135 - Developing and Implementing a Digital Readiness Screener

The AHIMA Foundation and Jefferson Health: Developing a tool to assess patients' readiness to use technology in health care

ABSTRACT

Background: The COVID-19 pandemic facilitated unprecedented growth in telehealth use. While the rapid uptake of telehealth led to its increased acceptance as a care option, preparedness for using technology for healthcare is not equal among healthcare consumers. This preparedness, for which we use the term “digital health readiness”, depends on a range of factors from more technical aspects (e.g., access, knowledge) to import considerations such as individuals’ trust in use of technology for healthcare needs. Having a means to identify individuals with low digital readiness, and to understand their specific barriers to readiness, can help health systems in efficient deployment of resources to support patients in need. To that end, the goal of this work was to develop the Digital Health Readiness Screener (DHRS), a tool designed to quantify an individual’s overall readiness and to identify specific barriers to readiness to engage in digital health services.

Methods: The DHRS was created in four phases. First, we interviewed 32 patients, 17 clinicians, and 4 health informatics professionals about their experience with telehealth and overall use of and trust in technology. Next, we used responses from the interviews to draft potential items for the DHRS. Then we conducted 15 cognitive interviews with patients to refine the scale items. Finally, we administered the scale to 304 patients for initial reliability and validity testing to evaluate the psychometric properties of the new DHRS.

Results: The initial interviews uncovered 21 concepts to be covered in the DHRS, for which the team developed 48 items for the scale. Cognitive interviews resulted in revised wording of 15 items, revised wording of scale responses for 9 items, reversed scale responses for 7 items, the addition of 4 items, and the removal of 13 items. A total of 30 items were examined for psychometric purposes. The final DHRS consists of 22 items that comprise 2 factors, one with 18 items (Technical Readiness) and the other with 4 items (Quality of Care Readiness).

Conclusion: This is, to our knowledge, the first scale designed to comprehensively assess an individual’s digital health readiness. The 22-item DHRS in its entirety exemplifies the complexity of factors influencing digital health uptake among various populations and highlights several areas for potential intervention to support increased digital health uptake at both the individual and population levels.