Patient portals have been used much more in recent years. According to the Office of the National Coordinator for Health Information Technology (ONC), as of October 2023, 57% of patients accessed their medical records through portals in the past year. Before the COVID-19 pandemic, this number was about 25%. At Lurie Children’s Hospital in Chicago, patient portal use increased to 87% from around 25% by working on digital health equity. These increases happened because of better features, improved designs, and efforts to reduce differences in access.
Even with these improvements, gaps still exist. Black and Hispanic patients are less often offered portal access compared to White patients. Also, even when they get access, fewer patients from these groups use the portals. Problems include low digital skills, not having good internet, language differences, and not trusting electronic sharing of health data. About one third of patients who sign up log in within 30 days of a healthcare visit. This shows it is hard to keep people using these tools.
Techquity means making sure all patients have fair access to healthcare technology. This means everyone should be able to use and keep using these tools, no matter their background or income. Alexis Anderson from Ipsos calls it a bridge between technology and the people who need it. She says healthcare must meet patients where they are, both in culture and technology, to close access gaps.
Techquity is important because if technology ignores social, economic, and infrastructure challenges, it may leave out vulnerable groups. People who are poor, live in rural areas, or belong to racial minorities often have problems like bad internet, low digital skills, or language barriers. These problems make digital tools less helpful.
For example, between 15% and 24% of Americans do not have broadband internet at home. This stops them from using patient portals or telehealth systems. Even in cities like New York, about one-third of households lack broadband despite the infrastructure being there. This gap in internet access is something techquity efforts try to fix.
Ravi Patel from Lurie Children’s Hospital notes two key problems with patient portal access:
Lurie’s team worked to fix these problems by making portals easier to use, fixing sign-up problems, and improving communication. These actions helped increase use. Still, 12% of patients don’t use portals, showing that digital divides remain.
Techquity connects closely with health equity, which means making sure everyone has a fair chance to be healthy no matter their race, income, or where they live. The Centers for Medicare and Medicaid Services (CMS) says health equity means giving everyone the chance to reach their highest health level.
Factors like income, education, job status, neighborhood safety, and housing affect how people use healthcare technology. For instance, a patient in a rural area with poor internet may not use portals or telehealth regularly. Patients who do not speak the main language well or have low digital skills may avoid these tools because they find them confusing or hard to trust.
Florence Kariuki from Health Recovery Solutions (HRS) says technology and health programs must focus on health equity to avoid repeating old problems. HRS helps by giving tablets with cellular SIM cards so patients don’t need their own Wi-Fi. Their tools support 16 languages and include easy-to-read education materials for patients with low literacy.
Healthcare leaders and IT staff have duties to make patient portal use fair and equal. Some important steps include:
One important part of techquity is using artificial intelligence (AI) and automation in office phone systems. This can make patient contact easier and cut down communication problems. For example, Simbo AI uses conversational AI to answer calls fast, manage appointments, and update prescription status without human help. This helps patients avoid long waits and confusing phone menus.
Using AI together with portals can make a smooth system. After scheduling an appointment by AI, patients can be shown how to use the portal for future needs. AI can also translate languages and handle different health literacy levels. This helps non-English speakers and patients with low literacy.
For clinics, AI reduces front desk work so staff can help patients with harder problems. Simbo AI supports equity by making phone calls easier and faster for all patients. This helps get patients more involved with digital health tools and closes technology gaps.
Even when patients sign up for portals, keeping them active is hard. The ONC says before extra efforts, only about one third logged in regularly after 30 days. Problems may include:
Organizations aiming for techquity need ongoing communication to show portal benefits and offer personal support. Getting feedback from users helps spot problems and improve. At Lurie Children’s Hospital, surveys of 4,000 patients help understand why some avoid portals and guide improvements.
Federal agencies and healthcare groups now require technology to support health equity. The Centers for Medicare & Medicaid Services (CMS) created a Health Equity Framework (2022-2032) that calls for better data, diverse staff, culturally sensitive care, and access improvements. Providers in Medicare and Medicaid must follow these rules to get funds.
The Joint Commission updated health equity standards in January 2023. Providers must name leaders to reduce disparities, check patient social needs, sort data, and report progress yearly. These rules push healthcare organizations to work on techquity in clear ways.
Groups like the AMA-backed In Full Health Learning and Action Community promote digital health tools for marginalized groups without bias. They stress that companies need diversity in partnerships and leadership to build fair technology.
Despite progress, health disparities linked to technology still exist along lines of race, income, and location. For example, American Indian, Alaska Native, Native Hawaiian, and Black populations face higher deaths from chronic diseases that could improve with better digital engagement and remote care.
Telehealth and remote patient monitoring (RPM) have shown promise in promoting health equity when planned with techquity in mind. Evara Health, a federally qualified health center in Florida serving mostly minority and low-income patients, uses RPM with cellular tablets for prenatal and chronic disease care. These programs get grant support to address maternal health disparities.
Still, much work remains. The digital divide—caused by lack of internet, devices, or skills—is a major factor in health. Technology that does not meet the needs of all patients may make gaps worse instead of smaller.
For healthcare administrators, owners, and IT managers, addressing techquity is key to fair care and meeting rules. Good plans should focus on:
Making sure every patient can use portals will improve health, lower differences, and make healthcare work better. Techquity is not just about technology. It is a needed part of managing healthcare and patient care today.
Patient portals transform patient engagement by facilitating essential functions such as online appointment scheduling, communication with providers, and access to medical records, thereby accommodating modern healthcare consumerism.
Initially, patient portal acceptance was low, but as of October 2023, it improved significantly, with 57% of patients accessing their medical records via the portal, compared to just 25% in 2019.
Increased engagement is driven by improved portal functionalities and the rise of healthcare consumerism, which encourages patients to utilize digital tools for convenience.
Lurie Children’s Hospital boosted portal adoption from 25% to 87% by enhancing user experience, addressing implicit biases, and promoting digital health equity.
Barriers may include personal preferences, low digital health literacy, lack of access to devices, and insufficient internet connectivity.
Techquity emphasizes ensuring equal access to digital health resources, recognizing that disparities exist among different demographic groups regarding portal access.
Organizations can improve user experience, promote the portal’s benefits through tailored communication, and offer comprehensive support for onboarding patients.
Bidirectional communication allows patients to actively engage in their healthcare, enabling more interactive and responsive communication between patients and providers.
Collecting user feedback can help organizations understand what features are valued and what obstacles non-users face, guiding improvements to the portal.
Higher digital health literacy enables patients to navigate portals effectively, but organizations need to address gaps to ensure equitable access for all patients.
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