Dolph Smith, RN, staff nurse in the MGH Emergency Department (ED), has always enjoyed gardening. As his fresh produce sprouts, Smith is using his green thumb to give back to his local community.
As an emergency physician, Alister Martin, MD, MPP, MGH Emergency Medicine, learned countless lessons working through the COVID-19 pandemic. He recalls one shift in particular – during the virus’s second surge – that opened his eyes to the drastic digital divide he says impacts patients’ lives every day.
“We had just intubated two elderly Latino patients in the ER,” Martin says. “Later in the shift, I was treating another elderly Latino man with severe COVID. Vaccines were just becoming available, and he would have qualified to be vaccinated against the disease. I asked him if he had considered making an appointment online to get the vaccine.”
The patient said no.
“He told me he couldn’t access the website because he didn’t have internet access on his home computer,” Martin said. “His daughter – who typically helped him with these tasks – was limiting in-person visits for fear of transmitting the virus.”
Martin wondered if the two other patients he had just intubated had trouble getting the vaccine because they didn’t have internet access or a home computer.
“The inequity was happening in front of my eyes, right then and there,” Martin says. “Perhaps we are building systems that assume a lot about our patients’ ability to get online.”
This interaction prompted him to start Link Health – a program that connects patients to the Affordable Connectivity Program (ACP). The ACP was created through the Bipartisan Infrastructure Law and provides eligible patients up to $75 a month to help them pay their home or wireless internet bill, as well as a one-time $100 discount to purchase a laptop, desktop computer or tablet.
It is estimated that 15 to 24% of Americans currently lack broadband internet access. With digital health tools such as patient portals and remote monitoring devices becoming more common, this lack of access has been declared a “super” social determinant of health.
“Link Health was started at Mass General as a way to get patients signed up for the ACP in a convenient way that meets them where they are at,” says Martin. “We trained organizers – mostly pre-medical and medical students at first – who really cared about getting this benefit in the hands of our patients.”
These organizers have since been woven into hospital operations at the MGH, visiting community health centers and working with the Mass General Brigham Community Care Vans. RJ Russel, a student at Harvard Medical School, is a member of the Link Health team and believes the ACP is a great first step on the path toward health equity.
“Signing patients up for the ACP is incredibly important to me and the rest of our team,” Russel says. “As current or future health care providers, we understand the impact of social determinants of health on our patients. Everyone deserves a voice and has a right to internet access in our increasingly globalized society.”
Martin, Russel and other Link Health organizers recently spearheaded the White House ACP Health Care Day of Action on June 16 in Washington, D.C., where Link Health served as the health care coordinating partner for the national Day of Action. Throughout the day, more than 40 health care organizations leveraged Link Health’s resources and materials to raise awareness about the importance of the ACP and to help eligible families sign up.
“This event was a great opportunity for us to engage in digital advocacy and mobilize organizations across the country to get the word out about ACP and the importance of expanding it,” Martin says. “Action is so important in situations like this. The talk is all well and good, and telehealth as a concept is on the cutting edge of health care, but if we’re not careful, we’ll be leaving millions of people in this country behind without the ACP.”
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