Breast cancer screening a bellwether service in radiology’s drive to bridge the ‘digital divide’
Mammography practices need to continue supporting pre-Digital Age channels for patients to schedule appointments, participate in community health programs and receive annual screening exams in mobile settings close to where they live, according to the authors of a succinct study report published Aug. 30 in Radiology [1].
The radiology researchers suggest their findings likely generalize to other radiology subspecialties, as the unabated demand for non-electronic outreach owes not to computer illiteracy per se but to historic and persistent gaps in healthcare access and resource availability.
Corresponding author Peter Abraham, MD, of UC-San Diego, senior author Anand Narayan, MD, PhD, of the University of Wisconsin and colleagues made the call after analyzing survey responses from 7,255 women who participated in the 2018 National Health Interview Survey (NHIS) and had no history of breast cancer.
Within this slice of the vast database, only 18% of respondents (n = 1,197) said they’d used a computer to schedule a clinical appointment.
What these 18% tended to have in common with one another were younger than average age, higher than average education, higher than average income and White race.
Members of the computer-using cohort also were more likely to be married, insured and employed.
Meanwhile, respondents who used computers for personal healthcare tasks—not only scheduling appointments but also filling prescriptions, researching conditions and communicating with providers—showed a stronger propensity for keeping up with annual screening mammography exams.
To Do: Keep Neighbors from Falling Through Proverbial Cracks
In their discussion, Abraham and co-authors point out the paradox that the expansion of digital health has, in classic through-the-cracks form, worsened some socioeconomic disparities in healthcare access.
“Radiology practices and healthcare leaders must collaborate better with underserved communities to co-create feasible and scalable digital interventions,” they write.
Along with paper-based scheduling, community outreach and such, the authors call on local communities and U.S. healthcare at large to consider ways to:
- identify and rectify broadband coverage gaps,
- supply broadband and smartphone device subsidies,
- conduct community-driven digital literacy programs,
- appoint digital navigators,
- maintain “linguistically and culturally concordant” Web portals, and
- situate telehealth access points in convenient locations.
Difficult but Doable: Ensuring Equitable Access to Imaging Technologies
During the COVID-19 pandemic, improving health equity emerged as an especially pressing priority, the authors suggest. This development coincided with healthcare’s accelerating evolution into a largely digital landscape, they add.
“Patient portals and telehealth have become vital pillars in the digital health transformation, offering tremendous potential to improve access to preventive care services, including cancer screening,” Abraham et al. write. “Despite this potential, the development of digital tools may exacerbate existing disparities due to lower rates of technology adoption among underserved populations.”
The authors conclude:
Intentional planning and user-centered design of health technologies paired with community-based participatory approaches will help to ensure that the expansion of digital outreach platforms supports equitable access to imaging technologies.”
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.