Digital healthcare equity in primary care: implementing an integrated digital health navigator

Author:

Rodriguez Jorge Alberto12ORCID,Charles Jean-Pierre1,Bates David W123,Lyles Courtney456ORCID,Southworth Bonnie12,Samal Lipika12

Affiliation:

1. Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital , Boston, Massachusetts, USA

2. Harvard Medical School , Boston, Massachusetts, USA

3. Department of Health Care Policy, Harvard Medical School , Boston, Massachusetts, USA

4. Division of General Internal Medicine, Department of Medicine, University of California San Francisco , San Francisco, California, USA

5. UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital , San Francisco, California, USA

6. Department of Epidemiology and Biostatistics, University of California San Francisco , San Francisco, California, USA

Abstract

Abstract The 21st Century Cures Act and the rise of telemedicine led to renewed focus on patient portals. However, portal use disparities persist and are in part driven by limited digital literacy. To address digital disparities in primary care, we implemented an integrated digital health navigator program supporting portal use among patients with type II diabetes. During our pilot, we were able to enroll 121 (30.9%) patients onto the portal. Of newly enrolled or trained patients, 75 (62.0%) were Black, 13 (10.7%) were White, 23 (19.0%) were Hispanic/Latinx, 4 (3.3%) were Asian, 3 (2.5%) were of another race or ethnicity, and 3 (2.5%) had missing data. Our overall portal enrollment for clinic patients with type II diabetes increased for Hispanic/Latinx patients from 30% to 42% and Black patients from 49% to 61%. We used the Consolidated Framework for Implementation Research to understand key implementation components. Using our approach, other clinics can implement an integrated digital health navigator to support patient portal use.

Funder

National Institute of Diabetes and Digestive and Kidney Diseases

National Institutes of Health

National Institute of Minority Health and Health Disparities

Research in Implementation Science for Equity

National Health Lung and Blood Institute

Publisher

Oxford University Press (OUP)

Subject

Health Informatics

Reference13 articles.

1. Digital health equity as a necessity in the 21st Century Cures Act Era;Rodriguez;JAMA,2020

2. Addressing equity in telemedicine for chronic disease management during the Covid-19 pandemic;Nouri;NEJM Catal Innov Care Deliv

3. Differences in the use of telephone and video telemedicine visits during the COVID-19 pandemic;Rodriguez;Am J Manag Care,2021

4. Legal, practical, and ethical considerations for making online patient portals accessible for all;Lyles;Am J Public Health,2017

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