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      Digital Health Equity and COVID-19: The Innovation Curve Cannot Reinforce the Social Gradient of Health

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      , MD, PhD, FRCP 1 , 2 , , , MBA, PhD 1
      (Reviewer), (Reviewer)
      Journal of Medical Internet Research
      JMIR Publications
      virtual health, digital determinants of health, digital health equity, digital health, equity, COVID-19, public health, eHealth, social

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          Abstract

          Digital health innovations have been rapidly implemented and scaled to provide solutions to health delivery challenges posed by the coronavirus disease (COVID-19) pandemic. This has provided people with ongoing access to vital health services while minimizing their potential exposure to infection and allowing them to maintain social distancing. However, these solutions may have unintended consequences for health equity. Poverty, lack of access to digital health, poor engagement with digital health for some communities, and barriers to digital health literacy are some factors that can contribute to poor health outcomes. We present the Digital Health Equity Framework, which can be used to consider health equity factors. Along with person-centered care, digital health equity should be incorporated into health provider training and should be championed at the individual, institutional, and social levels. Important future directions will be to develop measurement-based approaches to digital health equity and to use these findings to further validate and refine this model.

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          Most cited references8

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          Fair Allocation of Scarce Medical Resources in the Time of Covid-19

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            Covid-19 and Health Care’s Digital Revolution

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              Digital Mental Health and COVID-19: Using Technology Today to Accelerate the Curve on Access and Quality Tomorrow

              As interest in and use of telehealth during the COVID-19 global pandemic increase, the potential of digital health to increase access and quality of mental health is becoming clear. Although the world today must “flatten the curve” of spread of the virus, we argue that now is the time to “accelerate and bend the curve” on digital health. Increased investments in digital health today will yield unprecedented access to high-quality mental health care. Focusing on personal experiences and projects from our diverse authorship team, we share selected examples of digital health innovations while acknowledging that no single piece can discuss all the impressive global efforts past and present. Exploring the success of telehealth during the present crisis and how technologies like apps can soon play a larger role, we discuss the need for workforce training, high-quality evidence, and digital equity among other factors critical for bending the curve further.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                June 2020
                2 June 2020
                2 June 2020
                : 22
                : 6
                : e19361
                Affiliations
                [1 ] Virtual Mental Health and Outreach Centre for Addiction and Mental Health Toronto, ON Canada
                [2 ] Department of Psychiatry University of Toronto Toronto, ON Canada
                Author notes
                Corresponding Author: Allison Crawford allison.crawford@ 123456utoronto.ca
                Author information
                https://orcid.org/0000-0002-1320-0664
                https://orcid.org/0000-0001-5467-923X
                Article
                v22i6e19361
                10.2196/19361
                7268667
                32452816
                855987ff-e2c6-4c14-b9ed-facf474d274e
                ©Allison Crawford, Eva Serhal. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.06.2020.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 14 April 2020
                : 21 May 2020
                : 23 May 2020
                : 25 May 2020
                Categories
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                Medicine
                virtual health,digital determinants of health,digital health equity,digital health,equity,covid-19,public health,ehealth,social

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