The great leveller or an opportunity to widen existing inequalities? 

Since the pandemic, we’ve witnessed dramatic changes in the way we operate as a society. One of these key shifts has been an increase in technology, a move towards web 3.0, and increasing levels of digitisation when it comes to our daily lives.

For some people, the rise of the metaverse has been the sign of tumultuous times to come as we all shift to adjust to our new reality that will take place in a virtual space that parallels the real world. For advocates of the metaverse, it has been widely been seen as a hail mary that will solve the most pressing issues of our time, particularly within the healthcare industry.

Remote health offerings in particular are gaining traction, especially due to the effect on in-person healthcare during the pandemic. But will the rise of the metaverse improve accessibility to healthcare, or will it widen the existing inequalities amongst the least privileged?

Western countries that already benefit from rapid technological advancement will pave the way when it comes to telemedicine and the adaptation of healthcare into the metaverse. Developments like the creation of digital twins mean that countries that have existing access to high-level medical technology will continue to thrive and will spearhead the movement.

Analysts propose that eventually, everyone could have access to a digital twin of their genetic profile, any necessary surgery would then be performed on the digital twin before conducting real-life surgery. This eliminates some of the risks associated with high-level surgery.

As people become more comfortable with these kinds of technology, an entire meta-health ecosystem could develop. For those living in countries where this is the case, accessibility to healthcare will vastly improve. Elderly patients can access healthcare from the comfort of their living room, people don’t have to take as much time off work to attend routine medical appointments and the general efficiency of the system improves.

But, is this vision a complete utopia? How will those in low and middle-income countries (LMICS) be affected, and can access to healthcare improve in these areas? There are numerous factors to consider when it comes to this issue: geographical complexity, ICT infrastructure and the availability of high-speed internet, and sociocultural barriers that may prevent a society from fully accepting healthcare delivered through the metaverse.

Many analysts see the rise of telehealth as being the solution to gaps in healthcare across LMICS, as those living in remote areas wouldn’t have to make the trip to their capital city to receive the appropriate healthcare for their condition. Many LMICS also do not have emergency transportation for patients that urgently need to get to a hospital.

According to Forster G, Simfukwe V, Barber C. up to 60% of individuals living in an LMIC live up to 8km away from the nearest hospital. By implementing healthcare in the metaverse, those living in the most remote corners of LMICS have a renewed chance to access quality healthcare, which has the potential to reduce patient mortality in life or death situations.

Whilst countries across Africa have access to the internet, affordability, and quality can pose a challenge when it comes to ideas as advanced as telemedicine. According to the Alliance for Affordable Internet (2017), the average citizen in Africa will spend about 18% of their monthly income to purchase 1GB of data compared to 1% of income for the average European citizen. Internet access is therefore less affordable for the average citizen in LMICS and the quality is also not as high as it is throughout Europe.

This can make it logistically challenging to implement telehealth and advanced technology such as healthcare within the metaverse, as most telehealth requires a strong internet connection of at least 4G. Thus, despite the well-intentioned goals of metaverse advocates, without first developing the required ICT infrastructure and power supply, this form of healthcare cannot be successfully applied in LMICS.

Where it is possible to implement, researchers report reduced costs and more timely diagnosis. Wang et al argued that in the context of China, telemedicine connects specialists with healthcare facilities. Their study showed the net saving of some USD 2.3 million for patients and USD 3.7 million for specialists, because patients received proper diagnosis services without moving to specialist’s health facilities.

This has clear time and money savings for both patient and specialist and makes the field of healthcare much more collaborative. In time, actions that can only be carried out by specialist facilities or clinicians, can be opened up to people all over the world. One question this does raise, though, is what will happen to health tourism if it is no longer necessary to travel for healthcare?

There are further sociocultural barriers when it comes to implementing technologically-advanced medical services. First of all, some communities may be reluctant to accept telehealth as being the same quality as in-person health services or they may be opposed to using technology altogether. The dominance of English and French language resources may also eliminate healthcare in the metaverse and exclude those who speak other languages as their first language from engaging with it.

The use of blockchain technology in healthcare in the metaverse is vital for improving accessibility. Medical records will be stored in a way that enables the patient to have access to their full medical record at all times, allowing them to be in control of their data and share this with anyone who they see fit. This means that they could share this information with doctors and specialists from all over the world, increasing global interconnectedness and the autonomy of the public when it comes to being the custodian of their medical records.

Ultimately, web 3.0 and the metaverse have the potential to completely revolutionise healthcare as we see it today, and improve accessibility across regions that are geographically challenging. There are, however, limits to what can be achieved logistically due to the lack of high-quality ICT infrastructure and power supply in some areas. By implementing these infrastructures, LMICs that typically have the poorest levels of healthcare can operate on a more level playing field and provide the quality of care necessary to allow citizens to live a better life.