Including Digital Health Equity Education in Medical Training

Last summer, I delivered a presentation on digital health equity to 45 high school, college, and medical school students participating in the 𝐒𝐮𝐦𝐦𝐞𝐫 𝐔𝐫𝐛𝐚𝐧 𝐇𝐞𝐚𝐥𝐭𝐡 𝐅𝐞𝐥𝐥𝐨𝐰𝐬𝐡𝐢𝐩 𝐏𝐫𝐨𝐠𝐫𝐚𝐦 (𝐒𝐔𝐇𝐅).

During my talk, I showcased maps of Los Angeles County and contrasted the prevalence of diabetes with the accessibility of internet services.

"The maps look the same!" exclaimed one student enthusiastically. He shared that his diabetic grandparents lived in Long Beach, where, according to the map on the right, the prevalence of diabetes exceeds 14.4%, which corresponds to between 20.1% and 100% of households without internet access.

"My grandparents always call me to request refills for their medications. I thought it was just because they were old, but maybe it's also because they don’t have internet at home" the student explained.

Typically, we consider race, income, and education level as social determinants of health. But how often do we think about internet access?

Internet connectivity is essential for education, housing searches, online banking, registration for safety net programs, access to wellness portals, utilization of remote patient monitoring, and staying updated with the latest medical information. Internet access has become so crucial that it has been termed a "Super Determinant of Health" (1) due to its indirect connection to all previously recognized social determinants. If healthcare practitioners are unaware of the technological barriers their patients face, how can they effectively address factors that depend on internet usage?

As the intersection of medicine and technology widens, it is imperative to incorporate digital health equity into the core of medical education. Students are eager for this integration.

Following my presentation at 𝐒𝐔𝐇𝐅, a survey revealed that 94% of the attendees felt a responsibility to educate their future patients about digital health, and 93% recognized the value of additional education in digital health equity. However, only 50% felt confident in addressing barriers to digital health equity.

Medical schools are heeding the call from students to acquire new skills. Institutions like the David Geffen School of Medicine at UCLA offer a discovery year, allowing students to immerse themselves in various disciplines beyond medicine, including entrepreneurship and innovation.

The American Academy of Family Physicians has declared that each resident must have an individual learning plan, including six months of elective time to delve into an area of interest. As program directors seek to expand their curricula, I encourage residents and medical students to request time for digital health equity education.

With 𝐕𝐢𝐕𝐄, one of the largest digital health conferences in the US, on the horizon, I invite you to follow my weekly article series on digital health equity. These pieces will highlight the critical need to weave digital health equity into medical training. Join me for my session at ViVE "Prepping Clinicians to Manage Health Disparities through Med-Ed Innovation," taking place on February 26 from 3:25 to 3:45 pm.

I will discuss the significance of an equity-focused curriculum in medical education and its role in combating health disparities. It is only through our collective efforts that we can create a more equitable future in healthcare.

𝐒𝐨𝐮𝐫𝐜𝐞𝐬

1.     van Kessel R, Wong BLH, Clemens T, Brand H. Digital health literacy as a super determinant of health: More than simply the sum of its parts. Internet Interv. 2022 Feb 7;27:100500. doi: 10.1016/j.invent.2022.100500. PMID: 35242586; PMCID: PMC8861384.