Bridging the gap

Despite the widespread adoption of Electronic Health Systems, many patients still struggle to access their health portal, a clear manifestation of the digital divide that persists despite advancements in technology. This divide goes beyond access to technology, encompassing broadband availability, digital literacy, and socio-economic factors that underpin health disparities.

My journey toward understanding and championing digital health equity began as a pre-medical student. While working as a clinical research coordinator at UCSF amidst its transition to the Epic electronic medical record (EMR) system, I encountered barriers facing older patients in accessing digital health services. My job involved teaching hospitalized patients to navigate the EMR system, where I learned that older patients are eager to be connected but require more support to use technology. This realization underscored the importance of not just providing access to digital technologies, but also adequate support and education for all users.

Fast forward to my residency in Family Medicine. My patient panel includes monolingual Spanish-speaking patients, and many older patients who do not have access to their health portal. Social determinants of health (SDOH), such as financial resources, housing, and education, have long been recognized for their impact on well-being, but the advent of the internet has introduced a "super determinant of health," internet access. This new determinant underscores the role of technology in accessing essential services, including healthcare, thereby highlighting the intersection between technology and social determinants in influencing health outcomes. Digital health literacy is another critical aspect, extending beyond the basic ability to use technology. It involves understanding and engaging with digital tools to manage one's health effectively. The lack of digital health literacy further widens health inequities, presenting a significant challenge to overcome.

One promising approach to bridging this divide is the implementation of digital health navigators. These individuals play a crucial role in guiding patients through digital health systems, ensuring comprehensive engagement with healthcare providers, telehealth management, and the integration of wearables and other digital health tools into patient care. As medicine continues to evolve, addressing the digital divide is becoming increasingly imperative. By advocating for and implementing solutions like digital health navigators, we can ensure that technological advancements in healthcare benefit all patients equally. It is our responsibility, as future leaders in medicine, to commit to making digital health equity a cornerstone of our practice, ensuring that no patient is left behind in the digital age.

Published in the Sonoma Mendocino Lake County Medical Association News Briefs, March 2024. View the original PDF.