Rewiring Health: The Digital Health Equity Loop (DHEL)

Purpose

The Digital Health Equity Loop (DHEL) is a visionary framework designed to rewire healthcare delivery systems in resource-constrained environments through a regenerative, mobile-first model. Developed by the Xamayca Foundation, DHEL repositions telemedicine as a foundational pillar of primary care, integrating digital health into the everyday lives of underserved populations. This framework lays the groundwork for inclusive, adaptive, and scalable health systems built around equity, resilience, and user agency.

Core Concept
At its heart, DHEL is a systems innovation. It organizes healthcare into five interconnected rings:

1. Access – Ensures digital infrastructure, affordability, and digital literacy

2. Prevention – Embeds health education and behavior change via mobile tools

3. Entry – Delivers AI-enabled triage and virtual consultations

4. Integration – Connects digital services to physical healthcare infrastructure

5. Continuity – Supports chronic care, remote monitoring, and reso-regenerative follow-up

These rings function as a loop—where each reinforces the next—creating a living ecosystem that adapts to users and communities over time.

Why It Matters
In many low-resource settings, health systems remain fragmented, facility-centric, and exclusionary. Despite widespread mobile phone penetration, digital health is often underutilized, siloed, or treated as a stopgap solution. DHEL shifts the paradigm by building systems from the "device outward," centering care on tools people already use—phones, apps, and community networks.

DHEL responds to core challenges:

• Inequitable access to care

• Health system fragmentation

• Workforce shortages

• Lack of continuity in chronic care

• Underdeveloped health IT infrastructure

Strategic Relevance for Jamaica & the Caribbean
Jamaica’s high smartphone penetration, improving internet infrastructure, and decentralized geography make it an ideal testbed for DHEL. The Caribbean faces the dual challenge of expanding health access while managing non-communicable diseases and rural inequities. DHEL’s modularity allows local leaders to scale interventions over time, starting with what’s feasible—SMS health campaigns, CHW triage apps—and growing into national, interoperable telemedicine platforms.

Implementation Requirements

• National and regional integration standards

• Public-private partnerships across health, telecom, and tech sectors

• Policies to support zero-rated access to essential health apps

• Training and equipping of community health workers

• Inclusive design that reflects local language, culture, and tech fluency

• Governance models that support both centralized interoperability and decentralized self-custody of health records

Call to Action
DHEL is not a finished solution; it is a living blueprint. It is a call to health system leaders, policymakers, innovators, and community organizations to collaborate on building regenerative, equity-centered health systems. The Xamayca Foundation stands ready to lead pilot implementations, foster partnerships, and share the lessons of Jamaica as a model for health equity innovation throughout the Global South.

Let us build from the device outward together.