Abstract
BackgroundOne of the promises of digital health is to better engage patients and improve care for vulnerable populations. Patients with drug use disorders are a vulnerable population who often do not receive the care they need, both for their drug use disorders as well as their other health care needs. Appropriate primary care for patients with drug use disorders needs to be patient-centered, holistic, highly accessible, and engaging. The electronic Case-finding and Help Assessment Tool (eCHAT) was designed as a patient-centered tool for the identification and measurement of problematic health behaviors and mood states.ObjectiveThe aim of this study was to explore the patient experience of eCHAT at an Australian family medicine clinic for patients with drug use disorders.MethodsA total of 12 semistructured interviews were conducted with patients, two interviews were conducted with doctors, and one focus group was conducted with patient advocates who were former patients of the clinic where the study took place. The transcripts were analyzed using inductive thematic analysis.ResultsThe key themes identified from the interviews and the focus group were as follows: (1) eCHAT helped reduce stigma related to drug use in the doctor-patient consultation, (2) restricted answer options impacted the ability of patients to tell their stories, (3) patient-related response factors, (4) increased efficiency in the consultation process, and (5) divergence in level of concern around security and privacy.ConclusionseCHAT has the potential to help vulnerable patients in primary care to engage more with their doctors and reduce experiences of stigma. eCHAT may be a useful digital health intervention in a family medicine clinic for patients with drug use disorders. It has the potential to improve patient engagement and access to health care, which are crucial areas of need in this vulnerable population. However, it is important to clearly communicate the privacy risk of digital health tools and to implement eCHAT such that it will add value to, rather than displace, in-person consultations with the family doctor.
Highlights
The Promise of eHealthThe expanding presence of digital health and eHealth is driven by its potential to improve health care outcomes [1]. eHealth refers to the use of internet-based technology for health care and can be used by systems, providers, and/or patients [2]. eHealth is one component of the wider concept of digital health, which is the use of information and communication technology to improve patient well-being and health [3]
The key themes identified from the interviews and the focus group were as follows: (1) electronic Case-finding and Help Assessment Tool (eCHAT) helped reduce stigma related to drug use in the doctor-patient consultation, (2) restricted answer options impacted the ability of patients to tell their stories, (3) patient-related response factors, (4) increased efficiency in the consultation process, and (5) divergence in level of concern around security and privacy
Conclusions: eCHAT has the potential to help vulnerable patients in primary care to engage more with their doctors and reduce experiences of stigma. eCHAT may be a useful digital health intervention in a family medicine clinic for patients with drug use disorders
Summary
The Promise of eHealthThe expanding presence of digital health and eHealth is driven by its potential to improve health care outcomes [1]. eHealth refers to the use of internet-based technology for health care and can be used by systems, providers, and/or patients [2]. eHealth is one component of the wider concept of digital health, which is the use of information and communication technology to improve patient well-being and health [3]. EHealth has the potential to increase health care access and better engage diverse groups of patients [4]. If eHealth can improve access for vulnerable patients, one key anticipated outcome of increasing eHealth use should be an improvement in health care equity [4]. The Health Care Needs of Patients With Drug Use Disorders. One example of a vulnerable population affected by health care inequity is people with drug use disorders. They often do not receive adequate treatment support and are more likely to have disability and reduced social and emotional functioning [5,6]. One of the promises of digital health is to better engage patients and improve care for vulnerable populations. The electronic Case-finding and Help Assessment Tool (eCHAT) was designed as a patient-centered tool for the identification and measurement of problematic health behaviors and mood states
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