Due to its convenience and flexibility, it’s clear that virtual care and digital health technology are here to stay. Yet, absent thoughtful efforts to ensure inclusive adoption of digital health tools, health care systems may well exacerbate health disparities that many advocates have been working hard to mitigate.
Until the pandemic, many health systems seemed to believe that they couldn’t do anything about people who weren’t connected. Not able to have a virtual visit? No worries, we can just call you! Your connection? Not our problem. Not in our mission. Not a core competency. However, the Emergency Broadband Benefit (in the 2020 CARES Act) and its 2021 successor, the Affordable Connectivity Program, changes the equation. If health systems could justify screening people for health-affecting issues for which even scarce community-based resources were available, then how could they justify NOT screening people for free internet eligibility?
A First Step: Assessing Digital Readiness
Fortunately, many health systems are now trying to figure out what they can do, recognizing screening for telehealth readiness as a first step. Unfortunately, it requires a more nuanced approach than asking a seemingly straightforward question such as “Are you able to have a telehealth visit?” Elsewhere, Public Health Innovators has written about why this strategy will be ineffective. We can help your organization develop questions that are tailored for your objectives, patient population, community and available resources. In addition, you will need to determine a work-flow, an approach for addressing whatever gaps are identified during screening, and a method to track what’s been done or is needed. For many of these processes, Public Health Innovators recommends engaging (or training existing staff) to serve as Digital Health Navigators.
What is a Digital Health Navigator (DHN)?
A digital health navigator is an individual trained to identify someone’s barriers to using the internet. The DHN will then ensure someone has a device, connectivity and the basic skills needed to use the internet. So far, these duties mirror those of Digital Navigators (DNs). As developed over the last several years by the National Digital Inclusion Alliance and other organizations, DNs “help people address the whole digital inclusion process-home connectivity, devices, and digital skills—with community members, through repeated interactions.” DNs work in community settings such as libraries, educational and employment programs, or community-based organizations. DNs may refer clients to digital literacy specialists for basic skill training. While such specialists are generally prepared to help clients use common applications, most will need addition training to address digital health-specific functions. With this added training, Digital Health Navigators can work in community settings where people seek assistance, or they may work in the health care setting directly.
Who becomes a Digital Health Navigator?
Based on our experience, community health workers (CHWs), and or individuals deeply familiar with the lived experience of their clients are well-suited to be effective DHNs. A key element of this familiarity is understanding and addressing the fear facing many new or novice Internet users. CHWs scope of practice covers all of the functions of a DHN, and many have chosen this path because they want to help people who are like them. In turn, DHNs are likely to be trusted by the people they seek to help.