Khanbhai Mustafa, Flott Kelsey, Darzi Ara, Mayer Erik
Centre for Health Policy, Imperial College London, London, United Kingdom.
J Med Internet Res. 2019 Jan 14;21(1):e9076. doi: 10.2196/jmir.9076.
One of the essential elements of a strategic approach to improving patients' experience is to measure and report on patients' experiences in real time. Real-time feedback (RTF) is increasingly being collected using digital technology; however, there are several factors that may influence the success of the digital system.
The aim of this review was to evaluate the digital maturity and patient acceptability of real-time patient experience feedback systems.
We systematically searched the following databases to identify papers that used digital systems to collect RTF: The Cochrane Library, Global Health, Health Management Information Consortium, Medical Literature Analysis and Retrieval System Online, EMBASE, PsycINFO, Web of Science, and CINAHL. In addition, Google Scholar and gray literature were utilized. Studies were assessed on their digital maturity using a Digital Maturity Framework on the basis of the following 4 domains: capacity/resource, usage, interoperability, and impact. A total score of 4 indicated the highest level of digital maturity.
RTF was collected primarily using touchscreens, tablets, and Web-based platforms. Implementation of digital systems showed acceptable response rates and generally positive views from patients and staff. Patient demographics according to RTF responses varied. An overrepresentation existed in females with a white predominance and in patients aged ≥65 years. Of 13 eligible studies, none had digital systems that were deemed to be of the highest level of maturity. Three studies received a score of 3, 2, and 1, respectively. Four studies scored 0 points. While 7 studies demonstrated capacity/resource, 8 demonstrated impact. None of the studies demonstrated interoperability in their digital systems.
Patients and staff alike are willing to engage in RTF delivered using digital technology, thereby disrupting previous paper-based feedback. However, a lack of emphasis on digital maturity may lead to ineffective RTF, thwarting improvement efforts. Therefore, given the potential benefits of RTF, health care services should ensure that their digital systems deliver across the digital maturity continuum.
改善患者体验的战略方法的关键要素之一是实时衡量和报告患者体验。目前越来越多地使用数字技术来收集实时反馈（RTF）；然而，有几个因素可能会影响数字系统的成功。
本综述的目的是评估实时患者体验反馈系统的数字成熟度和患者接受度。
我们系统地检索了以下数据库，以识别使用数字系统收集RTF的论文：考克兰图书馆、全球卫生、卫生管理信息联盟、医学文献分析与检索系统在线、EMBASE、心理学文摘数据库、科学引文索引和护理学与健康领域数据库。此外，还利用了谷歌学术和灰色文献。根据数字成熟度框架，基于以下4个领域对研究的数字成熟度进行评估：能力/资源、使用情况、互操作性和影响。总分4分表示数字成熟度最高水平。
主要使用触摸屏、平板电脑和基于网络的平台来收集RTF。数字系统的实施显示出可接受的回复率，患者和工作人员总体上持积极看法。根据RTF回复得出的患者人口统计学特征各不相同。女性、以白人为主以及年龄≥65岁的患者占比过高。在13项符合条件的研究中，没有一个数字系统被认为达到最高成熟度水平。三项研究的得分分别为3分、2分和1分。四项研究得0分。7项研究展示了能力/资源，8项研究展示了影响。没有一项研究在其数字系统中展示出互操作性。
患者和工作人员都愿意参与通过数字技术提供的RTF，从而打破了以往基于纸质的反馈方式。然而，对数字成熟度缺乏重视可能导致RTF无效，阻碍改进工作。因此，鉴于RTF的潜在益处，医疗服务机构应确保其数字系统在数字成熟度连续体上都能发挥作用。
