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Addressing digital inequity is a business imperative

3 business outcomes from prioritizing digital inequity

Addressing digital inequity is more than a moral obligation—it’s a business imperative.

Misconceptions about digital inequity prevent health care leaders from prioritizing efforts to address it. But we’re entering a world where digital will be pervasive in health care, and leaders who don’t start to address digital inequity will have a harder time engaging with patients.

Organizations that prioritize digital inequity efforts will benefit from a bigger market for digital solutions, design tools that a wider range of patients will want to use, and reduced cost-of-care through improved outcomes.


A definition of digital inequity

A health disparity characterized by a lack of access to and literacy of digital tools and interactions, leading to worse care outcomes for affected populations.


The conventional wisdom

Digital inequity is often left out of the health care industry’s overall commitment to health equity—either because many leaders don’t consider it, or they don’t feel the same responsibility to close the gaps of digital inequity. They think of it as someone else’s problem, like the government’s, or they deprioritize it because they don’t think their business will be negatively impacted by it.

There are a few misconceptions that perpetuate inaction around digital inequity:

Misconceptions about digital inequity

It isn’t an issue for a majority of the population.

Digital inequity is only experienced by a small subset of patients served. Digitally-enabled patients are the majority and building for them is smart. Organizations can design or implement digital solutions for digitally-enabled patients and ignore the patients who can’t use their digital solutions without consequence to overall outcomes or their bottom line.

It can’t be the main priority of any one leader or department.

While addressing digital inequity may be an organization-wide goal, there doesn’t need to be a single, accountable leader because it doesn’t fall wholly into any one person’s existing responsibilities.

It’s just a feel-good mission-driven initiative.

A commitment to addressing digital inequity is nothing more than virtue signaling. Without concrete ROI to measure impact, there’s no impetus to prioritize digital inequity over other organizational goals that have quantifiable outcomes.


Our take

Addressing digital inequity is more than a moral obligation—it’s a business imperative.

We are entering into a health care landscape where we can’t separate care delivery from digital. Effective care delivery will be contingent on digital elements centered around the patient and their care teams. Health care leaders can’t afford to not address digital inequity.

Truths about digital inequity

Digital inequity isn’t binary.

Digital inequities span a wide range of access, skills, and confidence—meaning any patient could be impacted by digital inequity. For example, a patient may have strong broadband connectivity, but not have a device or the digital literacy to use the solution. Or a patient might have the knowledge to use a digital solution but lack the confidence and trust to use it.

Addressing digital inequity is part of a competitive, long-term strategy.

Other organizations, including retail, big tech, and health are incumbents are all fighting for patients, including those at the margins. The organizations that can successfully address digital inequity will win patient engagement and patient loyalty, which will lead to even bigger wins down the road.

Digital health is a component of quality.

Digital health solutions improve access and convenience and are the most beneficial for the patients who are the most at-risk and disengaged from care. Connecting patients with digital solutions to help them effectively manage their care will lead to better care outcomes.


Three reasons digital inequity is a business imperative

Beyond the moral imperative to help patients, addressing digital inequity could benefit health care organizations by allowing them to:

Remember: digital inequity is not binary, and patients experience digital inequity along a spectrum of ability, access, and confidence—and often experience multiple components of digital inequity at once. The tendency to view patients as either experiencing digital inequity completely or not at all drastically limits potential market share for digitally enabled care.

If you can address digital inequity to help more patients use digital solutions, you could expand your market share. Not only would you have more patients using your digital solutions, but you’d also be engaging with patients both in-person and digitally with the potential to solidify patient relationships and prevent patients from falling through the cracks. By empowering patients digitally, you are creating another touchpoint with them.

And there are a lot of patients you’re missing out on because of digital inequity.

Sizing out the problem

We can use access to broadband in Detroit, Michigan as an example. Almost 40% of the 1.75 million people living in Wayne County, the county that includes Detroit, don’t use internet at broadband speeds. That’s over 670,000 people.

Imagine how many more people that would include when you think about access to devices, digital literacy, and affordability of these solutions, which are harder to map out, but just as impactful—that’s a lot of people who can’t use digital solutions.

Spotlight

ChristianaCare’s Patient Digital Ambassador program provides support to patients for better patient engagement

ChristianaCare, a nonprofit health system headquartered in Delaware, targets patients who require digital support with their patient digital ambassador program. The digital ambassadors, a new role that resembles a social worker, help patients get comfortable with digital solutions, like online portals or virtual visits, and help them navigate their care journeys. Patients can reach out to ambassadors at any point for anything from help with a new device to scheduling an appointment. Through this program, ChristianaCare found that they’ve been able to engage with patients who would have otherwise avoided seeking care.

Health care currently struggles to collect quality data and turn that data into actionable insights. It’s particularly difficult to get quality data on who uses digital solutions and how they use those solutions. Part of the problem is that the data is heavily skewed towards the groups that most often engage with digital solutions—typically young, white, commercially-insured patients. Health care organizations miss out on data on underserved populations. It’s a cyclical problem: we have data on patients who are already using digital solutions, which makes it easier to design and tailor new solutions towards those same patients.

Organizations that successfully capture a broader portion of the population will access a bigger, more diverse dataset. That data will help organizations:

  • Learn more about their patient population and how patients interact with health care solutions
  • Change when and how organizations communicate with their patients
  • Improve marketing efforts for their target population
  • Better design, or redesign, tools for a broader patient population.

Addressing digital inequity will help digital health fulfill its ultimate promise: providing better care through improved access. We’ve already seen many examples of that promise in practice. The increase in virtual visits during the pandemic helped patients find and receive care during the Covid lockdowns that prevented patients from seeking in-person care. Remote patient monitoring (RPM) allows providers to continuously monitor patients outside of traditional office visits. And asynchronous solutions, like chat bots, increase provider efficiency, which means bigger panel sizes.

While the ROI on digital solutions can be nebulous, most organizations persist with investment because they count on the downstream financial gain that come from providing better care outcomes. For this reason, digital health solutions are often touted as good options for patients with multiple chronic conditions or require ongoing, low-cost care. But ironically, it’s often these same patients that are most impacted by digital inequity and can’t access these solutions. In other words, digital health solutions fail to reach the people who would benefit the most from them.

Organizations that successfully address digital inequity will reach more patients, increase access to care, and have a better chance of delivering on the promise of lower costs and better outcomes.

Spotlight

New York City Health and Hospitals’ virtual urgent care successfully expands access to its most vulnerable populations

New York City Health and Hospital (NYC H+H) rolled out Virtual ExpressCare in March 2020 to provide virtual urgent care for its most vulnerable communities. NYC H+H intentionally designed their virtual urgent care model to ensure it was a patient-first, digitally equitable experience.

Since the rollout, NYC H+H has seen over 35,000 patients through the service. The service has greatly improved access to the health system and continues to satisfy patients and staff:

  • 95%: Overall patient satisfaction rating for Virtual ExpressCare
  • 2,300: Unnecessary EMS transports prevented by Virtual ExpressCare, for savings of approximately $2.8 million
  • Five in six: Patients that were able to stay at home and avoid in-person urgent or ED care within seven days of their virtual appointment

Parting thoughts

Treating digital inequity as a business imperative doesn’t have to be an entirely new or separate business venture. Instead, leaders can modify other equity-driven initiatives and apply lessons learned from addressing health equity more broadly to include digital inequity.

Think of digital inequity as another social determinant of health

Health care organizations are already addressing social determinants of health (SDOH). Digital must be recognized as a new SDOH because of the way it impacts every other aspect of life—work, education, and social. Organizations could learn from how they’ve addressed other SDOH and adapt those methods for digital inequity. As an example, organizations could adapt health literacy education to create digital literacy training. Or organizations can look at how they’ve already connected patients with other resources, like housing or food, and connect them with digital resources, like devices.


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