Reframing Equity: A Multi-Perspective Analysis of Telehealth Screening Tools Through the Lens of Patients and Clinicians

Abstract

Background: Telehealth usage increased dramatically during the COVID-19 pandemic, but equitable access remains a concern. Patients lacking technology access, skills, and digital literacy may not benefit fully. Validated telehealth literacy screening instruments are lacking. This study evaluated existing tools from patient and clinician perspectives. Methods: Five telehealth literacy screening tools were identified through a literature review: 1) Digital Literacy Self-Assessment Tool (DLSA), 2) Electronic Health Literacy Scale (eHEALS), 3) Digital Health Literacy Scale (DHCLS), 4) Telehealth Literacy Screening Tool (TLST), and 5) University of Alabama-Birmingham Technology Comfort Survey (TCS). Patients (n=44) and clinicians (n=24) completed an online survey rating each tool across domains of 1) User experience, 2) Engagement, 3) Relevance, and 4) Health literacy. Results: Clinicians overall had greater technology comfort and more digital healthcare usage than patients. Patients ranked TCS highest overall, while clinicians preferred DHCLS. TLST performed well for both groups. All participants ranked eHEALS lowest. Patients valued simplicity and clarity while clinicians favored brevity and clinical focus. Conclusion: Perspectives differed between patients and clinicians regarding optimal telehealth literacy screening tools. Screening instruments should align with key engagement drivers: access, competency, digital literacy, relevancy, trust, and preferences. Tailored tools co-designed with patients and clinicians can promote equitable telehealth adoption and engagement.