Health systems can provide care and help bridge the digital divide in Milwaukee
- Amelia Papadimitriou is studying to be a doctor at the Medical College of Wisconsin. Nicky Joseph and David Velasquez are studying medicine at Harvard Medical School.
- They outline a pilot program that uses health care interactions to help poor patients get access to the internet.
- Link Health not only helps patients get digital access, it can help them utilize telehealth services.
The United Nations declared access to the internet as a human right in the summer of 2016, cementing the importance of the internet across the world for all people. In spite of this, the United States lags behind much of the developed world in granting easy access to the internet for traditionally marginalized populations, ranging from populations of color in poorer parts of major cities to individuals living in rural locales around the nation.
In Milwaukee, one of the most segregated U.S. cities, neighborhoods that have historically been subjected to discriminatory redlining and systemic disinvestment are more likely to not have access to the internet and when they do, receive worse quality connectivity. U.S. census data shows that about 27% of people in Milwaukee don’t have internet in their households. According to the Wisconsin Policy Forum, 13% of Black residents have no computers compared to 8.3% of Hispanics and only 8% of white residents.
The internet has become a crucial point of access for daily tasks and items, including banking, accessing the news, and maintaining contact with loved ones. For healthcare specifically, the internet has become a lifeline for people by providing them with virtual healthcare services. Furthermore, the COVID-19 pandemic has made telehealth a more frequently used mode of healthcare delivery by doctors.
Despite the impact of the internet and increased use of telehealth, access to telehealth is unsurprisingly worse for certain vulnerable populations. One likely cause of this disparity is a lack of access to the internet combined with low digital literacy. Nearly 25% of Americans lack quality home internet connection and although smartphones may serve as a reasonable alternative to an internet home connection, almost 40% of those above the age of 65—one of the most vulnerable populations in America—do not have access to a smartphone.
Realizing the crucial role of internet access to health equity and beyond, especially on the backdrop of the COVID-19 pandemic, the Biden-Harris Administration moved to help bridge this gap. Spearheaded by the Administration, the Infrastructure Investment and Jobs Act committed over $14 billion to help ensure that all Americans have access to affordable, high-speed, and reliable broadband connection, through an initiative known as the Affordable Connectivity Program (ACP). It provides access to the internet for qualifying households through participating internet service providers by providing a subsidy of up to $30 per month (and $75 per month for those on tribal lands). Furthermore, it also comes with a $100 subsidy for a one-time purchase of a desktop, laptop, or tablet.
So far, the Federal Communications Commission (FCC) has signed up approximately 16.6 million people. However, nearly 35 million eligible households have yet to sign up and receive the programs benefits. And at the current rate of uptake, the ACP’s funding is projected to run out as soon as mid-2024. The FCC is tracking enrollment data at the state, zip, and county level, allowing for identification of areas of lower uptake of the program to target for further intervention. Nonprofit, community-based organizations are working to close this gap and sign people up for the ACP. These include the National Digital Inclusion Alliance, Chicago Connected, and Black Churches 4 Digital Equity. According to data released by the non-profit Education SuperHighway, just over half of 131, 639 eligible households in Milwaukee have enrolled in the program with 33% of eligible households participating statewide.
However, healthcare organizations, such as clinics and groups of doctors, which regularly interface with the very same populations in need of the ACP, are an untapped avenue partner that can connect people to the program. And with the consideration that Medicaid enrollment automatically qualifies households for the ACP, this leaves much potential to be tapped through health systems.
Link Health is a possible solution in this space, having now worked on the ground and serving as a model for connecting eligible patients with the ACP. First piloted at Massachusetts General Hospital in Boston, MA, Link Health looks to close the digital divide by partnering with community health centers, medical students, doctors, and other volunteers. Its model could be trialed in other cities like Milwaukee, perhaps even to the point where hospital staff are automatically notified that a patient does or does not qualify for the ACP after their insurance status is known. Through the inclusion of this eligibility in a conversation a patient has with one of their trusted providers—nurse, physician, social worker, and the like—enrollment in the ACP may increase, and patients may have access to one of the most vital services of the 21st century.
The potential in closing the digital divide and increasing access to telehealth is clear. However, its potential will only be fulfilled if it successfully reaches its target population. With less than 30% of eligible households currently signed up — many of whom represent the most vulnerable segments of society — further action is needed. Healthcare and health systems can play a key role in closing this gap, one patient encounter at a time.
Amelia Papadimitriou is a second-year medical student with a background in public health. Nicky Joseph and David Velasquez are studying medicine at Harvard Medical School.View Comments