Amid the Covid-19 pandemic, media reporting has focused on how the pandemic is accelerating a new era of healthcare, utilizing emerging technologies like AI, IoT and telemedicine to make the industry more efficient, intelligent and responsive. While it is vital that the industry continues to explore solutions enabled by these technologies, this narrative overlooks an important barrier: the issue of access.
A recent study by the National Poll on Healthy Aging highlighted the scale of the “digital exclusion” challenge facing the healthcare industry, revealing that nearly half (45 percent) of adults over 65 have not created patient portal accounts to access their medical information. As the pandemic accelerates digital transformation in healthcare, there is growing concern that this digital divide will further expand. The industry must take steps to keep healthcare information accessible to all patient populations.
While the internet and digital exclusion is not a new issue, the pandemic shed light on populations that lack the digital literacy, inclination or access needed to utilize online systems. According to a 2019 report from the Pew Research Center, nearly one-third (30 percent) of people in the U.S. over the age of 65 do not use the internet, and more than 40 percent do not have broadband access at home. Additionally, nearly 40 percent of Americans over 65 don’t own a smartphone. Yet, healthcare organizations are growing their online presence at a rapid pace, with more than 90 percent offering patient portal access. This disconnect has been highlighted during the pandemic, with older generations expected to navigate complex online systems in order to obtain access to vaccines, testing and appointments.
The Digital Disconnect
Migration to the Electronic Health Record (EHR) began more than a decade ago in the U.S. and was accelerated by the Health Information Technology for Economic and Clinical Health Act (HITECH Act) and Meaningful Use. Early enforcement efforts made hospital funding contingent on reaching certain levels of technological adoption. Today, non-compliance can result in fines and penalties.
While digitization brings significant benefits, it is accompanied by the unintended side effect of digital exclusion. In the race to digitize and go paperless, healthcare leaders risk overlooking what their patient populations actually want and need. For example, when post-visit instructions or test results are posted online in the patient portal, not all patients are able to easily access it. And in the case of the Covid vaccine roll-out, where many health systems are using patient portals for vaccine scheduling, reliance on digital systems can add hurdles for those without online access, delaying their ability to receive life-saving treatments.
Supporting both digital and offline workflows also has an important role to play in interoperability. Long-term care providers such as care homes may not use online and digital systems for their records. When these providers need to share records with hospitals and other community care providers, there can be a process disconnect, leading to delays and additional cycles. Considering proactive solutions that support both workflows can help address these challenges before they adversely affect patients.
If we don’t prioritize solutions now, the healthcare digital divide may present more widespread national and international challenges. In the next few years, countries that are moving rapidly through their digitization journey, like Canada and the UK, will likely face similar challenges as digitization continues to roll out within their health systems at pace.
Hybrid Communications Solutions
Developing hybrid patient communications and records channels across digital and offline tools, such as physical print, can help bridge the gap. Use of printed patient communications can complement email, app/online, phone and text message options and ensure all types of patients have access to information.
When thinking about IT infrastructure, healthcare delivery organizations (HDOs) should utilize print devices that link to the EHR system to help ensure effective communication for all patients. These devices are particularly beneficial in hospitals and clinics that cater to populations with low internet access, to ensure they’re able to access information and advice in a format that works for them.
Ultimately, the first rule of medicine is to do no harm. But with the drive toward digitization of patient records and online patient communications, there’s a risk it may outpace the digital access of the population. This can affect patient communication and quality of care which, as we’ve seen with the pandemic, can literally translate into a matter of life or death.
While digital transformation in healthcare improves patient care, HDOs must continue to support those who, by choice or necessity, rely on offline healthcare services.
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