Addressing digital inequity is a business imperative

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