JMIR Publications

ABSTRACT

Background:

Given the expansion of virtual dermatology NHS services, 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 virtual services to the needs of their patient population.

Objective:

This quality improvement project (QIP) aims to inform the re-design of virtual services to optimally support the ongoing needs of patients with chronic skin diseases, ensuring this is tailored to their digital health literacy requirements.

Methods:

Cluster analysis of READHY dimensions in responding participants (n=116) revealed seven groups with distinct digital and health literacy characteristics. High READHY scores in groups 1 (n=22 (19.0%)) and 2 (n=20 (17.2%)) represent those 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.

Results:

Cluster analysis of READHY dimensions in responding participants (n=116) revealed seven groups with distinct digital and health literacy characteristics. High READHY scores in groups 1 (n=22 (19.0%)) and 2 (n=20 (17.2%)) represent those 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.

Conclusions:

By identifying patient groups with distinguishable patterns of digital access and health literacy, our method demonstrates that 63.8% of people attending specialist clinics in our centre require support in order to optimise virtual follow-up or need an alternative approach. Future efforts should streamline the READHY question profile to improve utility and employ focus groups to elicit strategies for engaging patients with digital services.