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A Community-Level Digital Health Readiness Index for the US.

Saif Khairat1,2, John Geracitano1, Zhaoqiang Zhou1

  • 1Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill.

JAMA Network Open
|June 18, 2026
PubMed
Summary
This summary is machine-generated.

A new Digital Health Index (DHI) measures community readiness for digital care across US census tracts. This tool helps identify areas needing support for equitable digital health deployment.

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Published on: July 27, 2018

Area of Science:

  • Digital Health
  • Health Services Research
  • Public Health Informatics

Background:

  • Community readiness for digital health services is highly variable.
  • A lack of granular, validated readiness measures hinders targeted support and equitable deployment.
  • Existing measures do not adequately capture the multifaceted nature of digital health readiness.

Purpose of the Study:

  • To develop and validate a reproducible census tract-level index of community digital health readiness.
  • The index integrates socioeconomic conditions, access to care, and digital connectivity.
  • To provide a tool for health systems and policymakers to assess and monitor digital care readiness.

Main Methods:

  • A cross-sectional index development and validation study using public data (2018-2022).
  • Constructed the Digital Health Index (DHI) from 21 indicators across socioeconomic, health access, and connectivity domains.
  • Validated the DHI using Delphi panels, factor analyses, and correlations with existing indices (SVI, ADI, DDI) and healthcare spending.

Main Results:

  • The DHI was computed for 85,396 US census tracts.
  • DHI scores showed moderate to strong correlations with SVI, ADI, and DDI, but identified distinct low-readiness communities.
  • Index rankings demonstrated stability under sensitivity analyses, and all indicators met consensus criteria.

Conclusions:

  • A reproducible, census tract-level Digital Health Index (DHI) was developed and validated.
  • The DHI integrates key factors influencing digital health readiness, offering a granular assessment.
  • This index can guide health systems and policymakers in identifying and supporting communities for equitable digital health expansion.