Bridging the Digital Divide in Healthcare to Improve Access to Care

July 20, 2021

The Federal Communications Commission reports that 19 million Americans still lack access to high- speed internet. As telehealth becomes more accessible due to increased federal funding investments and lifted policy restrictions catalyzed by the COVID-19 pandemic, the disparities in access to technology used for telehealth (i.e., smartphones, laptops) and high-speed broadband remain. This digital divide in healthcare remains a challenge, creating a growing a division between communities who have access to digital health technologies and efficient broadband resources versus those who experience limited access due to socioeconomic, geographic, and financial barriers.

Communities of color, older adults, people with lower educational levels, and families of low-income are more likely to experience limited digital access. Less densely populated rural and tribal lands experience slower broadband deployment services due to lower investments in infrastructure development. Some urban populations also fall into these gaps because of lower adoption of broadband services due to cost and digital literacy challenges. The design of telehealth platforms further inhibits certain populations from accessing digital healthcare due to limited translation services, screen readers, and other design features that people with disabilities or limited English proficiency may require.

Federal Investments to Expand Digital Access

Federal agencies are investing in programs that will bridge the digital divide in these communities and improve access to care for historically marginalized communities.

In March 2021, Congress passed the American Rescue Plan Act, which includes federal investments to improve broadband and digital infrastructure. The act also includes $500 million for the Emergency Rural Development Grants for Rural Health Care, that would, among other things, support telehealth programs. Furthermore, the bill directs $50 million to local behavioral health services and $140 million for the Indian Health Service to support information technology, telehealth, and electronic health records.

The Federal Communications Commission (FCC) is dedicated to “helping households connect during the pandemic” through its Emergency Broadband Benefit program. This program aims to support families and households who cannot afford internet services during the COVID-19 pandemic by providing up to $50-$75 per month towards broadband service for eligible households and discounts on technology purchases. FCC will also award a subsequent round of funding for the COVID-19 telehealth program and $1 billion for broadband connectivity on tribal lands.

Nationwide Efforts to Improve Digital Equity

State public health agencies are partnering with community champions to develop digital equity programs that connect communities to healthcare and deliver digital literacy learning platforms that support community adoption of telehealth.

The DigiAge program led by the Rhode Island Office of Healthy Aging connects older adults to technology and virtual opportunities that keep them connected. The program provides older adults with access to devices through a telephone equipment loan program offered by the state and training programs that support older adults who need assistance navigating technology. In Michigan, the Aging and Adult Services health agency division partners with GetSetUp, an educational technology company that creates learning opportunities for older adults. This partnership provides older adults with classes designed for and led by older adults, to support their adoption of technology and help them access telehealth services.

New York state is launching a digital equity pilot that will offer a telehealth facilitator program operated by healthcare partners under the guidance of Schmidt Futures and the state’s Reimagine Commission. The program will improve comfort levels and access to telehealth tools for underserved populations and provide hands-on-support for the intake and onboarding process.

State Investments in Broadband, Resource Sharing, and Partnerships

Florida has received funding from the Institute of Museum and Library Services, under the CARES Act, to expand digital network access, purchase internet accessible devices, and provide technical support services through eligible libraries and nonprofit organizations. The funding will be primarily used for addressing digital inclusion and preparing for, preventing, and responding to COVID-19. Hawaii has launched low-cost home internet services for low-income households and a digital resource page that provides information on digital access projects happening throughout the state, including broadband services, digital literacy, and the refurbishing of digital technologies.

In 2020, Illinois announced a $750,000 commitment to investing in digital equity by expanding access and adoption of high-speed internet. The digital equity package aims to develop the nation’s first integrated statewide network for improving digital equity and inclusion by addressing gaps in household access to computer devices, hotspot connectivity, and digital literacy skills. Lastly, South Carolina is investing $26 million in broadband infrastructure projects to increase high-speed broadband available to homes, businesses, schools, healthcare services in underserved areas of South Carolina.

Taking Action

Public health agencies interested in developing similar digital access projects may consider reviewing federal and state funding sources to begin this work. Developing partnerships with community champions and community entities like libraries can also inspire innovative interventions that link health agencies to underresouced populations. Furthermore, mapping out programs that improve digital access can support these populations in identifying available resources.

In the past year, states and federal agencies have mobilized efforts to address the gaps in digital access and improve digital equity nationwide. The expansion of broadband and digital services for all Americans, especially communities who have been historically marginalized, is incredibly important. As telehealth and other digital healthcare services become more accessible and widely available, states and territories can increase funding sources, harness partnerships, and develop resource sharing platforms that increase access to information, improve adoption, and ensure access to care.

The development of this product is supported by the Health Resources and Services Administration of the U.S. Department of Health and Human Services under grant number 2 UD3OA22890-10-00. Information, content, and conclusions will be those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.