On April 15th, we hosted a summit and panel on digital inequity to explore how disparities manifest, and what stakeholders across the health care ecosystem can do to effect change. Our panel featured four leaders across the industry, from health systems to technology vendors and interest groups.

Starter list: How to bridge the 'digital divide'

In our conversation, we learned how our panelists’ backgrounds led to their interest in health equity broadly, the steps they’ve taken to address digital inequities in their patient populations, and lessons learned from these efforts. Explore our main takeaways from our discussion, and how they may relate to your organization’s digital equity efforts or aspirations.

Cheat sheet: Digital inequity

1. Digital health literacy should be included as a social determinant of health (SDOH): Lack of access to technology is a social determinant of health, and digital health literacy should be considered as such. This encompasses patients’ levels of access and adoption, and health care organizations should routinely collect this information on their patients. However, most currently do not.

   Many health systems engage in screening for SDOH integrated into their EMR, but most still do not include measures of digital health literacy. Dr. Sarah Schenk from ChristianaCare found this to be true in her own experience and is currently taking steps to remedy this.

    

2. Health care organizations can identify patients without digital access as a first step, then work with other stakeholders towards solutions. Many non-health industries have made strong advances in addressing the digital divide – particularly public-school systems. As an early step, health systems can learn from these other industries to begin assessing where inequities are, as Dr. Shayan Vyas from Teladoc pointed out with a personal example.

   When his son’s school district asked all students’ families if they needed help with internet access for remote learning, Dr. Vyas noted the parallels in digital equity that education and health care share. While organizations may not be able to offer every patient broadband connectivity or tech devices, they can measure and record data on who lacks access to help build towards future solutions.

   
   Meeting: Addressing digital inequities

3. Ensure adoption, not just access. Improving access with connectivity and technology is important, but it’s only the first step. Even if patients have access to technology, they may still not use services if they lack knowledge or trust in the services, or if they feel the care is not meeting their personal needs. Organizations need to ensure full adoption of, not just access to, technology. This requires additionally addressing mistrust and non-compliance in underserved populations. Organizations should ensure their platforms are welcoming spaces that connect across consumer segments, preferences, and needs.

   April Mims, Vice President of Public Policy at Hims & Hers and co-leader of the Telehealth Equity Coalition, talked about how she started using the term “adoption” instead of “access” when talking about digital inequity issues. Promoting adoption of technology is the ultimate goal, and it is more complicated than promoting access to technology. Adoption requires more flexibility, personalization, and long-term buy-in.

   Similarly, George Sauter, Chief Strategy Officer at John Muir Health, refers to the term as “Adoption” (with a capital A) to highlight the importance of keeping the patient fully engaged in all channels of care.

   
   The 'digital divide' is stopping your patients from accessing telehealth. Here's how to bridge it.

4. Let community partners guide your digital equity response. Community partnerships are the glue between patients and health care organizations. Their nuanced understanding of the populations they serve can help tailor digital programs to best meet preferences and needs. Over time, this approach also helps facilitate trust between patients and clinicians, and pave the path towards larger, long-term initiatives. As George Sauter remarks with John Muir’s Community Health Improvement Initiative, “a lot of health inequity is an issue of trust, and our partners helped us bridge the trust barrier.”

   ChristianaCare has also seen success with this approach in their work across two local underserved communities. In March 2020, their initial efforts were focused on immediate need for Covid-19 testing, while also building trust among patients through bilingual support. Over the past year, ChristianaCare has been able to grow and evolve their community involvement to include Covid-19 vaccinations, as well as virtual primary care.

What’s next?

Equity is far from a new concept in health care. As more and more care delivery shifts to a virtual setting, payers, clinicians, and health systems have the logistical—and moral—imperative to ensure equity is embedded in their services for all patient populations.

Advisory Board will be researching digital equity throughout the year. If you have an exciting initiative or perspective you’d like to share, drop us a line at AderholM@advisory.com.