Abstract
As digital tools become more embedded in healthcare, their potential to improve outcomes is often tempered by concerns about equity. My capstone and STS research both examine how digital health innovations can either promote or hinder equitable care, focusing on definitions of value, implementation challenges, and stakeholder experiences. The capstone project evaluates UVA Health’s Interactive Home Monitoring program, which supports recently discharged patients through remote monitoring, proactive outreach, and patient engagement strategies. Using a mixed methods approach, we analyzed hospital data on readmissions, emergency department visits, and length of stay, alongside interviews with patients, clinicians, and program leaders. Patients enrolled in the program experienced significantly fewer readmissions and emergency department visits. Interviews revealed that patients valued emotional reassurance and feeling cared for, while health professionals emphasized education and access to services. However, data inconsistencies and a lack of formal evaluation metrics limited the ability to assess impact comprehensively. We recommended incorporating new outcome measures such as emotional support ratings and monitoring adherence to better capture program value. In parallel, my STS research investigates disparities in patient portal access using Actor Network Theory. A structured literature review was used to trace how patients, providers, developers, and policymakers interact within the sociotechnical system of digital health. Although patient portals are intended to empower users, they often reinforce existing inequities, particularly for older adults, rural populations, and those with limited digital access. Actor Network Theory made visible the complex network relationships that influence access and use. Together, these projects highlight the need for both technical refinement and sociotechnical sensitivity in designing equitable digital health systems.
