Hatef Elham, Hudson Scholle Sarah, Buckley Bryan, Weiner Jonathan P, Austin John Matthew
Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, United States.
Center for Population Health Information Technology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States.
JAMIA Open. 2024 Nov 15;7(4):ooae136. doi: 10.1093/jamiaopen/ooae136. eCollection 2024 Dec.
To develop an evidence- and consensus-based Digital Healthcare Equity Framework (the Framework) that guides users in intentionally considering equity in healthcare solutions that involve digital technologies.
We conducted an environmental scan including a scoping review of the literature and key informant interviews with health equity and digital healthcare technology thought leaders and convened a technical expert panel (TEP).
We grouped similar concepts from the scoping review and key informant interviews, synthesized them into several primary domains and subdomains, and presented the composite list of domains and subdomains to the TEP for their input. From those, we derived the following domains for the Framework: (1) Patient and Community Characteristics, (2) Health System Characteristics, and (3) Health Information Technology Characteristics. We structured the Framework around the following 5 phases of the digital healthcare lifecycle: planning, development, acquisition, implementation/maintenance, and monitoring/improvement/equity assessment.
The proposed Framework is designed to specify the aspects that need to be considered in a systematic and intentional approach to ensure digital healthcare solutions improve, and not exacerbate, healthcare inequities.
The proposed Framework serves as a tool to help users and other stakeholders assess whether their healthcare solutions that involve digital technologies are equitable at every phase of the digital healthcare lifecycle.
制定一个基于证据和共识的数字医疗公平框架(该框架),以指导用户在涉及数字技术的医疗解决方案中有意考虑公平性。
我们进行了一次环境扫描,包括对文献的范围审查以及与健康公平和数字医疗技术领域的思想领袖进行关键信息人访谈,并召集了一个技术专家小组(TEP)。
我们将范围审查和关键信息人访谈中的相似概念进行分组,将它们综合成几个主要领域和子领域,并将领域和子领域的综合列表提交给技术专家小组以获取他们的意见。据此,我们得出了该框架的以下领域:(1)患者和社区特征,(2)卫生系统特征,以及(3)健康信息技术特征。我们围绕数字医疗生命周期的以下五个阶段构建了该框架:规划、开发、采购、实施/维护以及监测/改进/公平评估。
拟议的框架旨在明确需要以系统和有意的方式考虑的方面,以确保数字医疗解决方案改善而非加剧医疗不公平现象。
拟议的框架作为一种工具,可帮助用户和其他利益相关者评估他们涉及数字技术的医疗解决方案在数字医疗生命周期的每个阶段是否公平。