This is a HUGE problem and not just because it is annoying, it will 100% exacerbate health disparities.
(Thread) https://twitter.com/polly/status/1348464494108954626

My group is running a small (n=200) trial to see if various digital health technologies can benefit patients with heart failure. https://clinicaltrials.gov/ct2/show/NCT04394754

Because of COVID, we are doing almost all our recruiting electronically. We worked with @medullan to create a really easy, mobile and desktop-friendly recruitment site.

You can consent and take your initial study surveys entirely electronically. Randomization occurs online as well. Super easy. It would take anyone on twitter like 5 minutes to complete.

But we were shocked to see first hand the digital divide in this country when we started calling patients to recruit them.

Only around 10% of the patients we called even had a computer in their house. For the vast majority, their ONLY access to the internet was through a smartphone.

Pretty much everyone had a smartphone, which was nice, but few knew how to use it. Asking them to open a web browser and enter our site address proved to be very difficult.

Many potential participants didn't know their own e-mail address or how to access e-mail.

When we finally got them to the site to enroll, older hands had trouble clicking the checkboxes, despite mobile-friendly design.

In the end, for many patients, we did it the old fashioned way. WE logged in, read them the questions, and recorded their answers.

COVID-19 affects disadvantaged communities particularly hard. A cumbersome web-based process to get vaccinated is going to make this worse.

You want to vaccinate people older than 75? Fine - set up vaccine distribution points and check IDs.

Unfortunately, scheduling is going to be necessary while supplies are so low. In that case, set up a simple phone number that people can call to schedule, staff / fund it appropriately, and get the word out every way you can.

I'm a techie. But tech solutions are not perfect for this crisis. Boots on the ground is what we need.