JMIR Publications

ABSTRACT

Background:

Limited digital literacy is a barrier for vulnerable patients accessing healthcare.

Objective:

The Stanford Technology Access Resource Team (START), a service-learning course created to bridge the telehealth digital divide, trained undergraduate and graduate students to provide hands-on patient support to improve access to electronic medical records (EMR) and video visits, while learning about social determinants of health.

Methods:

START students outreached to 1185 patients (60% from primary care clinics of a large academic medical center and 40% from a federally qualified health center (FQHC)). Registries consisted of patients without an EMR account (at primary care clinics) or patients with a scheduled telehealth visit (at an FQHC). Patient outcomes were evaluated by successful EMR enrollments and/or video visit set-ups. Student outcomes were assessed by reflections coded for thematic content.

Results:

Over 6 academic quarters, 57 students outreached to 1185 registry patients. Of the 229 patients contacted, 141 desired technical support. START students successfully established EMR accounts and/or set up video visits for 79% (111/141) of patients. After program completion, we reached 13% (19/141) of patients to provide perspectives on program utility. The majority (95%, 18/19) reported START students were helpful and 74% (14/19) reported they had successfully connected with their health care provider in a virtual visit. Inability to establish access included lack of Wi-Fi or device access, absence of an interpreter, and a disability that precluded the use of video visits. Qualitative analysis of student reflections showed impact on future career goals and improved awareness of health disparities of technology access.

Conclusions:

Of patients who desired telehealth access, START improved access for 79% of patients. Students found that START broadened their understanding of health disparities and social determinants of health and influenced their future career goals.