Translating Health Equity: Digital Health Entrepreneurship Across Institutional Worlds

• In Event: Knowledge, Expertise, and Economic Valuation

Abstract

A growing array of actors have proposed AI–enabled devices, at-home diagnostics, and big data interventions as solutions to long-standing problems of health equity. Yet while some of these new technologies gain traction, many fail to achieve sustained use in healthcare settings. Using the case of health entrepreneurs, this paper delineates how the success or failure of health enterprises – for-profit entities seeking economic value and health equity – is shaped not simply by technological performance or market demand, but by the socio-material contexts in which these health equity tools are evaluated, resourced, and integrated into healthcare systems.

Drawing on qualitative interviews with health entrepreneurs, as well as primary and secondary document analysis, this study examines the conditions that structure success for these hybrid entities. Building on insights from science and technology studies, the paper conceptualizes digital health technologies as sociotechnical assemblages whose viability depends on alignment across multiple institutional worlds, including public health, venture capital, medicine, and insurance. Health entrepreneurs must translate these technological artifacts sequentially into clinical evidence, financial models, reimbursement systems, and workflow compatibility. While health entrepreneurs frequently invoke health equity to pursue implementation, the material infrastructures of data collection, investment, and reimbursement often stall adoption. These tools are more likely to succeed when they fit health entrepreneurs’ biographies, investors’ imaginaries, dominant clinical workflows, and payer logics, immaterial of their capacity to address a targeted health disparity.

By foregrounding the socio-material determinants of success for health entrepreneurship, this paper contributes to medical sociology by shifting attention from the conditions for technological innovation and adoption to the multiple institutional contexts that govern the implementation of these new technologies. The analysis highlights the limits of technological solutions to health inequities and underscores the need for sociological scrutiny of innovation pathways that shape whose health futures are prioritized and in what ways.

Author

• Emily Barman, Loyola University Chicago