Can technology put some patients at a health care disadvantage?


Keila Lopez, MD, MPH
Keila Lopez, MD, MPH

COVID-19 helped propel telemedicine to the mainstream, but did it improve access to care across the board? Consider patients in rural areas without a stable Internet connection. Or those who rely on their phone for access to the Internet with limited data plans. Or even those patients with whom English is not their first language. These are just some examples of how technology — though shaping the future of medical care delivery — can disproportionately affect patient populations.

Monday’s session: “Digital Impact on Disparities in Cardiovascular Care: Can Big Tech Step Up to the Challenge?” from 8-9 a.m. EST, will examine how technology can put some patients at a health care disadvantage.

“While big tech can help us in lots of ways, we also have to keep health equity in mind,” said Keila Lopez, MD, MPH, director of transition medicine, division of pediatric cardiology at Texas Children's Hospital/Baylor College of Medicine in Houston.

“It’s critically important to understand how and why people are using technology differently and how it’s impacting their health care.”          Dr. Lopez will talk about how the use of technology can affect access to care in underrepresented racial and ethnic groups as well as patients with lower socioeconomic status, those who live in rural areas, those with lower health literacy, and those in which English is not their first language.

“Assuming everyone can easily access telemedicine via their electronic devices is not a fair assumption because not everybody has the ability to do that,” Dr. Lopez says. Black and Latino adults in the U.S. are less likely than white populations to have a traditional computer or have high-speed Internet access in their home. Moreover, as many as 25% of Latino people are smartphone-only Internet users, and cellular data may be limited based on their data plan, Dr. Lopez said.         

Online patient portals are another example of how technology can put some patients at disadvantage. As of April 2021, the 21st Century Cures Act mandates that eight categories of clinical notes created in an electronic health record must be immediately available to patients through their online patient portal, including lab and imaging reports.

“In theory, this is a good thing because we’re encouraging data transparency, but who could that impact disproportionately in a negative way? What if you’re a teen seeking confidential services, but your parents have access to your medical portal? Or what if you’re a patient with low health literacy, and you have an advanced illness? Without having careful interpretation or context for test results, it can cause significant mental distress,” Dr. Lopez said.         

With the tide of technology rising quickly, Monday’s session will highlight the digital disparities technology can create for patients and offer solutions for increasing health care equity for all.