Bridging the Digital Divide in Health Care: A New Framework for Equity
Digital technologies are transforming health care delivery, but significant disparities in access and utilization persist. A recent study published in JAMIA Open, led by researchers from the Department of Health Policy and Management, including Elham Hatef, MD, MPH, and Jonathan P. Weiner, DrPH, presents a new framework to address these inequities.
The Digital Health Care Equity Framework (DHEF) was developed through a collaborative process involving a diverse panel of experts and supported by the U.S. Agency for Healthcare Research and Quality. This framework aims to ensure that digital health tools benefit all communities equitably by guiding the intentional integration of equity throughout their lifecycle.
“The digital divide isn’t just about internet access—it’s about tailoring health care technologies to meet the diverse needs of every patient, regardless of their background,” said Hatef. “This framework provides a systematic way to embed equity at every development and implementation phase.”
Digital health care tools, ranging from telehealth platforms to wearable devices, have revolutionized patient care. However, for many underserved populations, barriers such as limited broadband access, low digital literacy, and cultural mismatches in technology design exacerbate existing health disparities.
The framework was designed as a comprehensive tool to help stakeholders—including health care developers, vendors, health systems, and policymakers—assess and address equity across all stages of the digital health care lifecycle. These stages include:
- Planning and Development: Ensuring digital tools are designed with input from diverse communities.
- Acquisition: Evaluating the inclusivity and accessibility of technologies procured by health care providers.
- Implementation and Maintenance: Identifying barriers to use and adapting technologies to meet local needs.
- Monitoring and Equity Assessment: Measuring outcomes to ensure equitable benefits across all demographics.
The framework emphasizes addressing “digital determinants of health,” including infrastructure challenges like broadband access and individual barriers like digital literacy. It also highlights the importance of participatory design and community engagement to ensure tools are culturally and contextually relevant.
For example, during the COVID-19 pandemic, many vaccination sign-ups relied heavily on internet access, disadvantaging individuals in rural or low-income areas. The framework encourages systems to offer alternative methods, such as phone-based sign-ups, alongside digital tools.
One of the framework’s unique aspects is its emphasis on collaboration among diverse stakeholders, including patients, caregivers, community leaders, and public health officials, in developing and refining digital health care solutions.
