Blog by Joe Babaian
According to a study from The University of Texas at Austin, nearly half of Americans are skeptical of the benefits of Health information technologies — such as wearables, patient portals and mobile apps.
We should let that sink in for just a moment. Nearly Half. We discuss #Innovation, #DigitalHealth, #DesignThinking, #PatientExperience, #PatientCenteredCare and other key aspects of what we know comprise a great, modern healthcare system – but if so many people are skeptical of the benefits of technology, we must address that now and as we move forward. If not, we’ll see the progress that is not taken up/absorbed by the very people who are the reason behind all of this great work.
The UT study makes clear the connection between low health literacy and this skepticism of health technologies. The study found:
Americans who are less health literate — those who struggle to find and understand medical information — tend to be skeptical of health technologies. They also expressed a strong distrust for government, media and technology companies in general.
The lack of health literacy is exacerbated in minority, rural, and low-income populations that are already falling into the digital divide. We can’t just address health literacy without addressing the digital divide. There is not a one-step fix. Let me repeat that there is not a one-step fix; we must not fall into the trap of “build it, and they will come.” That is not happening for many people, and more than one wall is standing in their way. What can we do to help?
A stunning conclusion from a recent Microsoft study – “Digital Divide Is Wider Than We Think, Study Says” lays out a sobering challenge:
Over all, Microsoft concluded that 162.8 million people do not use the internet at broadband speeds, while the F.C.C. says broadband is not available to 24.7 million Americans. The discrepancy is particularly stark in rural areas.
Cathy Newkirk of The Michigan State University Extension lays it out:
Those who are more likely to experience low health literacy are older adults, racial and ethnic minorities, people with less than a high school diploma or GED, people with low income levels, non-native speakers of English and people with compromised health status, such as those with chronic health conditions. Culture and access to resources also affect people’s health literacy.
It can be argued that the digital divide reduces health literacy and the converse – low health literacy worsens the digital divide. Let’s take a look at two examples:
- Someone without reasonable access to stable and affordable internet access and/or reliable devices to use that access? A chance that this person is going to spend time online reading about health, new options, and how to become a more empowered part of the healthcare system? Doubtful.
- Someone with low health literacy visits the patient-centered clinic with all the bells and whistles, quality EMR, useful portal, advice for tracking tools and apps, things to send home to try, you name it. This person’s low health literacy worsens their outcome since they cannot absorb, process, and effectively use (don’t know how AND can’t effectively access) what they have been given at their visit! They are simply overwhelmed and back away (while politely nodding and smiling).
David Tseng, MD mentions his concern that poor health literacy in and of itself is deepening the digital divide:
Patients with poor health literacy make less use of EHRs [& Portals], fitness apps
This week on #hcldr, let’s talk about technology access in healthcare, the digital divide, and health literacy
Join the #hcldr community of professionals, patients, clinicians, administrators, lurkers, counselors, social workers, designers, and advocates! Please join us on Tuesday, August 16th, 2022 at 8:30pm Eastern as we discuss the following topics:
- T1: What are some of the worst effects of the digital divide/low health literacy in healthcare? Examples?
- T2: How might reliable access to the internet and associated resources be considered a human right? Should this be a priority?
- T3: How might we extend health literacy and needed access to patients now and keep them engaged? Examples?
- T4: Where should health literacy begin? At home, school, clinic? Why or why not?
“Digital gap between rural and nonrural America persists.” Andrew Perrin, Pew Research Center. May 2019.
“Digital Divide Is Wider Than We Think, Study Says.” Steve Lohr, The New York Times, Dec 4, 2018.
“The rural broadband divide: An urgent national problem that we can solve.” Brad Smith, Microsoft, Dec 3, 2018.
“Health Literacy and Health Information Technology Adoption: The Potential for a New Digital Divide.” Mackert M, Mabry-Flynn A, Champlin S, Donovan EE, Pounders K. J Med Internet Res 2016; April 10, 2016. DOI: 10.2196/jmir.6349
“Bridging the Digital Divide in Health Care: The Role of Health Information Technology in Addressing Racial and Ethnic Disparities.” Lopez, Lenny and GREEN, ALEXANDER R. and TAN-McGRORY, ASWITA and KING, RODERICK K. and Bentancourt, Joseph R. Joint Commission Journal on Quality and Patient Safety, 37 (10). pp. 437-445. October 2011.
“Poor Health Literacy Worsens Healthcare’s ‘Digital Divide’” David Tseng, MD., Medpage Today, December 12, 2016.
“Latinos face digital divide in health care.” Mariaelena Gonzalez, The Conversation, August 4, 2016.
“Bridging the Healthcare Digital Divide: Improving Connectivity Among Medicaid Providers.” Andy Slavitt, Karen DeSalvo, The CMS Blog, March 2, 2016.
“New Digital Divide: Low Health Literacy Connected to Distrust of Health Technologies.” UT News, November 29, 2016.
“What health literacy is and why we should care.” Cathy Newkirk, Michigan State University Extension, December 5, 2016.
Photo by Roberto Reposo on Unsplash