In the year 2000, when I was director of NCI's Division of Cancer Control and Population Sciences, only about half of U.S. adults had Internet access. The first iPhone was still 7 years in the future. Few health systems used electronic health records (EHRs) for patient care, and the notion of patients communicating with their health providers and accessing their health records via their own computers was science fiction for most people.
There were—and still are, to a lesser extent—large disparities by age and race in access to and use of the Internet, and at NCI, we were already focused on overcoming this "digital divide." WiFi was not ubiquitous, and I remember many offsite meetings where we had to go outside to get a wireless signal.
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