Landscape of Digital Navigation in California 

Funded by the California Health Care Foundation, we developed this white paper to characterize the current digital navigation landscape of safety net primary care clinics in California and provide recommendations for best practices related to digital navigation across diverse primary care settings. 

Centering Equity in Digital Health: Solution Design 

This first module of a three-part series, developed in partnership with the American Medical Association, focuses on how an equity-first approach can be applied to digital health solution development, through meaningful engagement with and formal accountability to marginalized user communities across all phases of the design process. 

Centering Equity in Digital Health: Solution Implementation 

In this second module of a three-part series, developed in partnership with the American Medical Association, we discuss strategies for implementing and operationalizing digital health solutions that benefit and do no harm to all patients. Because of the critical role that safety-net settings play in delivering care to marginalized patients, this module centers the considerations for safety-net settings, in line with the value of “centering the margins.” However, lessons about delivering equitable care through innovation are broadly applicable across care settings. 

Centering Equity in Digital Health: Solution Evaluation 

In this final module of a three-part series, developed in partnership with the American Medical Association, we focus on how to position technology so that it can improve health for all. Digital health interventions exclude and harm communities that have been marginalized by the US health system by way of historical and current injustices. This necessitates an equity-first approach by evaluators assessing digital health innovations. 

Bridging the Digital Health Divide Series 

In collaboration with the California Health Care Foundation, we created a series of briefs focused on how to create equity and inclusion during technology implementation and design to help health care providers, health plans, and developers reach everyone. The first brief covers how providers and plans can help communities better adopt health tools, and the second brief covers how designers can create more inclusive digital health tools. 

Telemedicine for Health Equity Toolkit 

Developed in partnership with the Center for Care Innovations and with support from The Commonwealth Fund, the Telemedicine for Health Equity Toolkit helps remote care reach patients with low-incomes and from racial and ethnic minority groups to promote health equity rather than exacerbate health disparities.  

Digital Health Equity - Stanford Department of Medicine Grand Rounds 

In September 2022, Dr. Sarkar mapped elements of health equity to the socioecological framework and identified high priorities for intervention to achieve digital health equity at Stanford Medicine Grand Rounds.

Implementing Innovative Solutions with an Equity Lens, AMA Innovation Academy 

In August 2021, Dr. Lyles outlined best practices for implementing new health care technologies—including telehealth—in practice in an equitable, inclusive way focusing on both the impact to marginalized and minoritized patients and the clinicians and systems that care for them, at the American Medical Association Innovation Academy.

The Digital Divide: Addressing Patient Barriers - AMA Telehealth Webinar  

In July 2020, Drs. Lyles and Sarkar presented key patient barriers to adopting telehealth and offered strategies, resources, and tools to reduce limitations to access at the American Medical Association Telehealth Webinar.

Therapy for People Who Can't Go to Therapy, New York Times Opinion 

In a guest essay for the New York Times Opinion, Dr. Adrian Aguilera highlights the promises and potential inequities in digital mental health. Questioning whether the proliferation of digital mental health is good news for our country, he says it depends. "America's mental health industry faces a stark choice: take advantage of this moment to get help to the millions who need it - including, especially, poor Americans and immigrants - or allow the inequalities that already exist to deepen." Dr. Aguilera also indicates signs of progress, including app-based programs like DIAMANTE. His piece adds a critical equity focus to the New York Times'  series on America's mental health crisis. 

Real-world insights from launching a Peer Mentoring Program in a Safety-Net Health Setting 

We conducted a real-world case study with InquisitHealth (now Pyx Health) Peer Mentoring Program. This showed strong uptake and enrollment among racial/ethnic minorities (83% non-white) and individuals with high comorbidity (79% had at least 3 chronic conditions). Participants also showed improvements in HbA1c. Most used phone calls instead of the app, highlighting the need for multi-modal approaches in peer coaching. Patient-centered approach, such as mentor matching and addressing social determinants of health, helped effectively engage diverse populations in remote care. Patients had substantial engagement with mentors and had significant improvements in clinical outcomes, expanding the program’s reach and impact. Coaching, technology, and interoperability can empower individuals and communities to lead and engage in healthier lives, all while improving access to care in vulnerable populations. The ability to leverage digital solutions to promote health literacy and chronic conditions management in low-income and racial/ethnic minority groups moves us a step closer to cultural and health evolution.