Boston Researchers' 3-Pronged Approach to Combating 'Digital Redlining'

Aiming to eliminate barriers associated with the digital divide, Boston University School of Medicine, Boston University Questrom School of Business, and Boston Medical Center researchers examined ways to increase telehealth access for all individuals at both state and federal levels.

As telehealth takes an increasingly permanent position in healthcare delivery, it has produced various benefits. However, its distribution also creates health inequities, often driven by digital redlining, the researchers said in a perspective piece published in the Journal of General Internal Medicine.

Digital redlining is a term created to represent the redlining that leads to health inequities based on race and technological access. These inequities are common among Black Indigenous People of Color (BIPOC), immigrants, and low-income communities.

Two key inequities include digital fluency, that is, the ability to use digital tools effectively, and the capacity for health advocacy, which is the ability of a patient to advocate for their medical needs.

To reduce these inequities, researchers came up with a three-pronged strategy that includes creating federal and state policies to operationalize telehealth infrastructure, establishing national standards for healthcare access portals, and providing support to families as they adopt new care modalities.

“By establishing platform standards for accessing telehealth, and supporting societal and health system investments to increase health literacy, advocacy and technology fluency, we can begin to address the disparities in telehealth engagement and healthcare access,” said Rebecca G. Mishuris, MD, MPH, MS, assistant professor of medicine at BUSM, and primary care physician and Chief Medical Information Officer of the BMC Health System.in the press release.

The researchers aim to address disparities in telehealth access, eliminating the digital divide and creating equal levels of access among all individuals, with their recommendations.

“Without addressing these critical, less often discussed elements of telehealth implementation, it is our belief that telehealth will fall short of its promise and rather than mitigate health inequities, will perpetuate health inequities in the very communities that stand to benefit most from its implementation,” said co-author Katherine Gergen Barnett, MD, clinical associate professor of family medicine at BUSM and Vice Chair of Primary Care Innovation and Transformation at BMC.in the press release.

In recent years, various studies have shown how social determinants of health impact telehealth access.

A study published in JAMA Oncology detailed research describing how cancer patients with low socioeconomic status were less likely to use telehealth. This finding shows how social determinants of health and care disparities can play a role in enhancing the digital divide.

But there have been efforts to mitigate the care gaps that arise form the digital divide.

In July 2021, a program created in South Carolina attempted to teach seniors how to use technology. This program provided senior citizens with lessons on digital literacy, teaching them how to become more comfortable in using devices such as tablets and cell phones.