Digital health and equitable access to care.

Area of Science:

• Digital Health
• Health Equity
• Health Systems

Background:

• Digital health equity research has advanced, particularly post-COVID-19, with policy recommendations.
• A health system perspective is needed to understand digital technologies' role in equitable access to care.
• Structurally marginalized communities face unique barriers to accessing healthcare.

Purpose of the Study:

• To examine the role of digital technologies in enabling equitable access to care.
• To identify how digital health solutions can support or hinder access for marginalized populations.
• To analyze the alignment of digital health applications with patient-centered access and digitally enabled health systems frameworks.

Main Methods:

• Utilized Levesque et al.'s patient-centered access framework.
• Employed the World Health Organization's digitally enabled health systems framework.
• Mapped these frameworks to assess digital health's impact on various dimensions of access to care.

Main Results:

• Digital health interventions have disproportionately focused on downstream access enablers, yielding limited equity benefits.
• Key dimensions of access, particularly upstream enablement, are under-addressed by current digital health strategies.
• Digital health applications show lower equity impact when focused solely on downstream access points.

Conclusions:

• Digital health interventions are more equity-enhancing when they focus on upstream factors (understanding, perceiving, seeking care).
• Policy makers and funders should prioritize digital solutions that empower individuals' ability to navigate and access healthcare.
• A comprehensive health system view is crucial for leveraging digital technologies to promote equitable access to healthcare.