Are digital health tools reaching the populations that need them the most? That was the question that concerned two recent publications: a small study of patients with low health literacy conducted by the Commonwealth Fund, and a research letter published in JAMA looking at digital health usage by a cohort of 7,000 seniors over four years.The Commonwealth Fund study observed 26 low-income patients using 11 “popular and well-rated” mobile apps for diabetes, depression, and caregiving management. Seventy percent of said patients were deemed to have low health literacy. Researchers gave them specific instructions of things to do in the app and then debriefed them about the experience. They found that patients had trouble with manual data entry and were often confused about what information was being asked of them. All the apps required manual entry, but participants were only able to complete half the assigned data entry tasks without assistance. Similarly, they struggled with retrieving data from the apps with only 79 out of 185 data retrieval tasks being successfully completed. Researchers recommended that apps have larger buttons and simpler interfaces, and that they explain the purpose of their functions more — i.e. telling a person with diabetes why it’s valuable to them to record their meals.In the JAMA letter, Brigham and Women’s Hospital physicians looked at four years of survey data from a cohort that began with 7,609 elderly patients and ended with 4,355 (others either dropped out of the study or passed away). Patients were asked whether they used the internet to do each of four things: refill prescriptions, contact a clinician, address insurance matters, or research health conditions.