Equitable Healthcare Requires Digital Inclusion
On March 11, the Benton Institute for Broadband & Society hosted a discussion about collaboration, funding, and policy considerations around broadband, digital inclusion, and healthcare. Benton Opportunity Fund Fellow Sara Raza shared her new issue brief, Bridging the Broadband Health Gap, followed by short presentations from panelists working to support digital equity and healthcare stakeholders.
Broadband as a “Super” Social Determinant of Health
High-speed internet access impacts whether people can access care via telehealth, how patients connect with providers online, whether patients and providers can use tools like remote patient monitoring, and how they manage chronic conditions. Bridging the Broadband Health Gap, published jointly by Benton and Harvard Law School’s Center for Health Law and Policy Innovation, highlights how access to and use of broadband can impact access to healthcare, quality of care, and health outcomes. Raza highlights how broadband access is a “super” social determinant of health, one that intersects with and impacts other more traditionally recognized social determinants of health (SDOH)—such as access to food, housing, and transportation.
“We see that patients use telehealth for primary care visits, for behavioral health services, for chronic disease management, and specialist consultations,” said Raza. “But what is critical to emphasize here is that these tools only work when patients have reliable internet access and appropriate devices.”
In Bridging the Broadband Health Gap, researchers outline a framework with key actions for broadband and healthcare stakeholders to take in reducing the broadband health gap and addressing SDOH:
- Screening for Broadband Access and Digital Literacy: Screening for traditionally recognized SDOH, such as food insecurity or housing instability, has enabled healthcare professionals to offer tailored interventions to patients and make referrals for social services when necessary. Additionally, screening for broadband access and digital skills alongside other SDOH can more effectively address an individual’s needs. Helping a patient get broadband access can positively contribute to engagement in other essential activities that improve quality of life and well-being.
- Collaboration with Community Anchor Institutions: Healthcare stakeholders can identify opportunities to leverage community anchor institutions (CAIs) to address gaps in broadband access within their patient populations. These institutions can help to bridge the broadband health gap by providing on-site internet access and acting as a hub for related supports.
- Establish a Broadband-Healthcare Working Group: Establishing a broadband-healthcare working group will help healthcare and SDOH stakeholders communicate more effectively. Such working groups could include broadband and healthcare experts, policymakers, advocates, researchers, internet service providers, and healthcare providers, and could operate at the local, state, or national level.
The next two issue briefs in the series, coming this spring, will address funding opportunities for healthcare stakeholders to provide broadband-enabled care and policy considerations for expanding telehealth infrastructure and services. Taken together, Raza contends that “expanding digital healthcare requires real coordinated solutions across infrastructure, funding, and regulatory policy.” She also calls for collaboration of multiple stakeholders: healthcare systems, policymakers, broadband providers, and community organizations.
Including Digital Inclusion in Healthcare
Amy Sheon, President at Public Health Innovators LLC, spoke about how interest and awareness in the intersection of connectivity and healthcare have increased over time. Her work with the National Digital Inclusion Alliance, including at the Net Inclusion conference, has shown growing levels of engagement over the past decade.
Sheon’s work on these topics began with studies of disparities in the use of patient portals at Cleveland Public Hospital, which inspired an analysis linking disparities to access to broadband and digital redlining in Cleveland. Sheon has published two policy briefs in Health Affairs with Elaine C. Khoong that outline the direct and indirect pathways linking digital inclusion and health equity.
Sheon noted that connectivity alone isn’t enough to produce health equity “amidst pervasive and continuing racism and segregation,” but that identifying pathways advances “the conversation from recognizing the problem, moving towards actionable policy solutions.”
Engaging with the Healthcare System
Dr. Pablo Buitron de la Vega, a Primary Care Physician at Boston Medical Center (BMC), shared his insights on the broadband healthcare gap. BMC has established services to assist patients in learning to use digital care delivery, such as telehealth and a patient portal, and in finding affordable internet access and devices.
“The challenge is that digital health tools are increasingly essential to [enable] patients to communicate with us,” said Dr. Buitron. “But there are a lot of different challenges and barriers.”
These services have successfully helped patients attend telehealth visits, increase their confidence in using the patient portal, and subscribe to low-cost broadband service.
“We find that it was feasible in safety net settings to embed digital health navigators into the clinical workflows,” he said. “It helps our providers, it helps our patients, and it really helps provide better care. A targeted approach maximizes the impact.”
Transforming Healthcare in Rural Communities
Jamila McLean, Director of Health Equity, State Health and Value Strategies at Princeton University, introduced the audience to the Rural Health Transformation Program (RHTP), a $1 billion initiative outlined in 2025’s H.R. 1, the federal law known as the “One Big Beautiful Bill.” Half of the funding will go to the 50 states, with the other half allocated at the discretion of the Centers for Medicare & Medicaid Services. One of the five strategic goals of RHTP is to foster technologies that promote efficient care delivery. Funds cannot be used for broadband infrastructure.
“There was a very heavy focus on ensuring that the funding truly is transformational, as the title of the program suggests, and really leans into innovation,” said McLean. “It really emphasizes investing in programs and initiatives that support advances in IT, providing training and technical assistance, recruiting and retention efforts, and improving and adopting consumer-facing technology tools and AI tools and resources as a way of being truly innovative and improving access to care in rural communities.”
The majority of states sought public input to develop their RHTP plans and have now released the details of their applications for funding. Notably, states have designated a range of agencies to implement their RHTP plans, including departments of health and Medicaid agencies.
“This truly is the largest federal investment that we’ve seen solely dedicated to rural healthcare,” McLean said. “So there’s a lot of hope in ensuring that this funding is utilized to address the really unique challenges that rural communities face.”
Bridging the Digital Divide for Medicaid Populations
Matt Christie, Health-Related Social Needs Manager at the Washington State Health Care Authority, offered details about a waiver program in his state, as well as a COVID-19 response program.
A first Medicaid 1115 waiver program, launched in 2017, provided foundational community supports (FCS) to high-risk Medicaid clients. The FCS included assistance with finding supportive housing and employment opportunities—particularly for clients experiencing homelessness and without previous work experience—delivered via a network of more than 200 contracted provider organizations (e.g., shelters, community-based organizations) at more than 450 sites across the state.
During the pandemic, the Health Care Authority distributed laptops, mobile phones, and Zoom licenses to ensure that providers and participants could continue to offer and access care. Christie highlighted some of the ways that Medicaid funding has limitations, such as paying for mobile phones but not for cellular data plans or calling minutes.
These kinds of limitations prompted his conclusion that “ to meet the needs of each individual, we have to blend these services with other resources, around housing, around broadband, any sort of mobile connectivity to keep people connected to [healthcare] services.”
The case of Washington State offers a valuable example for using funding in resourceful ways to address SDOH, including digital inequality.
Cross-Sector Collaboration on Digital Equity and Healthcare
Jon Morrison Winters, City of Seattle Digital Equity Program and Broadband Manager, closed the set of presentations.
“We know there are two strategies proven to help us live better and longer: Keep moving. Stay connected,” said Morrison Winters.
Stay connected primarily refers to social connections, but we can also think of broadband connectivity as part of staying connected to community, healthcare, and other resources. Morrison Winters showcased the City of Seattle’s work to study technology access and adoption and to fund partner organizations to take on the work of digital inclusion.
In the current policy environment, local government can help residents adopt and use technologies so they can access healthcare. Seattle’s study of technology disparities informs where the city targets resources for digital inclusion.
Where We Go From Here
To close the session, Raza invited the speakers to share a best practice or opportunity to bridge the broadband health gap.
Dr. Buitron reminded the audience that using digital health tools is basically mandatory in modern healthcare, so patients’ digital access and literacy must be a priority. Sheon emphasized that existing mechanisms in clinical practice, such as SDOH screening and healthcare reimbursement, should be used more widely to support digital equity. Christie pointed to finding flexibilities within funding sources and opportunities to “connect the dots for clients.”
More broadly, Morrison Winters identified partnerships and the different levers that governments are able to pull to support health and digital equity at different levels, while McLean called for building on current momentum, as the states are implementing RHTP, and to “use the moment to highlight how effective digital access is improving health outcomes and reducing costs.”
The diversity of work that panelists shared, drawn from research and practical experience, underscores a theme of Raza’s work: bridging the broadband health gap will require coordinated efforts by members of healthcare and digital equity ecosystems. An awareness of the problem and a familiarity with available resources and successful practices will help expand everyone’s access to high-quality healthcare.
Dr. Caroline Stratton is the Director of Research and Grace Tepper is an Editor and Researcher at the Benton Institute for Broadband & Society.