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How can digital inclusion improve health care? Citizens brainstorm in a Charlotte retreat

Early analysis of the intersection of digital inclusion and health care by Charlotte citizens and government employees reveals at least 20 key concerns and potential solutions.

A discussion of the ways in which digital inclusion – including access to hardware, broadband, and education – affects the delivery of health care in Mecklenburg County took place on June 15, coordinated by the Charlotte Digital Steering Team and Livable Meck, an organization focused on county quality of life issues.

The “Engagement Café,” a type of issues-oriented retreat, included more than 40 Charlotte residents and employees of the city, county, the University of North Carolina at Charlotte, Queens University, and the Charlotte Mecklenburg Library, as well as students from Davidson College.

“There are many opportunities to improve how people receive health care services and the issue really hits home,” said Rebecca Herbert, community engagement and strategy manager for Livable Meck. “Anything from how much people pay for their medications to how they can age in place, or take care of their children.

“Digital inclusion is huge when we think about how are we now and how we will be in the future,” said Herbert, adding that one million more residents are expected to live in Mecklenburg County by 2030. “It involves how people receive health care services, how folks educate their children, and how they look for jobs, which goes hand-in-hand with livability.

In the future, she said, “a digitally inclusive community will look like one where there are no longer barriers to services. Where there are no more barriers to how folks get information to manage chronic conditions, and where there are no more barriers for how families receive health care services, even in an emergency situation.”

In concurrent panel sessions, participants raised issues, concerns and solutions in response to a series of five questions. A summary follows, along with four key issues, concerns, and potential solutions raised in each of the panels.

1. How does technology/internet access impact health care?

a. An aging population is vulnerable and sometimes reluctant to use digital technologies, raising concerns about ability to use technology, scams, privacy, self-diagnosis resulting from misunderstanding of information of misinformation, and the desire for face-to-face explanations.

b. Personal technology could help encourage and track prevention efforts by individuals and groups, but preventive care is typically not a priority nor paid for by insurance companies and programs.

c. Software applications that present and archive test results have enormous potential to educate patients and show progress over time, but people need to be educated on their use, and to change behaviors of how they access medical information. The idea of managing medical test results on a smartphone does not yet occur regularly to people.

d. Information sharing among competing hospital systems, medical offices, insurance companies, pharmacies, patients, and other parties presents substantial opportunities and efficiencies. It’s needed, but also raises concerns about privacy, security, and potential discrimination.

2. Does your organization or do you know of anyone who helps the community gain technology skills for health care purposes?

a. Both the Carolinas HealthCare System and Novant Health provide educational resources on patient information access. Insurance companies provide access and online education. The Charlotte Mecklenburg Library provides basic digital literacy workshops and tutoring in various issues, as well as Goodwill Industries, the Urban League, the Shepherd’s Center of Charlotte, and the Ada Jenkins Center in Davidson.

b. Some organizations, faith-based organizations and employers provide a “health coach” or other health services, who can educate people about online healthcare access.

c. Health care stakeholders might take advantage of existing digital literacy education and literacy programs already offered, such as those at Charlotte Mecklenburg libraries, to educate patients. Sometimes the issue is not digital literacy, but basic literacy itself.

d. Mobile devices and tablet computers that offer real-time video conversation capabilities present an opportunity for health care stakeholders to educate patients.

3. How should digital inclusion organizations prepare to work with healthcare organizations?

a. Connections among hospitals and clinics, and referral processes could be improved. A unified system would make diagnoses and patient information more easily transferrable. The system needs to address non-English-speaking populations.

b. Collaboration among competing health care systems also could make medical records more easily digestible and accessible.

c. Smartphone apps are sometimes less intimidating and provide guided experiences that could help with healthcare access.

d. Some version of a technology “genius bar” could provide education and resources on how people can access information, records, costs, bills, and test results.

4. How can you inform your organization about this community opportunity? How do you make people aware about the impact of the digital divide?

a. There is a correlation between lack of access to online technology, and the use of public transportation. Use that correlation to help educate and advertise. Additionally, face-to-face communication and analog means of communication are especially important with groups that do not have online access. Faith-based organizations might provide a communication channel.

b. Technology cannot be allowed to become a gentrification force, especially in health care.

c. The Charlotte Mecklenburg School system is aware of the digital divide, and educates students and parents about digital resources.

d. A health care system resource guide on the Digital Charlotte website would help, providing links to resources, basic education, and common issues.

5. Who is not at the table but should be? What other questions should we be asking? What else do you want to know?

a. At this particular session, administrators, accountants, and software and hardware engineers from the health care system, hospitals, medical professional organizations, and medical schools are missing. Representatives from veteran’s organizations are missing. There are only a few young people, and a few senior citizens. No one who is actually in the digital divide is represented in the discussions.

b. Digital inclusion leadership should focus on internal communication efforts among government organizations, and on training the trainers, technology mentors, and internal stakeholders.

c. In the Charlotte area, faith-based organizations will play a significant role in this issue, and need to be explicitly represented.

d. Funding sources and development processes need to be considered, because financial support will be necessary to execute on health care services and digital inclusion access, and multiple organizations will be pursuing the same funding. These efforts need to be organized and focused.