Prescription for Change

The 'digital divide' is stopping your patients from accessing telehealth. Here's how to bridge it.

by Sarah Evans, Ryan Furr-Johnson, and Camille Bridger

Telehealth is here to stay. And while it has the potential to dramatically increase access to care, many patients face barriers that prevent them from accessing virtual care options. These barriers constitute the 'digital divide,' which includes inadequate access to technology, unreliable internet coverage, and low digital literacy. In fact, the American Medical Informatics Association asserts that, "Access to broadband is, or will soon become, a social determinant of health."

Starter list: How to bridge the 'digital divide'

What research tells us about the digital divide

There is a wealth of data demonstrating that the digital divide is greater for some populations:

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Health Equity 101

  • The Pew Research Center found that only 58% of Black Americans and 57% of Hispanic Americans reported owning a desktop or laptop computer. Meanwhile, 23% of Black Americans and 25% of Hispanic Americans reported being "smartphone only" internet users, meaning they lack traditional home broadband services.
  • Pew reports that only 55-60% of American adults aged 65 and older own a smartphone or have broadband internet access.
  • It also found that, while 96% of Americans own a cellphone of some kind, among Americans with annual incomes under $30,000, only 82% use the internet, only 71% have cell phones, and only 56% have home broadband access.
  • Our Consumer Virtual Visit Survey reports that consumers with annual incomes under $24,000 represented only 18% of all new telehealth users. Consumers with annual incomes above $71,000 represented almost twice that amount, at 33%.
  • An Annals of Internal Medicine study found that less than 40% of the people who live more than a 70-minute drive from a primary care physician have the internet bandwidth necessary for a telehealth visit. This demonstrates that physical access challenges can often manifest virtually.
  • The National Center for Education Statistics reports that 16% of U.S. adults are not digitally literate, and adults who are not digitally literate are, on average, less educated, older, and more likely to be Black or Hispanic, or born outside the United States.
  • Collectively, at least 1 in every 4 Americans may not have the access to technology, access to the internet, or the digital literacy necessary to participate in video visits.

How to confront the digital divide

Left unaddressed, the digital divide means that widescale shifts to telehealth could actually exacerbate health inequities—not reduce them. As health care organizations iterate on the telehealth services they rapidly stood up this spring, they have an opportunity—and obligation to their patients—to address these barriers to virtual care.

Our starter list to bridge the telehealth digital divide offers guidance on how you can promote telehealth equity across your organization by:

  • Understanding how the digital divide manifests in your community
  • Evolving your telehealth offerings to be more accessible to your vulnerable patients
  • Connecting patients with the technology necessary for virtual visits
  • Building patients' digital literacy so they can engage in virtual visits
  • Raising community awareness of your organization's telehealth offerings

Download our starter list to bridge the telehealth digital divide

Help us add to the list. How is your organization bridging the digital divide?

If your organization is making additional investments to bridge the digital divide for your patients and you think other leaders should know about it, send a brief overview to Ryan Furr-Johnson at RFurrJo@advisory.com

Learn more: How Covid-19 will impact telehealth

The rapid embrace of telehealth in the wake of Covid-19 is simply astonishing. In less than one month, provider practices shifted from doing almost no virtual visits to doing only virtual visits.

While telehealth won't be the only way to access care in the future, it will be a much more commonplace one. Read our take on telehealth's sudden pivot from "nice-to-have" to baseline expectation.

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