Telehealth is for everyone, and hospitals and health systems must construct a digital equity strategy to better serve patients in the digital and telehealth space to ensure all persons can use telehealth, contended Alexandra Hunter, virtual care consultant at Henry Ford Health in Detroit.

The technology and internet space have rapidly proliferated over the last 30 years. As this field has expanded, so has healthcare in the way in which it delivers its services to its patients, specifically telehealth. Telehealth has been promising for the healthcare field to provide easier delivery of care where, when and how patients need it.

However, it has shined a glaring light on the contrast of patient populations with and without adequate access and digital health literacy to engage in this type of medical care. Digital equity is defined as the idea that everyone should have the information technology capacity needed for full participation in the society, democracy and economy.

Hunter will address this subject at the HIMSS 24 Global Conference & Exhibition in an educational session titled "Addressing the Gaps in Digital and Telehealth Equity Through Strategy."

How to construct a digital equity strategy

"Not every organization is equipped to support their patients in accessing telehealth," Hunter said. "In my session, attendees will learn about how to construct a digital equity strategy to better serve their patients. There is a strong connection between the populations that experience barriers in access to broadband and are digitally illiterate and those who have a higher prevalence of and premature mortality from chronic health conditions.

"This session will explore ways in which Henry Ford Health and other health systems have addressed the gaps and helped overcome barriers," she added.

Equity is important to health IT leaders at hospitals and health systems because telehealth is not going away, she said.

"Most organizations were building the plane while they were flying it at the start of COVID because they didn’t have a telehealth department, while others were simply trying to get providers to adopt it," she noted. "Now that the dust has settled and telehealth is a part of many providers' daily activities, it’s important to identify the gaps and barriers that are preventing patients from being able to access and utilize telehealth for their healthcare.

"Many people assume telehealth is in place of in-person visits when it is in addition to," she continued. "Patients who find themselves requiring many visits with their providers, like chronic disease or older adults, can benefit from using telehealth to adhere to their care plan and potentially have better health outcomes."

Broadband and WiFi

To achieve this, a health system must look at their patient population and assess their access to broadband and WiFi, she added.

"Ask questions such as who has devices? What are our patients' digital literacy skill levels? How are we increasing our patients' digital literacy skills? What technical support do we currently provide patients?" Hunter asked. "The future continues to trend toward a digital world and the telehealth landscape is not the field of dreams. If we build it, it doesn’t mean they will come.

"Health IT leaders at hospitals and health systems need to understand why and they need to understand that in investing in addressing the gaps and barriers of digital and telehealth equity is an investment in their patients’ health outcomes and their communities," she added.

Hunter would like session attendees to walk away with an understanding of what digital equity is and why it’s important.

"Digital equity is the idea that everyone should have the information technology capacity needed for full participation in our society, democracy and economy," she stated. "The National Center for Education Statistics found 16% of U.S. adults are not digitally literate, and of that percentage, these individuals are less educated, 65 years or older, and Black and brown individuals. These traits are typically found across those who don’t have access to WiFi or devices, require technical support, and could benefit from digital literacy training.

"Additionally, we know that patient-facing health-related apps, like MyChart, have poor usability for those with low digital literacy skills," she added.

Why should a health system care?

It is vital to healthcare and health IT because in order to be able to address the digital inequities within a patient population, one must understand what it is and why a health system should care about it, she said.

"Without it, any initiative or leadership buy-in is at risk for failing because you haven’t taken the time to understand it," she explained. "Additionally, in order to assess telehealth/digital equity within your health system, you have to understand how to apply any findings to your strategic goals.

"Which brings me to my next point: What are the organization’s strategic goals in terms of addressing telehealth and digital equity? Do they have any? If not, why not? What is the landscape of your executive leaderships understanding of digital/telehealth equity? Do you have executive leadership that supports tackling telehealth/digital inequities?" she asked.

Prior to embarking on creating Henry Ford Health’s digital equity strategy, there was no process to provide both patients and staff with technical support. Henry Ford Health had no way to identify patients who needed assistance; and for the patients who self-identified as needing assistance, the organization had nothing in place to provide assistance.

"Internally, our providers and front desk staff were not equipped to deal with the technical support questions being presented to them," Hunter noted. "Our community health workers and social workers were not aware of the resources that existed for patients to overcome their digital barriers. In certain scenarios, patients were not offered and not considered for telemedicine visits because of providers' lack of knowledge about the resources that existed to support patients in getting connected.

"These offerings ranged from chat functionality that assists those who are hard of hearing, to integration of interpreter services in video visits for those who do not speak/understand English well enough to participate in a medical visit, to proactive outreach support for those at a higher risk of experiencing difficulties," she continued.

A cautionary tale

This is a real-life example of the ways in which Henry Ford Health was not able to equitably serve its patient population. These learnings can serve as a cautionary tale for other health systems and IT leaders to assess and address their digital equity strategy to ensure telehealth is for everyone, Hunter said.

Also during the session, Hunter will highlight easy, actionable areas to create a digital equity strategy and assess one's current offerings within a health system.

"Take a look at populations and their access to telehealth visits who fall into the following categories: older adults, low socioeconomic status, limited health literacy, limited English proficiency, and racial/ethnic minorities," she noted. "Assess your education offerings on telehealth to your patients.

"What are your current tip sheets like? Are they translated to multiple languages? Does your health system offer any trainings or classes on increasing patients' digital skills and comfortability with telehealth?" she continued. "Organizations can think about how to make their frontline staff aware of resources that exist to address some of their patients’ digital needs to be able to inform them."

Better equipped at conducting telemedicine

Investing in creating a digital equity strategy and assessing current offerings can assist providers and support staff in being better equipped at conducting telemedicine visits and supporting the patient connectivity, she added.

"Henry Ford Health created patient technical support roles as a result of our own assessment," she said. "The creation of patient technical support roles have resulted in an increase in positive patient experiences through contact with these designated employees to handle technical issues.

"Additionally, Henry Ford Health has sought out partnerships outside of our immediate virtual care team to achieve our goals," she continued. "These partnerships have allowed us to receive external funding to conduct digital literacy programs aimed at increasing skills among older adults and subsequently increasing their use of telehealth and telemedicine."

All these items and more have positioned the Henry Ford Health team to make impactful strides in the digital equity space and continue to be subject matter experts and thought leaders on digital equity strategy inside and outside of the health system, Hunter said.

"Lastly, there is a direct correlation between Henry Ford Health digital equity strategy and Press Ganey likelihood to recommend scores for telemedicine," she noted. "Our top box score for likelihood to recommend was 75.06% in Q2 of 2020 and we have been able to increase it to 76.98% for Q2 of 2023. Our team reads the patient comments from these surveys monthly.

"These comments inform us of opportunities that we have to better support and confirm our strategy is in alignment with patient needs," she added.

Hunter's session, "Addressing the Gaps in Digital and Telehealth Equity Through Strategy," is scheduled for March 12 from 1:30 p.m. to 2:30 p.m. in Room W206A at the HIMSS24 in Orlando. Learn more and register.

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