Technology access, digital health literacy, and inclusive design are major health IT roadblocks that interfere with promoting health equity since the debut of the Office of the National Coordinator for Health Information Technology (ONC) interoperability rule, according to an article published in JAMA Network.
The new regulations from the Office of the National Coordinator of Health IT (ONC) aim to boost health information exchange, give patients more access to their health data, specifically on their cellphones, and address information blocking.
“Delivering interoperability actually gives patients the ability to manage their healthcare the same way they manage their finances, travel and every other component of their lives,” Don Rucker, MD, national coordinator for health information technology said at the time of the ONC final rule.
“This requires using modern computing standards and APIs that give patients access to their health information and give them the ability to use the tools they want to shop for and coordinate their own care on their smartphones,” Rucker continued.
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The ONC interoperability rule forced new criteria for EHRs to make all patient data available through application programming interfaces (APIs), which will allow providers and patients to have access to health information.
However, not all EHRs are equipped with the same capabilities and interoperability is not always a given. As an example, underserved COVID-19 patients may not be able to access the same care quality as others.
Jorge A. Rodriguez, MD; Cheryl R. Clark, MD; and David W. Bates, MD, penned this viewpoint article to highlight health IT implementation and design strategies that health systems can adapt to ensure care across the country.
Patient portals and mobile health apps are two features that the ONC rule highlights and both give valuable patient access.
Patient portals are severely underutilized and not as accessible to traditionally underserved populations, those with limited English literacy, and those with low socioeconomic status, the authors noted.
Likewise, mobile apps have not been designed for those same populations and the ONC rules should aim to fix digital health equity.
In an effort to fix these issues, health IT professionals can address technology access, digital health literacy, and inclusive design problems.
First, more than 21 million individuals in the country do not have broadband access. The majority of those individuals come from underserved backgrounds or live in rural areas. And although 81 percent of individuals have a smartphone, the majority of racial or ethic minorities who have a smartphone, solely rely on that device for internet access.
The writers said state and local programs should expand and increase broadband access. Providers can also help by asking patients about their technology access and how they can adapt once given the answer.
Next, digital health literacy is lacking across the country. Not only can some individuals not access their health information, but most cannot process and understand the digital information.
The new ONC rules make it easy for third party apps to access patient health data, putting the patient at risk. The writers also said ONC should implement sociodemographic and literacy metrics, along with new digital health initiatives.
Lastly, the ONC rules promote patient data access, yet they do not address the design of those apps, such as complex interfaces that result in user burden.
The writers noted a previous study that said patients with low literacy could only complete half of the necessary data entry in their respective mobile health app.
To combat this issue, mobile app and patient portals should be inclusive to all languages, literacy levels, and linguistic needs, wrote the authors.
“The field is still early in the development of patient-facing digital health, but the new ONC rules, along with the shift to digital care prompted by the COVID-19 pandemic, marks a turning point that could bring about rapid change,” the authors concluded.
“This demands close attention and action to ensure underserved populations are not left behind. Through inclusive approaches, the promises of increasing patient access to data and enhancing health equity can be achieved.”
Source: EHR Intelligence