match to patients (beneficial, neutral, or risky) shapes inequities in their allocation and use. The second phase of the project adds organizations outside of specialty clinics, including PCPs, tech companies, and schools, as well as interactions across organizations. This phase involves shadowing and interviewing 40 demographically-similar patients recruited from specialty clinics to understand how other organizations (tech companies, schools) and interactions across organizations shape equity in medical device use. Project findings will inform and evaluate an organizations-based intervention, providing additional information on how to transform equity research into policy and practice.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.