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Round-Up for the Week of June 16-20, 2025

Ever since the onset of the COVID-19 pandemic, it has become ever more clear that all U.S. residents need accessible healthcare. For those who may not have broadband access at home or who struggle to navigate the increasingly complex digital tools used by our healthcare system, that accessibility becomes even more challenging.

This past week, the Benton Institute for Broadband & Society released "The Digital Access Coordinator (DAC) Program Playbook," a tool for clinicians, practice staff, and hospital leaders who are interested in addressing digital literacy gaps in their patient populations through the implementation of a digital navigator program. Following the playbook's release, Benton Executive Director Dr. Revati Prasad hosted a conversation on June 17 around broadband access and healthcare with a group of experts on the subject, including the playbook's lead author—Marjorie and Charles Benton Opportunity Fund Fellow Dr. Jorge Rodriguez.

Developing the Digital Access Coordinator Program

The Digital Access Coordinator Program was established at Mass General Brigham (MGB), a large integrated health care system in New England. The organization consists of 1.25 million primary care patients and 1,211 primary care clinicians.

"As the pandemic was sort of at its peak, it became evident that a lot of the gaps in our health technology tools were affecting our patients in marginalized communities," said Rodriguez. 

Digital Access Coordinators assist patients in the MGB system in two main ways: 1) in-person as a part of the healthcare teams at clinics and 2) remotely as a support system to patients when they may need it via phone calls.

The program evolved to center around enrolling patients in the online patient portal at MGB, which is the main patient-facing tool in its healthcare system. Since its creation, the DAC Program has enrolled over 20,000 patients in MGB's portal across the organization.

While MGB's DAC Program focused on patient portal enrollment and telehealth support, there are a number of ways in which other healthcare organizations can use the DAC model to fit their needs. Dr. Rodriguez provided four main ways to think about how healthcare professionals can use the DAC Program Playbook. 

"One, thinking about your organizational commitment to digital health equity. Two, your understanding of the digital landscape of where your healthcare organization is. Three, looking at your own digital infrastructure, and then four, obviously, staff capacity and funding."

Dr. Rodriguez says the technological needs of a healthcare organization can really differ based on the type of work and equipment needs. This can look like deploying a certain mobile app, looking at continuous glucose monitors, or using remote blood pressure cuffs—all digital tools that may require support and digital literacy skills. After identifying what those needs might be, it's important to ensure your organization has a clear mission and the leadership to support that mission.

But integrating new digital tools into a healthcare practice means that an organization has to understand its current landscape of digital infrastructure, such as its patient portal, and the staff who help to run that portal and communicate with the rest of the healthcare team. Staff and funding capacity can be the biggest challenge, Dr. Rodriguez says. In some cases, when an organization may not have the funding and staff to implement new digital tools, Rodriguez says it may rely on students, volunteers, or other community anchor institutions for support.

The DAC Program learned how to do these things as it grew; program leaders also learned how to capture the data to further understand patients' needs and ways the program can continue to improve. Dr. Rodriguez and his team—Angela Rui, Jessica Szulak, Ana Isabel Garcia, and Lovely Merdelus—developed the DAC Program Playbook to help other organizations do the same.

The DAC Program Playbook was designed to help any healthcare organization to:

• Identify gaps in digital access in its practice;
• Involve multidisciplinary stakeholders in the development of a digital navigator program;
• Develop workflows for implementing a digital navigator program;
• Promote the patient portal as a key digital tool for all patients; and
• Evaluate the impact of a digital navigator program.

Dr. Rodriguez says that these steps, and fully integrating digital access coordinators' work into a healthcare system's operations, helps patients view the technologies used and navigators present as an essential "part of care." The other healthcare experts who discussed this work on June 17th echoed both the importance of healthcare technology in the modern care system and what happens when patients are left behind.

Broadband's Impact on the Healthcare Ecosystem and Its Outcomes

As researchers continue to understand how healthcare access is impacted by the use or lack of broadband connectivity, they are increasingly understanding digital access as a social determinant of health itself. Sara Raza, from the Center for Health Law and Policy Innovation at Harvard Law School, defines the social determinants of health (SDOH) as the conditions in which we live, learn, or work, and things that shape our health and quality of life.

"[These things] influence how easy or hard it is for someone to get healthcare or for someone to stay healthy and get the care when they need it the most," says Raza, who is also a Marjorie and Charles Benton Opportunity Fund Fellow.

Raza is currently exploring how policy and legal frameworks help or hinder efforts to close the broadband healthcare gap, especially in rural areas. She's found that broadband is a super social determinant of health, meaning it does not just impact health on its own—like enabling telehealth—but it affects health in a very tangible way.

"It helps people access food assistance, housing support, transportation resources, and so much more that indirectly shape and drive our health outcomes," adds Raza.

Internet Use and Healthcare

Dr. Erezi Ogbo-Gebhardt, Benton Opportunity Fund Fellow and Assistant Professor in Information Science at North Carolina Central University, studies the impact of broadband in historically marginalized communities. Her recent work analyzed disparities in health-related uses of the internet, including telehealth, drawing on data from the 2023 National Health Interview Survey (NHIS).

"My goal was to analyze the [NHIS] data to see who was using the internet for different health-related tasks," says Dr. Ogbo-Gebhardt. "I focused on the four health-related tasks that it measured in this survey: telehealth, communicating with the provider, searching for health-related information, and retrieving test results online."

Focusing on adults who already had internet access, Dr. Ogbo-Gebhardt wanted to understand the disparities across different subpopulations, if any, in using the internet for those tasks. Education, gender, and area of residence were the strongest predictors across all four health-related internet users.

Adults with a high school degree were half as likely to use telehealth as their counterparts with a bachelor's degree or higher, according to Dr. Ogbo-Gebhardt. When it comes to searching for health-related information online, they were four times less likely to do so, and about a third as likely to communicate with the provider online or to retrieve test results online.

On gender, Dr. Ogbo-Gebhardt found that women were 40 percent more likely to use telehealth. They were also about 46 percent more likely to communicate with the provider online, and they were about 60 percent more likely to search for help-related information or retrieve test results online.

And when it comes to the urban-rural divide, NHIS data showed that adults living in rural areas were about 40 percent less likely to use the internet for telehealth or for retrieving test results online, and they were about half as likely to communicate with the provider online. On top of this, they were 27 percent less likely to search for health-related information online.

Dr. Ogbo-Gebhardt found that disparities in healthcare access are experienced similarly to the barriers to broadband connectivity experienced by the eight "covered populations" listed in the federal government's Digital Equity Act.

"What the results showed is that many of the adults belonging to the Digital Equity Act covered populations experience a third-level digital divide related to health outcomes," Dr. Ogbo-Gebhardt said. "So that means that there is a difference in the outcomes that they get relating to health from using internet access or from their internet access."

What About Those Who Still Lack Internet?

After visiting family in rural Kansas, Sarah Jane Tribble, the Lead Reporter of Rural Health News at KFF Health News, wanted to know if residents in rural areas were less likely to use telehealth because they didn't have internet connectivity, and if they were more likely to need it because of known provider shortages in rural areas. After working with her team at KFF Health News and researchers at George Washington University, Tribble found their hypothesis to be true: Millions of people and 210 counties across the US lack adequate access to high-speed internet and healthcare providers, including both primary care providers and behavioral healthcare providers.

Tribble and her team saw this in mostly rural areas, including the rural south, Appalachia, and the remote west.

"We overlaid [these findings] with some CDC data and other health outcomes data, and saw the correlation that other panelists here have mentioned...and that is that people live sicker and die younger in those counties," she says.

Expanding access to telehealth and digital tools in our healthcare system can bring critical services to those who currently lack them. This can mean daily needs like better blood pressure monitoring, glucose monitoring, cancer care, and more. But an internet connection is needed for all of this in today's healthcare environment.

"I think the move in the healthcare system is increasingly towards technology, technology, technology," says Dr. Rodriguez. "And that relies on internet and broadband."

How Does Federal Funding for Broadband Impact Healthcare Access?

During the discussion, the panelists explored policy interventions that can help expand internet access and use and impact disparities in healthcare.

In Tribble's reporting, she has explored how internet affordability further impacts health outcomes for those who may have the broadband infrastructure built out to them but struggle to pay for the service. Part of this was examining the impact of the Federal Communications Commission's Affordable Connectivity Program (ACP)––a federal broadband subsidy program that had enrolled over 23 million households by its end in 2024––on rural and low-income households.

"As far as health outcomes, what I found talking to just citizens in rural areas, including on [Tribal] reservations, is that they were thrilled to be able to afford the bill so that they could log on even if it was at a slow rate to check their banking or to send a note on a portal to their doctor," she says. "I think it made a big difference to them, and they got to see exactly that access that they could have and how it could improve their lives."

Dr. Rodriguez reiterated the importance of programs like ACP to fill connectivity gaps and maintain support for low-income communities.

"Funding like the ACP is ... critical to getting all of this done and providing that extra support people need," he said "It has implications throughout not only healthcare, but throughout people's lives," he says.

Raza highlighted efforts on the state level, including SB 338, a bill introduced in California that would create a Virtual Health Hub for Rural Communities Pilot Program. If approved and enacted, this law would establish the program and require the State Department of Public Health to administer the program to expand access to health services for farmworkers in rural communities. Under the bill, the virtual health hubs would include, at a minimum, computers, Wi-Fi, cubicles for virtual visits, and exam rooms for telemedicine. 

"Any organization that receives these funds would be required to deploy virtual health hubs into rural communities based on farm worker population and access to healthcare," says Raza.

Initiatives like this, she says, would make a huge impact in these underserved communities.

"This healthcare delivery and financing mechanism is not just aimed at improving someone's physical wellbeing, but in fact is a way to help farm workers get connected to educational services as well as healthcare access," she adds.

Tribble compared expanding broadband access to expanding rural electricity, historically, into rural areas that had gone without.

"It's like the rural electricity program. You put electricity to all these homes across the U.S., they had access, and it increased their economic viability and their ability to participate in the modern world," she says.

Connectivity touches on every part of our lives in an age where everything moves online. According to Raza, building out the digital infrastructure of our healthcare systems can go hand in hand with all the other ways we can provide social care to U.S. residents, connected through broadband technology.

"Healthcare and social care both go hand in hand...a community anchor institution can provide that access to telehealth, which is not just consultations with your physician, not just access to virtual health, but also embeds in it a platform or a governance system where patients have access to other resources like housing support or food assistance mental health services, and are working side by side with social workers as well as community health workers to really bridge that gap," she says.

Watch the June 17 webinar How Broadband Could Improve Health Outcomes

And see the Digital Access Coordinator Program Playbook

Quick Bits

• Senate confirms Olivia Trusty for FCC
• Sens Fischer, Luján Announce Bipartisan, Bicameral Universal Service Fund Working Group
• 140 Organizations Call on Secretary Lutnick to Reinstate the Digital Equity Act
• Maine Launches Tech Share Program for Businesses to Safely Recycle Tablets, Laptops and Cellular Devices

Weekend Reads

• 2025 Internet Use Survey Information Collection
• 2025 Digital News Report 
• The California Report on Frontier AI Policy

ICYMI from Benton

• Digital Navigation in Health Care
• Lessons From Broadband Adoption Trends
• States Still Have a Path to Fiber with BEAD
• What Do We Know About LEO BEAD Bids?
• The Sky is Falling!!!! (or Maybe Not)
• Does Starlink Have the Speeds for BEAD?

Upcoming Events

Jun 24—Space and Spectrum Policy Conference (University of Colorado)

Jun 26—June 2025 Open Federal Communications Commission Meeting (Federal Communications Commission)

Jul 7—Hurricane Season Resiliency Roundtable (Federal Communications Commission)

Jul 23—Navigating E-Rate Federal Policy (Libraries for Digital Equity)

Jul 24—July 2025 Open Federal Communications Commission Meeting

The Benton Institute for Broadband & Society is a non-profit organization dedicated to ensuring that all people in the U.S. have access to competitive, High-Performance Broadband regardless of where they live or who they are. We believe communication policy - rooted in the values of access, equity, and diversity - has the power to deliver new opportunities and strengthen communities.

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