Implementing A Digital Health Navigator: Strategies & Experience in The Hospital Setting to alleviate Digital Equity
DOI:
https://doi.org/10.30953/thmt.v9.462Keywords:
Digital Health Navigator, digital health technologies, hospital, patient portal, telehealthAbstract
Background: The implementation of telemedicine and digital health technologies in healthcare has increased, but patients still need help adopting and utilizing these technologies. To address this, a Digital Health Navigator (DHN) program was implemented to evaluate the benefits of improving patients’ adoption.
Objectives: To alleviate digital equity within hospitals, we introduced a holistic digital health navigator program designed to promote the utilization of digital tools among hospitalized patients. To implement a DHN program to improve patient adoption of digital portals to engage in healthcare. To learn from the program to further develop patient-facing portal education for hospitalized patients to expand to other hospitals.
Methods: Over a period of thirty days, the DHN program conducted patient visits in two hospitals, on portal usage, collecting data, and adapting protocols based on patient feedback.
Results: Feedback from patients indicated 98% of patients found the education and the DHN to be helpful. 92% recommend the UPMC Central PA Portal for accessing their healthcare information. The DHN program proves beneficial in promoting portal usage and addressing technological barriers experienced by patients. We provide strategies and recommendations on how to implement such a program.
Discussion: We successfully implemented a digital health navigator program for hospitalized patients across two hospitals. Patients reported a positive perception and satisfaction with digital health navigator visits . Notably, our model overcomes challenges related to limited internet access and mitigates technology-related anxiety during hospital stays. The DHN program proved beneficial in promoting hospital portal usage and addressing technological barriers experienced by patients. Implementation and sustained adoption of digital technologies across a large healthcare organization can be achieved through a well-coordinated, team-based, and systematic approach with a DHN. We provide strategies and recommendations on how to implement such a program
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References
of a digital navigator in behavioral health: a systematic review.
Lancet Digit Health. 2023 Dec;5(12):e925–32. doi: 10.1016/
S2589-7500(23)00152-8
2. Carini E, Villani L, Pezzullo AM, et al. The impact of digital
patient portals on health outcomes, system efficiency, and
patient attitudes: updated systematic literature review. J Med
Internet Res. 2021 Sep 8;23(9):e26189. doi: 10.2196/26189
3. Dendere R, Slade C, Burton-Jones A, et al. Patient portals facilitating
engagement with inpatient electronic medical records: a
systematic review. J Med Internet Res. 2019 Apr 11;21(4):e12779.
doi: 10.2196/12779
4. Tapuria A, Porat T, Kalra D, et al. Impact of patient access to their
electronic health record: systematic review. Inform Health Soc Care.
2021 Jun 2;46(2):192–204. doi: 10.1080/17538157.2021.1879810
5. Grossman LV, Masterson Creber RM, Ancker JS, et al.
Technology access, technical assistance, and disparities in inpatient
portal use. Appl Clin Inform. 2019 Jan;10(1):40–50. doi:
10.1055/s-0038-1676971
6. Julien HM, Eberly LA, Adusumalli S. Telemedicine and the
forgotten America. Circulation. 2020 Jul 28;142(4):312–4. doi:
10.1161/CIRCULATIONAHA.120.048535
7. Blount MA, Douglas MD, Li C, et al. Opportunities and
challenges to advance health equity using digital health
tools in underserved communities in Southeast US: a mixed
methods study. J Prim Care Community Health. 2023 Jan-
Dec;14:21501319231184789. doi: 10.1177/21501319231184789
Walker DM, Hefner JL, Fareed N, et al. Exploring the digital divide:
age and race disparities in use of an inpatient portal. Telemed J E
Health. 2020 May;26(5):603–13. doi: 10.1089/tmj.2019.0065
9. Sharma AE, Lisker S, Fields JD, et al. Language-specific challenges
and solutions for equitable telemedicine implementation
in the primary care safety net during COVID-19. J Gen Intern
Med. 2023;38(14):3123–33. doi: 10.1007/s11606-023-08304-2
10. Blanc J, Hahn K, Oliveira B, et al. Bringing health care equity
to diverse and underserved populations in sleep medicine and
research through a digital health equity framework. Sleep Med
Clin. 2023 Sep;18(3):255–67. doi: 10.1016/j.jsmc.2023.05.009
11. Jacob C, Sezgin E, Sanchez-Vazquez A, et al. Sociotechnical
factors affecting patients’ adoption of mobile health tools: systematic
literature review and narrative synthesis. JMIR mHealth
uHealth. 2022;10(5):e36284. doi: 10.2196/36284
12. Zoorob D, Hasbini Y, Chen K, et al. Ageism in healthcare technology:
the older patients’ aspirations for improved online accessibility.
JAMIA Open. 2022 Oct;5(3):ooac061. doi: 10.1093/
jamiaopen/ooac061
13. Jacob C, Sanchez-Vazquez A, Ivory C. Social, organizational,
and technological factors impacting clinicians’ adoption of
mobile health tools: systematic literature review. JMIR Mhealth
Uhealth 2020;8(2):e15935. doi: 10.2196/15935
14. Baumel A, Muench F, Edan S, et al. Objective user engagement
with mental health apps: systematic search and panel-based usage
analysis. J Med Internet Res. 2019;21(9):e14567. doi: 10.2196/14567
15. Kichloo A, Albosta M, Dettloff K, et al. Telemedicine, the current
COVID-19 pandemic and the future: a narrative review and
perspectives moving forward in the USA. Fam Med Community
Health. 2020 Aug;8(3). doi: 10.1136/fmch-2020-000530
16. Patel SY, Mehrotra A, Huskamp HA, et al. Trends in outpatient
care delivery and telemedicine during the COVID-19 pandemic
in the US. JAMA Intern Med. 2021;181(3):388–91. doi: 10.1001/
jamainternmed.2020.5928
17. Healthcare Information and Management Systems Society
(HIMSS). Electronic Medical Record Adoption Model (EMRAM).
2005 [cited 2023 Oct 18]. Available from: https://www.himss.org/
what-we-do-solutions/digital-health-transformation/maturity-
models/electronic-medical-record-adoption-model-emram
18. College of Healthcare Information Management Executives.
Digital health most wired 2023 [cited 2023 Oct 18]. Available
from: https://chimecentral.org/chime-most-wired-2/
Office of the National Coordinator for Health Information
Technology. The ONC Cures Act final rule. [cited 2020 May
20]. Available from: https://www.healthit.gov/sites/default/files/
cures/202003/TheONCCuresActFinalRule.pdf
20. Rodriguez JA, Clark CR, Bates DW. Digital health equity as
a necessity in the 21st century cures act era. JAMA. 2020 Jun
16;323(23):2381–2. doi: 10.1001/jama.2020.7858
21. Anthony DL, Campos-Castillo C, Lim PS. Who isn’t using
patient portals and why? Evidence and implications from a
national sample of US adults. Health Aff (Millwood). 2018
Dec;37(12):1948–54. doi: 10.1377/hlthaff.2018.05117
22. Wisniewski H, Gorrindo T, Rauseo-Ricupero N, et al. The role
of digital navigators in promoting clinical care and technology
integration into practice. Digit Biomark. 2020 Winter;4(Suppl
1):119–35. doi: 10.1159/000510144
23. Graetz I, Gordon N, Fung V, et al. The digital divide and patient
portals: internet access explained differences in patient portal
use for secure messaging by age, race, and income. Med Care.
2016;54(8):772–9. doi: 10.1097/MLR.0000000000000560
24. Chen C, Ding S, Wang J. Digital health for aging populations.
Nat Med. 2023;29(7):1623–30. doi: 10.1038/
s41591-023-02391-8
25. Rising CJ, Jensen RE, Moser RP, Oh A. Characterizing the
US population by patterns of mobile health use for health and
behavioral tracking: analysis of the National Cancer Institute’s
Health Information National Trends Survey Data. J Med
Internet Res 2020;22(5):e16299. doi: 10.2196/16299
26. Bertakis KD, Azari R, Helms LJ, et al. Gender differences
in the utilization of health care services. J Fam Pract. 2000
Feb;49(2):147–52.
27. Kurani N, Ranji U, Salganicoff A, et al. Health care coverage
and access for men, 2013–2015. JAMA. 2015;313(24):2414. doi:
10.1001/jama.2015.6551
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Copyright (c) 2024 Salim Saiyed, MD, MBA, Wern Lynn Ng, MD, Madeline Cherry, Safi Khattab, Hafsa Pathan
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