Abstract
The chapter discusses the rapid digitisation of healthcare during the COVID-19 global crisis and its implications for healthcare quality from patient, clinician, and provider perspectives. Using the example of patient portals, online interfaces that provide patients with real-time access to their health records, the chapter explores how this large-scale shift to digital healthcare has influenced key elements of healthcare quality. These elements include the safety, timeliness, effectiveness, efficiency, equity, eco-friendliness, and person-centeredness of care delivery, as well as patient and staff well-being. The discussion addresses health anxiety exacerbated by remote service delivery and potential associations with cyberchondria and online search behaviours. Additionally, concerns about digital health literacy, equality of access, patient data privacy, and cybersecurity are discussed in the context of increasing health system shocks. Recommendations are made about how the future adaptation of digital healthcare can support healthcare quality in a post-pandemic era.
TopBackground
The provision of healthcare quality is a key goal of healthcare systems worldwide. Quality healthcare systems aim to provide services and service outcomes that are without deficiencies or wide variations, conform to agreed standards and meet the defined needs and expectations of those who use the service (National Economic and Social Council, 2011). Since the turn of the century, the objective of quality healthcare has been understood as increasing the likelihood of health outcomes consistent with current professional knowledge (Institute of Medicine Committee on Quality of Health Care in America, 2001). Yet, the notion of quality in healthcare is continuously evolving in tandem with developments in knowledge and societal expectations (Health Foundation, 2021). In 2018, the Lancet Global Health Commission on High Quality Health Systems asserted these systems should be efficient and resilient, and consistently provide for better health and its equitable distribution (Kruk et al., 2018). Reflecting these developments, quality in healthcare has recently been conceptualized as progressing through three overlapping phases:
- 1.
The establishment of standards for a care area (Quality 1.0).
- 2.
The improvement of disease management (Quality 2.0).
- 3.
The enhancement of the value of the health service to health (Quality 3.0) (Lachman et al., 2020).
Key Terms in this Chapter
Healthcare Quality: Healthcare systems aim to provide healthcare services that at least meet or exceed the standards expected by stakeholders: regulatory and accreditation bodies, healthcare payers, patients, and families. Healthcare quality is a multi-dimensional term and is achieved when patients receive safe, timely, effective, and person-centred care. Further, healthcare quality is achieved when resources are not wasted and are fairly distributed among diverse population cohorts.
Digital Health Literacy: Digital health literacy refers to an individual’s knowledge and skills in accessing, understanding, and applying digital health information to their decision-making processes to better their health.
Patient Portal: A patient portal is an online interface that enables patients on demand real-time access to their personal electronic health records. Key features of patient portals include access to diagnostic test results and medical notes. Further, patient portals enable healthcare service users to communicate with their healthcare provider online which is helpful for enhancing patient understanding of their health records and for patient ability to schedule their healthcare. The expected benefit of patient portals is the empowerment of individuals to take control of and manage their health.
Cyberchondria: Cyberchondria refers to health anxiety exacerbated by repeated online search behaviour of health complaints and concerns.
Health System Resilience: Healthcare systems are subject to unexpected events or shocks that will require them to immediately change their way of delivering services in order to continue to function. Examples include pandemics, cyber-attacks, and extreme weather events. Health system resilience is the ability of a healthcare system to quickly manage and learn from these shocks and to create a transformed service, better prepared to meet the demands of the future.
Digital Health: Digital health is a broad term referring to numerous technology-mediated forms of healthcare delivery including e-health, telemedicine, big data analytics and artificial intelligence for example. Use of information technology as part of digital health is expected to improve key elements of health care quality, such as the timeliness, accessibility, and sustainability of healthcare.