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Urgent work needed to tackle ‘substantial’ digital health inequality



Millions of people in the UK are suffering from digital health inequality because of poverty, experts have warned

A new study says that urgent work is needed to ensure those from deprived areas can access healthcare as the NHS increasingly turns to the use of apps and online health portals for the provision of healthcare.

The team of doctors and academics found a “significant association” between increased poverty and reduced use of digital services. 

Their modelling estimates that this association accounts for 4.27 million patients across England who have not downloaded the NHS App

Professor Robin L Pierce from the University of Exeter said:

“Our results are concerning and show how the use of technology risks widening healthcare inequalities. 

“Digital inequality between those from different socio-economic backgrounds is substantial. 

“What is needed now is for targeted work in communities to prevent digital disparity affecting health outcomes. 

“As the NHS aims to make apps the ‘front door’ to healthcare it is imperative that there is frank and open discussion about equitable digital technology implementation.”

In October 2022, it was estimated more than 37 million patients had activated the NHS App – 67.9 per cent of the population.

Researchers used aggregate data about patients and their use of digital resources from 6,356 primary care providers in England to measure the link between characteristics such as patient demographics, socio-economic deprivation and disease burden, with activation of the NHS App and online primary care portals.

The study found digital literacy and the availability of devices and infrastructure may account for some of the disparity. 

It says that digital transformation must be context-specific, based on local understanding and tailored to specific populations.

Infrastructure, education, and engagement are also important and the roll-out of digital systems should be driven through those who run integrated care systems, who can build strong community links, the study found.

Dr Zhang of Imperial College London said: “Although we found inequalities this is not necessarily a reason to decelerate. 

“Rather, digitally-enhanced pathways may offer efficiency savings that can be redirected to vulnerable and excluded populations.”  

The researcher added: “We have demonstrated substantial socio-economic inequality in digital health utilisation in NHS England. 

“Such patterns will likely be observable in any health system undergoing rapid digital transformation. 

“An approach that addresses [the] needs of specific groups disadvantaged by the increasing use of digital health technology is urgently required to avoid worsening digital health inequality.”

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