Decreasing health disparities through health ITSkip to issue
§1. Health IT’s potential role
Health IT can help reduce or even eliminate disparities in health care among rural and underserved populations. Differences in people’s access to technology (the “digital divide”) have existed for many years. However, recent research reveals that these differences are decreasing. Trends in both Internet access and mobile phones show signs of reducing the digital divide. Another recent report finds that many communities of color are increasingly using mobile technologies and other devices to engage online.
As access to the Internet and web-enhanced tools expands, the federal government is working with communities of color and other underserved populations to enhance use of health IT to improve health.
For example, ONC and other federal agencies are testing various ways to allow providers to “see” patients remotely. Both the Indian Health Services and the Veterans Administration have “telehealth campaigns,” in which videoconferencing allows providers or specialists to hold “virtual” office visits. This use of health IT tools for health care purposes is often referred to as telemedicine. (Learn more about federal telehealth efforts here.)
In addition, health IT can capture information that helps public officials and researchers identify differences in how vulnerable populations access health care.
- How can government assist people who don’t have Internet access or who may be uncomfortable using eHealth tools?
- Should the federal government or partner organizations develop training or educational materials, targeted at health care navigators and health coaches who work in underserved communities, to inform them about about health IT, mobile health apps, and other eHealth tools that can help their clients improve health?
For other discussions about developing educational and training materials, see
§2. Focusing on low-tech tools
Efforts are underway to (i) expand broadband Internet access to more rural and underserved areas and (ii) dedicate bandwidth to the high-speed needs of many health IT applications. Meanwhile, ONC and other government agencies are exploring ways to use low-technology tools that enable more people to benefit from home health monitoring and other health IT. In the U.S., 88 percent of adults have mobile phones and 56 percent of all mobile users access the Internet through their phones. Health IT applications can be as simple as text messages to help people stop smoking, to remind them to take medications, or to encourage them to make healthy food choices.
For example, Txt4Health is a text-messaging tool that sends messages that can include assessment of diabetes risks and information customized to the individual’s health status and location.
- How can the federal government reduce or eliminate health disparities using widely available technology such as mobile phones?
§3. Supporting new tool development
The federal government is challenging technology developers to create new tools that will help people understand and manage their health risks by running innovation competitions.
Now that Internet access and technologies such as mobile phones are becoming more widespread, ONC is exploring ways to help developers take advantage of this to make low-cost, easy-to-use eHealth tools. ONC can work with communities and developers to ensure that these new tools are easy to use and language- and culture-sensitive, and that the information offered addresses any health needs unique to particular populations. The federal government could provide guidance on the need for developers to consider physical or educational differences among potential users, as well as the tendency for many consumers to access the Internet solely through mobile phones.
- What types of eHealth tools could best address health disparities?
- What are some success stories from public or private sources where technology was used to meet traditionally underserved populations’ health needs?
- What can the federal government do to support the creation of tools that consumers or providers can readily adopt?
For other discussions about the role federal regulation should play, see
§4. Privacy & security
ONC recognizes that privacy and security concerns may impact the willingness of consumers and providers to use health IT to increase access to health information. Privacy and security are the topic of a separate section of the Strategic Plan (Goal 3), since these concerns cut across all areas of health IT. Although this public comment period is not targeted at updating Goal 3, ONC will be revising that section of the Plan and your discussion of these concerns, and ideas about addressing them, will help the federal government decide on appropriate future steps.
(You can read the current version of Goal 3 by clicking the Background Documents tab at the top of this page, and selecting 2011-2015 Federal Health IT Strategic Plan).