Digital healthcare equity in primary care: implementing an integrated digital health navigator

The 21st Century Cures Act and the rise of telemedicine led to renewed focus on patient portals. However, portal use disparities persist and are in part driven by limited digital literacy. To address digital disparities in primary care, we implemented an integrated digital health navigator program supporting portal use among patients with type II diabetes. During our pilot, we were able to enroll 121 (30.9%) patients onto the portal. Of newly enrolled or trained patients, 75 (62.0%) were Black, 13 (10.7%) were White, 23 (19.0%) were Hispanic/Latinx, 4 (3.3%) were Asian, 3 (2.5%) were of another race or ethnicity, and 3 (2.5%) had missing data. Our overall portal enrollment for clinic patients with type II diabetes increased for Hispanic/Latinx patients from 30% to 42% and Black patients from 49% to 61%. We used the Consolidated Framework for Implementation Research to understand key implementation components. Using our approach, other clinics can implement an integrated digital health navigator to support patient portal use.

Automated summary

The 21st Century Cures Act and the rise of telemedicine have brought attention to patient portals, but disparities in portal use still exist due to limited digital literacy. To address the digital disparities in primary care, we implemented a digital health navigator program to support portal use among patients with type II diabetes. Through our pilot, we successfully enrolled 121 patients (30.9%) onto the portal. Our overall portal enrollment for clinic patients with type II diabetes increased for Hispanic/Latinx patients from 30% to 42% and Black patients from 49% to 61%. By using the Consolidated Framework for Implementation Research, other clinics can implement a digital health navigator program to promote patient portal use.