How is digital health suitability measured for communities? A systematic review

Abstract

Background Digital health services continue growing in usage and popularity, with patients and healthcare organizations benefiting from their use. Despite this, no mechanism exists to measure a patient's and community's suitability to leverage these services. Objective This systematic review aims to evaluate the extent and nature of measuring the overall suitability of individuals and communities within the digital health landscape. Methods Database searches in February 2024 across PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, and IEEE Xplore yielded 1044 unique references. Two screening stages resulted in 10 articles that met all evaluation criteria for review inclusion. Results This systematic review found a gap in the ability to holistically assess a patient's and community's suitability to access digital health services. Myriad indices and tools identify isolated factors contributing to digital health accessibility (e.g., broadband availability); however, no comprehensive mechanism adequately informs providers, policymakers, and researchers. Conclusion A comprehensive index that accurately reflects suitability for digital health services is needed. Index factors should include a combination of indicators related to socioeconomic status, digital accessibility, such as device and internet access, and social determinants of health. Together, these form the predominant driving factors related to one's ability to participate in digital health services.