Presentation (CTI)

OBJECTIVES: Digital health tools (such as mobile apps, wearables, electronic health records) have the potential to reduce avoidable healthcare use and promote cost-effective self-management. However, their impact depends on digital health literacy (DHL). We examine how DHL, including both access to technology and confidence in using it, relates to engagement with patient-facing tools and to behaviours that influence healthcare costs.
METHODS: We use nationally representative sample (n=7,278) of U.S. adults from the 2024 Health Information National Trends Survey (HINTS). Using polychoric factor analysis, we reduce eighteen items on internet access, device ownership, technology confidence, and portal use into two latent dimensions: a digital health literacy factor and a tool engagement factor. We then apply survey-weighted logistic regression to link these factors to three cost relevant outcomes: tele-health use, redoing a test, and in-person visit frequency, adjusting for demographics, socioeconomic status, insurance, and health status.
RESULTS: Digital health literacy and tool engagement are both associated with increased tele-health uptake. A one-standard-deviation (SD) increase in the DHL factor increases the odds of having any tele-visit by 20% (OR 1.21, p = 0.007), while a one SD gain in engagement increases those odds by 50% (OR 1.50, p < 0.001). Tool engagement also slightly lowers the chance of repeating a test, while changes in overall in-person visit frequency are small and inconsistent. Assuming a conservative $40 saving per tele-visit versus in-office care, the observed 10-percentage-point increase in tele-visit probability corresponds to approximately $10-$15 in annual per-person savings. Scaled nationally, even modest gains in digital engagement imply potential cost reductions on the order of hundreds of millions of dollars.
CONCLUSIONS: Digital health literacy and tool engagement both increase telehealth use, but only active engagement avoids unnecessary repeat testing. Enhancing both access and practical use of digital health tools is key to reducing avoidable care costs.