Digital Health Technology Infrastructure Challenges to Support Health Equity in the United States: Scoping Review

Area of Science:

• Health Services Research
• Digital Health Equity
• Health Disparities

Background:

• Digital health technology (DHT) is prevalent in the U.S. but presents challenges exacerbating health inequities.
• Existing research indicates that DHT requirements can significantly amplify observed health inequities.

Purpose of the Study:

• To synthesize evidence on digital health technology inequities in the U.S.
• To explore DHT infrastructure needs for promoting health equity.
• To identify challenges faced by patients and providers regarding DHT.

Main Methods:

• Scoping review adapted from Arksey and O'Malley guidelines.
• Searches conducted in PubMed, Web of Science, CINAHL, PsycINFO, and Google Scholar.
• Inclusion of peer-reviewed publications (2020-2024) analyzing DHT infrastructure from a health equity perspective in the U.S.

Main Results:

• 27 studies were included, analyzing factors like age, education, race, ethnicity, and socioeconomic status influencing DHT inequities.
• Patients and providers face distinct challenges: providers struggle with infrastructure and integration, while patients face access and usability barriers.
• Key patient challenges include limited broadband, cultural/linguistic appropriateness, and access to digital tools.

Conclusions:

• Digital health technology is vital for U.S. healthcare delivery but faces significant challenges contributing to health inequities.
• Addressing these challenges through pragmatic solutions is essential for advancing health equity in digital health.