JMIR Publications

ABSTRACT

Background:

Following a large increase in the adoption of digital health amidst the COVID-19 crisis, there is increasing policy interest in the longer-term implementation of digital health services. Yet, there is still much unknown about the inherent quality of remote digital care, and research on patient perspectives remains comparatively small. Widespread usage amidst COVID-19 presents an important opportunity to better understand patients’ first-hand experiences with using these technologies.

Objective:

This study examined patients’ perspectives on main benefits and concerns with using digital health services in a large multi-site teaching hospital in North-West London during the COVID-19 crisis.

Methods:

Qualitative data was obtained from a larger questionnaire conducted during the COVID-19 pandemic on Care Information Exchange, which represents the largest patient-facing electronic health records in the English National Health Service. All responses were analysed using the framework analysis method. Quantitative content analysis was performed by mapping frequencies of reported themes across the respondent population.

Results:

Of all 6,766 respondents, 25.1% reported to have no concerns with digital health services, compared to 3.0% reporting no benefits. Reported benefits included: ease of access (37.1%), feeling empowered and informed (23.2%), improved timeliness of access and treatment (18.6%), healthcare capacity (11.5%), and care continuity amidst COVID-19 (7.4%). In contrast, reported concerns included issues around data security and privacy (17.5%), clinical uncertainty (17.0%), impact on patient-doctor relationship (11.9%), inequity in access and use (11.8%), misunderstanding health information (6.3%), and digital maturity (3.8%).

Conclusions:

Patients report many benefits with digital health services beyond immediate COVID-19 support, including improved access, timeliness, and enhanced healthcare capacity. Yet, some concerns remain, including some less-addressed problems such as the more fundamental impacts on clinical effectiveness and the patient-doctor relationship. These large-scale and patient-driven insights can inform main areas to be addressed in future research and practice.