Stop the Divide: Facilitators and Barriers to Uptake of Digital Health Interventions Among Socially Disadvantaged Populations
Price-Haywood EG, Arnold C, Harden-Barrios J, Davis T. Stop the Divide: Facilitators and Barriers to Uptake of Digital Health Interventions Among Socially Disadvantaged Populations. Ochsner J. Spring 2023;23(1):34-42. doi:10.31486/toj.22.0101
This qualitative study provided facilitators and barriers to implementing a new electronic patient portal (MyChart) in predominantly Black/African American and/or Medicaid-/Medicare-insured populations. MyChart is a portal accessible by mobile phone or computer with internet service. The program launched in Louisiana in 2020 and includes a digital medicine program that provides access to health coaches, clinical pharmacists, data from remote monitoring equipment, and appointment scheduling tools. For this study, 40 patients and 30 providers were surveyed about their experiences using the digital medicine platform. Participants described their access experience, attitudes, satisfaction, and challenges using health technology. Most patients were middle-aged, female, Black/African Americans who lived in urban areas and were insured by Medicaid. Most providers were young White male physicians who served predominantly Medicare/Medicaid-insured populations. Patients liked the consolidation of their health information, ease of appointment scheduling, medication refill requests, and medical advice messaging. As the mobile phone was the preferred access method, it is notable that most patients accessed these things successfully from their phones. Practitioners felt the largest barrier to implementation was the requirement to respond to too many messages, producing workload inefficiencies. While patients liked not traveling to clinics for visits, telemedicine visits were difficult on mobile phones. A lack of high-speed broadband access prevented some patients from engaging in telemedicine visits. Practitioners had concerns about video quality, safety when visits occurred in public spaces, like a car or workplace, and workflow issues around wait times. Most participants had positive views of using technology to help manage health. It remains critical to provide resources, like high-speed broadband access and digital navigators to push the digital health field forward in a sustainable way for patients and providers.