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Using routinely available electronic health record data elements to develop and validate a digital divide risk score.

Jamie M Faro1, Emily Obermiller2, Corey Obermiller2

  • 1Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01605, United States.

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Summary
This summary is machine-generated.

Electronic health record (EHR) data can identify patients facing the digital divide, enabling targeted support for equitable digital health access. This screening tool helps healthcare systems ensure all patients benefit from digital health services.

Keywords:
digital divideelectronic health recordhealth care accesshealth literacyscreening tool

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Area of Science:

  • Health Informatics
  • Digital Health Equity
  • Patient Access to Technology

Background:

  • Digital health tools like patient portals and remote monitoring are increasingly standard in healthcare.
  • The digital divide, however, presents a significant barrier to equitable access and utilization of these technologies.
  • Identifying patients at risk of this divide is crucial for effective intervention.

Purpose of the Study:

  • To develop and validate an electronic health record (EHR) screening tool.
  • The tool aims to accurately identify patients susceptible to the digital divide.
  • This facilitates targeted strategies to improve digital health equity.

Main Methods:

  • Retrospective EHR data extraction and cross-sectional survey within a single healthcare system.
  • Identified four key EHR markers: mobile phone number, email address, active patient portal, and patient portal login frequency.
  • Developed a risk score based on these markers to categorize patients (high, intermediate, low risk).

Main Results:

  • The four EHR markers demonstrated high sensitivity (81%-95%) and specificity (65%-79%) in identifying patients with digital access barriers.
  • The combined EHR marker-based risk score effectively predicted the absence of internet access (c-statistic=0.77).
  • Higher digital divide risk scores correlated significantly with lower eHealth literacy.

Conclusions:

  • The validated EHR screening tool accurately identifies patients at risk of the digital divide.
  • Healthcare systems can leverage these EHR markers to implement targeted interventions.
  • This supports equitable access to digital health services for all patient populations.