Hatef E, Hudson Scholle S, Buckley B, Weiner JP, Austin JM. Development of an evidence- and consensus-based Digital Healthcare Equity Framework. JAMIA Open. 2024;7(4):ooae136. doi:10.1093/jamiaopen/ooae136
This article details the development of a digital healthcare equity framework. The framework was designed to provide users with a guide for intentionally considering equity throughout the development and implementation of digital healthcare solutions. This framework would be ideal for each phase of the digital healthcare lifecycle. The framework was informed by an environmental scan consisting of a scoping literature review, key informant interviews, and a technical expert review panel review and survey. The scoping review (n=124) revealed failings in all of the currently existing proposed frameworks for equity in digital healthcare (n=2). The scoping review and key informant interviews informed the domains and subdomains of the digital healthcare equity framework. The three domains were: patient and community characteristics, health system characteristics, and health information technology characteristics. The subdomains included: sociodemographic characteristics, cultural characteristics and beliefs, digital determinants of health, social determinants, social risks, and social needs, access to care, care quality, digital healthcare technical design, and characteristics of data. The expert panel agreed with the domains and subdomains and the rationale for developing a new framework. The framework allows for equity to be considered at different points in the lifecycle and adjusts as stakeholders enter and exit at various stages as well. The proposed digital healthcare equity framework is an evidence and consensus-based tool that can help developers, vendors, health systems, providers, and other stakeholders critically consider equity at each stage of the digital health intervention lifecycle.