The Effect of Remote Digital Services on Health Care Inequalities Among People Under Long-Term Dermatology Follow-Up: Cross-Sectional Questionnaire Study
BackgroundGiven the expansion of remote digital dermatology services from the National Health Service, particularly during the COVID-19 pandemic, there is a need for methods that identify patients at risk of digital exclusion to guide equitable representation in service co-de...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2023-12-01
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| Series: | JMIR Dermatology |
| Online Access: | https://derma.jmir.org/2023/1/e48981 |
| _version_ | 1827592506481573888 |
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| author | Serena Ramjee Hanen Mohamedthani Aditya Umeshkumar Patel Rebeca Goiriz Catherine A Harwood Richard H Osborne Christina Cheng Zeeshaan-ul Hasan |
| author_facet | Serena Ramjee Hanen Mohamedthani Aditya Umeshkumar Patel Rebeca Goiriz Catherine A Harwood Richard H Osborne Christina Cheng Zeeshaan-ul Hasan |
| author_sort | Serena Ramjee |
| collection | DOAJ |
| description |
BackgroundGiven the expansion of remote digital dermatology services from the National Health Service, particularly during the COVID-19 pandemic, there is a need for methods that identify patients at risk of digital exclusion to guide equitable representation in service co-design processes and tailor remote services to the needs of their patient population.
ObjectiveThis quality improvement project aims to inform the redesign of remote services to optimally support the ongoing needs of patients with chronic skin diseases, ensuring that the services are tailored to patients’ digital health literacy requirements.
MethodsWe profiled the digital health literacy of 123 people with chronic skin conditions who require long-term surveillance in 2 specialist clinics (London, United Kingdom) using the Multidimensional Readiness and Enablement Index for Health Technology (READHY) questionnaire alongside the Optimizing Health Literacy and Access (Ophelia) process for hierarchical cluster analysis.
ResultsThe cluster analysis of READHY dimensions in responding participants (n=116) revealed 7 groups with distinct digital and health literacy characteristics. High READHY scores in groups 1 (n=22, 19%) and 2 (n=20, 17.2%) represent those who are confident with managing their health and using technology, whereas the lower-scoring groups, 6 (n=4, 3.4%) and 7 (n=12, 10.3%), depended on traditional services. Groups 3 (n=27, 23.3%), 4 (n=23, 19.8%), and 5 (n=8, 6.9%) had varying digital skills, access, and engagement, highlighting a population that may benefit from a co-designed dermatology service.
ConclusionsBy identifying patient groups with distinguishable patterns of digital access and health literacy, our method demonstrates that 63.8% (n=74) of people attending specialist clinics in our center require support in order to optimize remote follow-up or need an alternative approach. Future efforts should streamline the READHY question profile to improve its practicality and use focus groups to elicit strategies for engaging patients with digital services. |
| first_indexed | 2024-03-09T01:56:24Z |
| format | Article |
| id | doaj.art-270cae2c93b548b7ae23a062e2cbf86c |
| institution | Directory Open Access Journal |
| issn | 2562-0959 |
| language | English |
| last_indexed | 2024-03-09T01:56:24Z |
| publishDate | 2023-12-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Dermatology |
| spelling | doaj.art-270cae2c93b548b7ae23a062e2cbf86c2023-12-08T14:30:47ZengJMIR PublicationsJMIR Dermatology2562-09592023-12-016e4898110.2196/48981The Effect of Remote Digital Services on Health Care Inequalities Among People Under Long-Term Dermatology Follow-Up: Cross-Sectional Questionnaire StudySerena Ramjeehttps://orcid.org/0000-0003-4334-9918Hanen Mohamedthanihttps://orcid.org/0009-0004-2755-1707Aditya Umeshkumar Patelhttps://orcid.org/0000-0002-0896-7166Rebeca Goirizhttps://orcid.org/0009-0006-3548-5126Catherine A Harwoodhttps://orcid.org/0000-0002-1375-0965Richard H Osbornehttps://orcid.org/0000-0002-9081-2699Christina Chenghttps://orcid.org/0000-0002-8950-7689Zeeshaan-ul Hasanhttps://orcid.org/0000-0002-3391-2730 BackgroundGiven the expansion of remote digital dermatology services from the National Health Service, particularly during the COVID-19 pandemic, there is a need for methods that identify patients at risk of digital exclusion to guide equitable representation in service co-design processes and tailor remote services to the needs of their patient population. ObjectiveThis quality improvement project aims to inform the redesign of remote services to optimally support the ongoing needs of patients with chronic skin diseases, ensuring that the services are tailored to patients’ digital health literacy requirements. MethodsWe profiled the digital health literacy of 123 people with chronic skin conditions who require long-term surveillance in 2 specialist clinics (London, United Kingdom) using the Multidimensional Readiness and Enablement Index for Health Technology (READHY) questionnaire alongside the Optimizing Health Literacy and Access (Ophelia) process for hierarchical cluster analysis. ResultsThe cluster analysis of READHY dimensions in responding participants (n=116) revealed 7 groups with distinct digital and health literacy characteristics. High READHY scores in groups 1 (n=22, 19%) and 2 (n=20, 17.2%) represent those who are confident with managing their health and using technology, whereas the lower-scoring groups, 6 (n=4, 3.4%) and 7 (n=12, 10.3%), depended on traditional services. Groups 3 (n=27, 23.3%), 4 (n=23, 19.8%), and 5 (n=8, 6.9%) had varying digital skills, access, and engagement, highlighting a population that may benefit from a co-designed dermatology service. ConclusionsBy identifying patient groups with distinguishable patterns of digital access and health literacy, our method demonstrates that 63.8% (n=74) of people attending specialist clinics in our center require support in order to optimize remote follow-up or need an alternative approach. Future efforts should streamline the READHY question profile to improve its practicality and use focus groups to elicit strategies for engaging patients with digital services.https://derma.jmir.org/2023/1/e48981 |
| spellingShingle | Serena Ramjee Hanen Mohamedthani Aditya Umeshkumar Patel Rebeca Goiriz Catherine A Harwood Richard H Osborne Christina Cheng Zeeshaan-ul Hasan The Effect of Remote Digital Services on Health Care Inequalities Among People Under Long-Term Dermatology Follow-Up: Cross-Sectional Questionnaire Study JMIR Dermatology |
| title | The Effect of Remote Digital Services on Health Care Inequalities Among People Under Long-Term Dermatology Follow-Up: Cross-Sectional Questionnaire Study |
| title_full | The Effect of Remote Digital Services on Health Care Inequalities Among People Under Long-Term Dermatology Follow-Up: Cross-Sectional Questionnaire Study |
| title_fullStr | The Effect of Remote Digital Services on Health Care Inequalities Among People Under Long-Term Dermatology Follow-Up: Cross-Sectional Questionnaire Study |
| title_full_unstemmed | The Effect of Remote Digital Services on Health Care Inequalities Among People Under Long-Term Dermatology Follow-Up: Cross-Sectional Questionnaire Study |
| title_short | The Effect of Remote Digital Services on Health Care Inequalities Among People Under Long-Term Dermatology Follow-Up: Cross-Sectional Questionnaire Study |
| title_sort | effect of remote digital services on health care inequalities among people under long term dermatology follow up cross sectional questionnaire study |
| url | https://derma.jmir.org/2023/1/e48981 |
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