As a child, Jorge Rodriguez, MD, witnessed the ways in which Latinx communities are medically and socially disadvantaged simply because of the language barrier.

“I accompanied my uncle to job interviews, working to bridge the communication gap between him and the interviewer,” said Rodriguez. “Now as a practicing clinician, I continue to witness this gap in health care settings and patient-provider interactions.”

Today, as a member of the Division of General Internal Medicine and Primary Care, at the Brigham, Rodriguez continues to tirelessly seek technology that will increase health care access and understanding in medically underserved communities.

Journey to the Brigham

After attending Tufts University School of Medicine, Rodriguez completed his residency at Mass General Hospital, Clinical Informatics Fellowship at Beth Israel. After fellowship, he served as Medical Director of Clinical Informatics at Lawrence General Hospital. In 2019, he joined the Brigham as a clinician-investigator.

The decision to come to the Brigham was an easy one for Rodriguez. He notes that the organization has provided him with a wealth of mentors who each have the same mission in mind: achieving health equity. Given his experiences as an immigrant and health care professional, Rodriguez understood the vast number of disparities present in medical communication.

While caring for patients as an internist, Rodriguez began browsing multiple Boston-specific health care websites, assessing if patients like his uncle would be able to navigate and comprehend the wealth of English-only information provided. The unfortunate answer was no.

“Although we have an abundance of resources to ease patient-provider communication, they are tailored to our English-speaking patients,” said Rodriguez.

Evolving with the Pandemic and Rise in Type 2 Diabetes

When Rodriguez first arrived at the Brigham in September 2019, telemedicine was not a central part of care. Today, telemedicine is an essential tool for patients and providers, and Rodriguez notes that the rise of this technology further prompted him to investigate existing gaps in health technology and address barriers at the patient, clinical, institutional, and national level.

“Although digital health has taken off during the pandemic, marginalized populations—especially those with type 2 diabetes—are still unable to access their health portals or participate in video visits. They are being left behind,” says Rodriguez.

Today, Rodriguez is focused on understanding the rise in prevalence and incidence of type 2 diabetes among Latinx/Hispanic populations in the United States— and if appropriately harnessing technology can help mitigate this uptick. He firmly believes this trend is rooted in sociological, cultural, and economic problems that our current health care system must address. By investigating barriers to digital access, areas for improvement, and most importantly, the recently enacted Infrastructure Investment and Jobs Act (IIJA), an authorization for investments aiming to foster digital inclusion, Rodriguez is learning more about how to make these investments sustainable.

Fostering Digital Inclusion

Rodriguez and co-authors recently published a perspective piece in the New England Journal of Medicine (NEJM), noting that barriers to digital inclusion have only grown with time and impacted communities are typically those already experiencing poor health outcomes. A lack of access to the internet, high prices of broadband services and a dearth of culturally and linguistically tailored digital tools have constrained the use of telehealth.

To appropriately deliver equitable care for underserved patients, Rodriguez recommends that we first ensure everyone has access to internet-enabled devices and accessible, appropriately designed digital platforms. He commends institutions deploying digital navigators, or care team members who help patients navigate their digital health tools. Such resources, however, should be applied with a clinical goal in mind to ensure health disparities are addressed.

Ultimately, if the IIJA addresses health disparities stemming from digital exclusion, health care organizations must actively support anti-discrimination efforts. “The IIJA tasks the Federal Communications Commission with holding telecommunication companies accountable for equitable implementation, which can lead to tremendous progress in providing quality care for those in need,” Rodriguez and colleagues wrote in NEJM.

For Rodriguez, our health care systems need to understand this inequity, secure funding, and adopt policies that bolster digital inclusion. He firmly believes health care systems should actively advocate for digital-inclusion policies and argues that by doing so, “digital tools can serve to address existing health disparities experienced by marginalized patients with diabetes.”

 

 

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