Unlocking Digital Equity: Insights from Key Stakeholders' Experiences

Abstract

BackgroundHealth inequalities persist despite substantial efforts to reduce them within public healthcare systems. Digital health technologies raise new equity concerns and stakeholders play a key role in this transformation. However, their experience and perceptions of digital health equity remain unexplored, and a deeper understanding of these dynamics and insights is necessary to effectively promote digital health equity.ObjectiveThe study aims to explore how different stakeholders understand and perceive digital health equity and identify the factors that enable or hinder its achievement. Based on key findings it suggests strategies to guide interventions and enhance digital health equity.MethodsThis study uses a qualitative exploratory methodology, collecting data through individual semi-structured interviews with 33 key informants involved in digital healthcare transformation or working with vulnerable subgroups at risk of digital exclusion. Rigorous methods were applied to ensure data saturation, systematic coding using NVivo-12 Plus software and thematic analysis.  Results While stakeholders share a heightened awareness and concerns about digital equity challenges, perceptions of equity and vulnerability vary. Difficulties in translating equity into actionable strategies are identified. Barriers include policy and regulation choices, framing digital health as market opportunities, power concentration and the historical exclusion of marginalized groups along with inconsistent support strategies for users, lack of equity assessments and limited patient involvement. Enablers of digital equity address disparities in access, adoption, adherence and effectiveness of digital health. These include multilevel, interdisciplinary collaboration, building digital literacy, user engagement, developing equity guidelines, and adopting hybrid solutions. The findings, which often operate at multiple levels.ConclusionThis study offers insights into stakeholders’ experiences and perceptions of digital health equity. Results underscore the complex, interconnected nature of digital equity enablers and emphasize the need to integrate the different perspectives into new approaches and strategies to reinforce equitable digital transformation of healthcare organizations and systems.

Keywords: Digital HealthEquityHealthcare actorsHealthcare systemQualitative methodsHealthcare organizations