Here are comments submitted to the Broadband Opportunity Council by Dr. David Kaelber, Chief Medical Informatics Officer for Cleveland’s MetroHealth System.

An excerpt:

At some point, however, growth in MyChart adoption by our patients is going to run up against a major obstacle: the large percentage of Cleveland residents who lack broadband Internet access of any kind. The most recent American Community Survey found that 57% of Cleveland households with annual incomes below $35,000 still lack home Internet service of any kind, including mobile broadband. Three out of five households in our city have incomes below $35,000; and this lower-income majority, who are less likely than not to have Internet access, include a large share of MetroHealth’s patients.

MetroHealth can already see Cleveland’s economic digital divide reflected in our MyChart user data. Between January 2012 and May 2015, only about 20% of our Medicaid patients logged in to a MyChart account, compared to 36% of our patients covered by commercial insurance. There is good reason for concern that this disparity may widen, as continuing efforts to add MyChart users run up against the limited supply of lower-income patients who are actually able to respond.