Accepted for/Published in: JMIR Formative Research
Date Submitted: Nov 1, 2024
Date Accepted: May 25, 2025
Service Quality of Digital Health Solutions in Outpatient Care: A qualitative item repository development study
ABSTRACT
Background:
The integration of digital health solutions into healthcare systems has the potential to significantly enhance service delivery and health outcomes. Despite their benefits, the adoption remains slow, especially in outpatient care, and is hindered by various barriers, such as unclear effectiveness and high costs.
Objective:
Our study aimed to address the uncertainties regarding the cost-benefit ratio of digital health solutions by developing a comprehensive instrument to evaluate the effects of digital health solutions on healthcare service quality in various settings comparably.
Methods:
We conducted a multi-staged rapid review and interviews to identify and adapt existing instruments. A first rapid review of 40 papers was conducted to identify instruments currently used for digital health solution assessment after their deployment. The Outpatient Experience Questionnaire (OPEQ) was selected and combined with HEALTHQUAL, an established instrument for measuring healthcare service quality. Subsequent interviews with healthcare practitioners validated the healthcare service quality dimensions in HEALTHQUAL and OPEQ, and identified patient satisfaction as an additional dimension. A second rapid review with 35 papers was conducted to identify instruments used to measure patient satisfaction, resulting in the selection of Patient Satisfaction Questionnaire-Short Form (PSQ-18).
Results:
By combining HEALTHQUAL, OPEQ, and PSQ-18, we derived the DigiHEALTHQUAL questionnaire, which consists of 51 items across eight dimensions, including accessibility, efficiency, empathy, general satisfaction, improvements of care service, information, safety, and tangibles.
Conclusions:
The DigiHEALTHQUAL questionnaire aims to provide a standardized approach for assessing the impact of digital health solutions on healthcare service quality across various use cases, therapeutic areas, and perspectives, facilitating comparison between digital health solutions and supporting decision-makers in resource allocation and implementation decisions. Future research will focus on validating DigiHEALTHQUAL in real-life settings and further refining it to comprehensively encompass both patient and healthcare practitioner perspectives.
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