Journal: NPJ digital medicine
This study evaluated how local broadband infrastructure and patient-level digital literacy affect use of video telehealth visits in oncology.
Design and cohorts
- • Retrospective analysis of 13,897 patients with cancer in a multi-site oncology practice.
- • External validation in a separate regional cohort of 6,665 patients.
- • Survey-based assessment of digital literacy in 1,134 patients.
Key findings
- • Patients living in areas with poor broadband access (≤1 internet service provider offering ≥25 Mbps download speeds) had significantly lower use of video telehealth visits (p = 0.0009).
- • The regional validation cohort showed the same pattern: lower video visit utilization in low-broadband areas.
- • In the surveyed subgroup, higher digital literacy was the strongest predictor of video telehealth use (odds ratio 2.5; p < 0.001), including among patients residing in areas with limited broadband.
Implications for oncology care
- • Both structural (broadband availability) and individual (digital literacy) factors independently influence whether patients with cancer use video visits.
- • Strong digital skills can partially compensate for suboptimal broadband, but do not fully eliminate access gaps.
- • Improving tele-oncology access will likely require parallel efforts:
- • Investment in broadband infrastructure, and
- • Targeted digital literacy programs for patients, particularly in underserved regions.