Digital Health Care Leaving Patients Behind

Study finds most health systems fail to assess if patients can use online tools

Published on Feb. 26, 2026

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A new study from UC San Francisco found that most health care systems are not checking if their patients have the access and skills to use the growing number of digital health tools, like online portals and telehealth appointments. The researchers surveyed nearly 150 clinicians and informatics leaders, and only 44% said they asked patients about their digital readiness, with even fewer doing so for uninsured patients.

Why it matters

The lack of digital readiness screening means many patients, especially those with worse health outcomes and limited access to care, are being excluded from the shift to digital health tools. This raises concerns about equitable access to care as more health services move online.

The details

The UCSF study found that the top barriers to screening for digital readiness were lack of time and resources. Even among those who did screen patients, nearly half said they didn't have the resources to help patients access or learn to use the organization's online tools. The situation has worsened since the survey, as Congress cut funding for the Affordable Connectivity Program, the nation's largest internet subsidy for low-income households.

  • The survey was conducted in the first half of 2024.
  • In June 2024, the Affordable Connectivity Program shut down after Congress failed to renew its funding.

The players

Elaine C. Khoong

Associate professor of medicine at UCSF and a faculty member with the UCSF Action Research Center for Health.

Jonathan J. Shih

Co-first author of the study from UCSF.

Andersen Yang

Co-first author of the study from UCSF, MPH.

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What they’re saying

“Not everyone can access all these new digital health tools we're rolling out, and the people who are excluded are often those who experience worse health outcomes and limited access to care.”

— Elaine C. Khoong, Associate professor of medicine at UCSF and a faculty member with the UCSF Action Research Center for Health (Mirage News)

What’s next

The researchers recommend that health care organizations should train their workers to screen for digital readiness using standardized tools, and that policymakers should create stronger incentives for health systems to do this type of assessment. They also suggest it should be incorporated into other routine screenings.

The takeaway

This study highlights the growing digital divide in health care, where the shift to online tools is leaving behind vulnerable patients who lack access or digital skills. Addressing this gap in digital readiness assessment is crucial to ensuring equitable access to care as more health services move to digital platforms.