ONC's final interoperability rules aim to increase innovation and investments in patient-facing tools such as portals and mobile health apps, but the industry must address inequities associated with these tools to ensure they benefit all patients, according to a recent viewpoint article published in the Journal of the American Medical Association.
Article co-authors Jorge Rodriguez, MD, Cheryl Clark, MD, and David Bates, MD, all physicians at Boston-based Brigham and Women's Hospital physicians, explained that digital health inequities in technology access, digital health literacy and user interface design must be addressed for ONC's rules to transform patient care.
The authors note that broadband and device access must be improved, as an estimated 21 million people in the U.S., primarily located in rural populations, lack broadband connectivity. And while 81 percent of the U.S. population owns a smartphone, there are gaps across digital health literacy and socioeconomic status. Individuals who rely on their mobile devices first for internet access are largely from racial or ethnic minorities, and expanding access to mobile health apps will present more opportunities to engage in their healthcare, according to the report.
Here are five suggestions for various stakeholders to incorporate health equity within patient-facing digital health tools, according to the report.
1. Government agencies: Require future regulations of federal programs such as Promoting Interoperability to include metrics on use of digital tools by underserved populations and enact policies that update and increase broadband access and data.
2. Vendors: Create digital health tools that are tailored culturally and linguistically to engage diverse populations and work with academic institutions to assess digital tools among underserved patients.
3. Institutions: Track digital health access and usage across sociodemographics, including race/ethnicity and language; focus on patient training in deploying new tech to account for varied digital literacy levels, specifically relating to security and privacy; and create workflows that allow clinical teams to engage with diverse patients across digital health platforms such as telehealth.
4. Clinical teams: Provide access to all patients for digital tools and encourage patients to use tools as part of standard care.
5. Patients: Advocate for equitable digital health tools within respective healthcare systems.