National Digital Health Index shows communities most at risk of being left behind in the digital health era
The index was developed by a multidisciplinary team across several schools at Carolina and led by the UNC School of Nursing's Saif Khairat.
As telehealth, remote monitoring, and artificial intelligence-powered health tools become increasingly integrated into healthcare delivery, a new study from researchers across UNC-Chapel Hill published in JAMA Network Open introduces the first comprehensive national measure designed to assess whether communities are prepared to benefit from digital health services.
Approximately 100 million Americans live in areas with inadequate access to healthcare, with rural and underserved communities facing some of the greatest barriers. While digital health technologies can help bridge these gaps, successful adoption depends on more than internet access alone.
The Digital Health Index is an AI-powered, validated census tract–level measure of community digital health readiness that combines socioeconomic conditions, healthcare access, and digital connectivity. The study analyzed data from more than 85,000 census tracts across all 50 states and the District of Columbia. The findings reveal that many communities identified as digitally vulnerable differ substantially from those flagged by existing measures of social vulnerability, deprivation, or broadband access alone.
“When we compared the results of the DHI against the indices health systems and policymakers already use, we found that more than half of the communities with the greatest digital health vulnerabilities simply don’t appear in those existing tools. That’s not a data quality problem; it’s a blind spot with real consequences,” said Saif Khairat, Beerstecher-Blackwell Distinguished Professor at the UNC School of Nursing and chief artificial intelligence officer and vice provost for AI at Carolina. “Health systems that allocate digital health resources using only existing indices miss the majority of the communities that need support most. The DHI was built specifically to close that gap.”
Khairat led a multidisciplinary team from the UNC School of Medicine, UNC School of Nursing, and UNC Gillings School of Global Public Health, along with UNC Health and University Library to develop the DHI through the NIH-funded Center for Virtual Care Value and Excellence.
The AI-powered DHI tool can serve as a valuable planning and evaluation tool as healthcare organizations increasingly invest in digital care delivery. The tool can be used to identify communities that may require digital literacy support, device assistance, or broadband investments.
Digital health is becoming an essential component of healthcare delivery. Measuring community readiness will be essential for ensuring equitable access to emerging technologies.
