Background The adoption and use of technology have significantly changed health care delivery. Patient experience has become a significant factor in the entire spectrum of patient-centered health care delivery. Digital health facilitates further improvement and empowerment of patient experiences. Therefore, the design of digital health is served by insights into the barriers to and facilitators of digital patient experience (PEx). Objective This study aimed to systematically review the influencing factors and design considerations of PEx in digital health from the literature and generate design guidelines for further improvement of PEx in digital health. Methods We performed an umbrella systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. We searched Scopus, PubMed, and Web of Science databases. Two rounds of small random sampling (20%) were independently reviewed by 2 reviewers who evaluated the eligibility of the articles against the selection criteria. Two-round interrater reliability was assessed using the Fleiss-Cohen coefficient (k1=0.88 and k2=0.80). Thematic analysis was applied to analyze the extracted data based on a small set of a priori categories. Results The search yielded 173 records, of which 45 (26%) were selected for data analysis. Findings and conclusions showed a great diversity; most studies presented a set of themes (19/45, 42%) or descriptive information only (16/45, 36%). The digital PEx–related influencing factors were classified into 9 categories: patient capability, patient opportunity, patient motivation, intervention technology, intervention functionality, intervention interaction design, organizational environment, physical environment, and social environment. These can have three types of impacts: positive, negative, or double edged. We captured 4 design constructs (personalization, information, navigation, and visualization) and 3 design methods (human-centered or user-centered design, co-design or participatory design, and inclusive design) as design considerations. Conclusions We propose the following definition for digital PEx: “Digital patient experience is the sum of all interactions affected by a patient’s behavioral determinants, framed by digital technologies, and shaped by organizational culture, that influence patient perceptions across the continuum of care channeling digital health.” In this study, we constructed a design and evaluation framework that contains 4 phases—define design, define evaluation, design ideation, and design evaluation—and 9 design guidelines to help digital health designers and developers address digital PEx throughout the entire design process. Finally, our review suggests 6 directions for future digital PEx–related research.

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Since Covid-19, digital health interventions (DHIs) have been embraced as never before. The pandemic led to many new challenges, including the patient experience in digital health care delivery. In this literature study, we identified and synthesized factors that impact patient experience in digital health (dPEx), and reviewed the methods and strategies relevant to its design and implementation. We conducted an umbrella review including 15 reviews representing 543 studies. Four themes were identified that describe design-relevant factors that impact dPEx: individual context, content, technical issues, and design features. We propose a preliminary framework to explain the relationship between each factor and support user-centered design efforts. Further research is needed to identify which factors have the most impact.

BACKGROUND Despite the growing number of digital health (DH) applications, timely, cost-effective, and robust evaluations have not kept pace. Patient experience (PEx) was reported as one of the challenges facing the health system by the World Health Organization (WHO) in its 2018 classification of digital health initiatives report. To generate evidence of DH and promote the appropriate integration and use of technologies, standard evaluation of PEx in DH is needed. OBJECTIVE In this study, we systematically reviewed the literature on PEx evaluation timing considerations, evaluation indicators, and evaluation approaches in DH and generated an evaluation guide for further measurement of PEx in DH. METHODS We performed an umbrella systematic review following PRISMA, searching Scopus, PubMed, and Web of Science databases. Two rounds of small random sampling (20%) were independently reviewed by two reviewers who evaluated the eligibility of the articles against the selection criteria. Two-round interrater reliability was assessed using the Fleiss-Cohen coefficient (k1=0.88 and k2=0.80). Thematic analysis was then applied to analyze the extracted data based on a set of a priori categories. RESULTS The search yielded 173 records, of which 45 (26%) were eligible for analysis. Our review highlights five typical evaluation objectives which serve five stakeholder groups separately. We identified three evaluation timing considerations and classified them into three categories: intervention maturity stages, timing of the evaluation, and timing of data collection. Information on evaluation indicators of the digital PEx was identified and summarized into 3 categories (intervention outputs, patient outcomes, and healthcare system impact), 9 themes, and 22 subthemes. A set of evaluation theories, common study designs, data collection methods and instruments, and data analysis approaches were captured which can be used or adapted to evaluate the digital PEx. CONCLUSIONS Our findings enabled us to generate an evaluation guide to help digital health interventions (DHI) researchers, designers, developers, and program evaluators to evaluate the digital PEx. Finally, we propose six directions for encouraging further digital PEx evaluation research and practice to address the poor PEx challenge.