DIGITAL HEALTH INEQUITY: Increasing Use of Digital Health Portals in Los Angeles County

• In Event: Medicaid Policy and Access to Care: Evidence on Utilization, Outcomes, and System Design

Abstract

This Applied Policy Project investigates the structural barriers that restrict enrollment in and sustained engagement with patient portals in Los Angeles County. After relocating from Alameda County, the student researcher became interested in the LA Health Portal and sought to better understand the reported 50% adoption rate by systematically examining the barriers that limit equitable access and meaningful use. The study analyzes sociotechnical, socioeconomic, sociocultural, and socioenvironmental factors influencing portal adoption, drawing on expert interviews, survey data, and equity-centered analytical frameworks to provide a multidimensional and policy-relevant assessment. Key challenges identified through both primary and secondary data fall into four categories: technical, governance, organizational, and informational. Technical barriers include limited system interoperability, fragmented data infrastructure, and inconsistent data collection and measurement practices across providers. Governance challenges involve misinterpretation of HIPAA requirements, which can unnecessarily restrict data sharing and hinder patient access. Organizational barriers include bureaucratic decision-making processes, insufficient coordination across agencies, and under-resourced patient navigation programs that limit outreach and support. Informational barriers encompass low levels of patient and provider awareness, as well as language access limitations and gaps in digital literacy that disproportionately affect marginalized populations, including older adults, low-income communities, and non-English speakers.To address these issues, four policy options were developed. These include upgrading the LA Health Portal to improve usability and interoperability, expanding community-based digital equity infrastructure to increase access and literacy, strengthening cross-sector partnerships alongside sustainable funding strategies, and implementing a countywide multilingual awareness and education campaign. Together, these recommendations aim to reduce disparities in digital health access, improve care coordination and patient engagement, and enhance overall health outcomes. Increasing adoption and effective use of the LA Health Portal could also position Los Angeles County as a model for equitable digital health system implementation at the national level, particularly for large and diverse public health systems.

Author

• OMOLOLA ATOLAGBE, University of California - Los Angeles
  Presenting Author