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Appl Clin Inform 2025; 16(05): 1695-1708
DOI: 10.1055/a-2640-2742
Research Article

Exploring the Relationship between Digital Health Literacy and Patterns of Telemedicine Engagement and Appointment Attendance within an Urban Academic Hospital

Authors

  • Natali Sorajja‡   *

    1   Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, United States

  • Julia Zheng‡   *

    1   Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, United States

  • Sunit Jariwala

    2   Division of Allergy and Immunology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, United States

Funding None.
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Abstract

Background

Telemedicine use has surged since the COVID-19 pandemic, offering a convenient way for patients to access health care. Whereas digital literacy (general comfort with and ability to use digital tools) is necessary to utilize telemedicine, digital health literacy is a subset of this, focusing on the ability to use digital tools to seek out, understand, and utilize health information. Barriers such as the lack of high-speed internet and limited digital health literacy can hinder telemedicine's effectiveness, particularly for historically marginalized populations with lower technological access.

Objectives

This study aims to characterize the relationship between baseline digital health literacy, appointment no-shows, and telemedicine usage in a Bronx population.

Methods

In a Bronx-based cohort, we assessed digital health literacy using eHealth Literacy Scale (eHEALS) and eHealth Literacy Objective Scale-Scenario Based (eHeLiOS-SB), and health literacy with the Newest Vital Sign (NVS) instrument. Baseline sociodemographic characteristics (e.g., age, insurance type) were collected, and appointment no-show rates and telemedicine usage were calculated. Linear regression models were used to assess associations.

Results

Higher digital health literacy, private insurance (compared to Medicaid), and older age were associated with fewer no-shows. Higher video visit usage was also associated with fewer no-shows. Individuals at high risk of housing insecurity were less likely to use video visits, and higher phone visit usage was associated with patients experiencing financial resource strain. Digital health literacy was positively associated with White race and negatively associated with Medicare usage (compared to Medicaid).

Conclusion

Higher digital health literacy correlates with increased appointment attendance, indicating the need to address digital barriers in health care. Increasing telemedicine use may help reduce no-shows, and patient-specific strategies are needed to enhance digital health literacy and telemedicine effectiveness.

Keywords

allergy and immunology - outpatient care - internet and the web technology - telemedicine and telehealth - communication barriers

Protection of Human Subjects

This study complied with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines and the Albert Einstein College of Medicine (IRB) approved this study.


* These authors contributed equally to this work.




Publication History

Received: 19 February 2025

Accepted: 19 June 2025

Accepted Manuscript online:
24 June 2025

Article published online:
17 November 2025

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