Innovative Strategy to Tackle Telehealth Adoption Challenges in Various Patient Groups
In a recent publication in JAMA Network Open, researchers from Thomas Jefferson University have created a groundbreaking screening tool designed to assess digital health readiness, essential for overcoming challenges related to telehealth integration among different patient demographics.
The COVID-19 pandemic triggered swift transformations in healthcare, notably leading to a widespread adoption of telehealth services in the U.S., replacing face-to-face doctor visits. This transition allowed patients to receive essential medical care with just a mobile device or computer with a webcam. However, possessing a smartphone or tablet does not guarantee that patients can access their health records or utilize other health services effectively. Varying levels of telehealth adoption among different populations can exacerbate health inequalities, highlighting the urgent need to identify and address the obstacles some patients face in using telehealth.
Prior research has indicated that the level of telehealth adoption can differ based on factors like a patient’s digital and health literacy, as well as trust in the system. Yet, no existing tools thoroughly encompass all these challenges. Therefore, this research team focused on developing a tool to identify and quantify the diverse factors influencing patients’ abilities and willingness to engage with telehealth services.
“Are patients comfortable using technology for private discussions, such as health-related conversations? Do they have a confidential space to take part in telehealth? These aspects are crucial for assessing a patient’s readiness for telehealth and have not been fully explored. We need to quantify these factors to create effective interventions,” explains Kristin Rising, MD MSHP, executive director of the Jefferson Center for Connected Care and a professor at Thomas Jefferson University, who led the study.
The research team analyzed information from 367 participants, including patients and clinicians, at a single healthcare facility within the Jefferson Health network. They began with focus groups and interviews to explore all elements of “digital health readiness.” Next, they crafted initial screening questions based on these findings, refined them using patient feedback, and tested the final screening tool with 304 patients. The completed “Digital Health Readiness Screener” comprises 24 questions that measure two key areas: technical readiness and quality of care concerns. The majority of participants were Black (47%), predominantly male (56%), and half had completed high school or some college. The researchers found that younger individuals and those with higher education levels exhibited better technical readiness, while patients with high health literacy scored higher in overall readiness.
While the initial set of questions represents a positive move towards achieving digital health equity, Dr. Rising emphasizes that further research is essential to validate this screening tool with varied patient groups, including individuals for whom English is not the primary language. Substantial efforts are necessary to develop targeted interventions aimed at the different barriers identified in this screening tool.
“My mission is to ensure that everyone has access to the tools and knowledge required to make informed choices regarding their telehealth usage,” Dr. Rising comments. “Ultimately, the decision will lie with each individual, and some may choose not to engage with telehealth at all.”
“Health systems are keen to tackle digital health equity, yet there has been a notable lack of clear strategies to achieve this,” states co-author and population health researcher, Amy Leader, who also serves as the associate director of the Office of Community Outreach at the Sidney Kimmel Comprehensive Cancer Center — Jefferson Health. “We hope that this screening tool will serve as a practical starting point.”
Beyond creating this screener, Dr. Rising and her team are tackling another barrier to telehealth access for hospitalized patients. The Jefferson Digital Onboarding Taskforce, composed of staff and students, has been assisting hospitalized patients with onboarding and utilizing the patient portal since early 2023. Recently, they expanded their efforts by forming the Jefferson Bedside IT Training group to offer personalized digital literacy training to hospitalized patients. Dr. Rising aims for this initiative to not only enhance patients’ skills but also build their trust in the healthcare system and in telehealth services specifically. This isn’t the first time Dr. Rising and her team have developed a screener; in 2023, she secured a $400,000 grant from the MANNA Institute to improve the Nutrition Support Assessment Tool, aiming to boost patient access to nutritional support and identify nutritional needs.
Dr. Rising’s ultimate vision for the Digital Health Readiness Screener is to create a more concise version for routine use across various healthcare environments. “In an ideal future, we could use this screener as a standard part of healthcare interactions, enabling us to tailor interventions to meet each patient’s individual needs. Addressing access, digital literacy, and trust barriers requires different approaches, and this screener can guide us in effectively implementing those strategies.”
