Crossing the Digital Divide

Brigham researchers lay the groundwork for equity in telehealth.

Mass General Brigham’s technology loaner program is helping patients who need devices or internet access for telehealth services.

With the COVID-19 pandemic creating surging demand for virtual visits, Brigham leaders are taking care not to let access to telehealth further exacerbate disparities in care.

Several studies from the Brigham have examined this digital divide—the gap between those who have access to technologies and the digital literacy to use them and those who don’t. English-language proficiency, race, age, geography, health coverage, and more can all impact how—and if—patients adopt and use telehealth services.

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The Brigham and its parent organization, Mass General Brigham, are tackling the digital divide by:

Partnering with Tech Goes Home, a Boston-based nonprofit, to provide digital literacy courses for patients of Brookside Community Health Center and Southern Jamaica Plain Health Center.

Launching a loaner program to offer 2,000 iPads, medical monitoring equipment (like blood pressure cuffs), and cellular-enabled hotspot devices to help patients without devices or Wi-Fi internet access telehealth services.

Hiring digital health navigators and multilingual help desk support staff, and updating MGB’s digital patient portal, Patient Gateway, to translate electronic communications into Spanish, Portuguese, Haitian-Creole, Chinese, Arabic, and Russian.

In one study looking specifically at language barriers and technology, researchers found that among more than 84,000 patients, 15% identified as having limited English proficiency, which was linked to lower rates of telehealth use compared with proficient English speakers (4.8% versus 12.3%).

Jorge A. Rodriguez, MD, who co-authored the study with other Brigham investigators, explains that achieving equity in telehealth depends on several key factors: providing access to the internet and devices, promoting the digital literacy needed to use these tools, and boosting insurance coverage for telehealth programs, particularly for patients enrolled in Medicare and Medicaid.

“Our study reveals opportunities for multilevel policy changes that can ensure the equitable expansion of telehealth,” says Rodriguez. “Policymakers should collaborate with health organizations to apply a comprehensive approach that includes broadband access, device access, telehealth infrastructure, and community-based digital literacy programs.”