Development of an evidence- and consensus-based Digital Healthcare Equity Framework

Abstract

Objective: 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. Materials and Methods: 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). Results: 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. Discussion: 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. Conclusion: 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.