Towards a Minimum Information Set Needed to Define Patient-Facing Digital Health Technology for Outcomes Research

OBJECTIVES: Umbrella terms for Digital Health Technology (DHT) (digital health, eHealth, mHealth, telehealth/telemedicine) are insufficiently defined for health economics and outcomes research (HEOR). Definitions of secondary terms for DHTs lack information about PICOTS (population, intervention, comparator, outcome, timing, and setting) and health system or technology frameworks. We aim to develop a minimum information set to define patient-facing DHTs for HEOR purposes.

METHODS: A scoping review (PubMed, EMBASE, Cochrane Library, EconLit; 2015-2020) identified systematic reviews containing DHT definitions. Qualitative content analysis (QCA) of secondary DHT definitions was performed using variables from PICOTS, Shannon-Weaver information model, Agency for Healthcare Research and Quality (AHRQ) quality domains, World Health Organization DHT classifications and information on technology and geography. From the QCA, a two-level framework for definitions including domains and subcategories was proposed. To generate feedback on the proposed items' impact on the value of DHTs, a two-round, modified Delphi survey has been initiated. ISPOR members with DHT expertise have been recruited to volunteer for an online Delphi survey to develop a consensus on a minimum information set for patient-facing DHT definitions.

RESULTS: Sixty-eight unique secondary DHTs were found in 77 papers; 84% had a single definition. Most frequent definitions were for telerehabilitation (11), electronic health record (6), electronic consultation (5), and telemonitoring (5). Among 24 QCA variables, only four (intervention, message, technology, and system) contained information in >50% of definitions. For the Delphi survey round 1, PICOTS and three technology-related domains and 28 subcategories were proposed; feedback from eighteen round 1 respondents, representing a diverse, balanced Delphi panel, is being used to complete the survey.

CONCLUSIONS: Definitions of DHTs contain insufficient information for HEOR use. We propose that by extending the PICOTS framework, both medical and technological aspects should be specified. By involving ISPOR members, a minimum information set is under development to initiate discussion with other stakeholders.