Health and digital health equity are top-of-mind at Boulder Community Health (BCH). Knowing digital equity is a concern for Colorado's disconnected communities, BCH joined in partnership with Ayva and the Magnolia Road Internet Cooperative (MRIC) to expand broadband coverage by hosting long-range radios for the initiative on their hospital roof. This allowed Boulder Community Health to have a new role in its communities, while also staying true to what they do best: providing patient care.
Earlier this year, we spoke with Mike Jefferies, CIO at BCH, and Ayva CEO Nick Wilson to learn about this initiative, as well as other considerations for health care organizations as they begin to think about digital equity across their own populations.
Digital inequity is a pervasive, cyclical issue. Inadequate education limits employment opportunities, which exacerbate disparities in housing, nutrition, and safety. Parallel to these inequities is a widening gap in technology access and digital literacy. This results in disadvantaged individuals who are also disconnected from important technological touchpoints, such as health care. As more care delivery shifts to the virtual setting, digital equities will worsen health outcomes related to technology, as well as the existing cycle of other social determinants of health.
Ayva and Boulder Community Health understand this cycle, and the imperative to act now. However, rather than reinvent the wheel and have a hospital learn how to augment broadband infrastructure, they focused on partnership opportunities in this space. Ayva initially approached BCH to use their hospital building as a site for their new fiber uplink, and to host the long-range radios required. Jefferies notes that hospitals are often the tallest buildings in towns and small cities, making them uniquely positioned to serve as a conduit for connectivity efforts.
This allowed for Ayva to utilize existing dark fiber in the area to establish an uplink site at BCH, bringing high-speed connectivity throughout the region to rural mountain residents. The broadband services provided through the cooperative are for general day-to-day use, but Jefferies and Wilson both hope that it increases access and utilization of telehealth in care delivery as well.
Unlike most digital equity programs helmed by health systems, BCH is taking on this role as part of their nonprofit community benefit mission, without any transactional expectation of financial ROI. Jefferies emphasized that through expanding internet access, BCH wants people in their community to be able to better access virtual care – even if that care is delivered by a non-BCH-affiliated organization.
This remains an ongoing initiative between the organizations with no hard costs to BCH, but a significant positive effect in digital equity efforts for the surrounding community. Throughout the Covid-19 pandemic, this partnership has proven especially critical for community members, who now rely on BCH for connectivity to conduct even the smallest tasks in their daily routines.
Nick Wilson reflects on the "absolutely invaluable" effects the program has had: "Kids are able to learn from home, residents can telework, and families no longer have to budget their bandwidth utilization for entertainment… it prevents residents from having to drive down difficult mountain roads in potentially difficult and hazardous winter conditions. Even within my immediate neighborhood, access to telehealth has improved for both patients and providers."
Digital inequity is a multipronged issue and demands a complex response. Here, one thing is clear: no single stakeholder is responsible—or capable—of addressing it alone. Partnerships like BCH and Ayva show how health care organizations can be involved in the challenge of addressing these inequities—without having to invest in broadband infrastructure or learn outside of their wheelhouse. As this issue receives more and more attention, explore Advisory Board's host of resources on addressing digital inequities and literacy across your organization.
Access to technology is a social determinant of health. This cheat sheet outlines why health care organizations must work to improve digital equity as they continue to invest in new technologies.