Patients’ perceived needs and critical issues in the use of digital health: a qualitative study

Background

Digital health represents a strategic transformation that can improve continuity of care and equity. However, uptake may be hindered by technical, organizational and cultural barriers, particularly for people who are more vulnerable or less digitally equipped. Patients’ perceptions regarding the use of digital health were analyzed to inform the development of more accessible, usable and equitable digital health tools.

Methods

Participants were trained through the Patients Academy initiative in Friuli-Venezia Giulia (Italy) via in-person and online meetings. After obtaining informed consent, two 90-minute focus groups (groupA=7; groupB=9) were conducted using semi-structured interviews in November 2024, with audio recording. Data were transcribed verbatim and analyzed using Qualitative Content Analysis. Descriptive analyses of keywords and semantic macro-areas, as well as automated analyses of sentiment (FEEL-IT in Italian; RoBERTa on translated sentences) and emotions, were performed.

Results

Sixteen participants took part (56% female), mean age 59.9years (range 26-81), with limited previous training experience in digital health (19%). Four main themes emerged: 1) health-related needs, with a strong request to preserve the relationship and adopt a hybrid digital/in-person model; 2) technical needs (simplicity/usability, clear communication, privacy/security and interoperability); 3) difficulties, described as fragmented pathways, “digital fatigue” and “digital loneliness”; 4) gaps including training, resources, inclusion of vulnerable groups, privacy and accessibility. Sentiment was more often negative (FEEL-IT;55%) or neutral (RoBERTa;61%).

Conclusions

Participants recognized the potential of digital health, but requested simpler pathways, genuine support, ongoing training and more integrated/interoperable systems. Digitalization appeared to be more accepted when perceived as to strengthening rather than replacing human care.

Key messages

• The engagement of patients in the design and development process for digital health tools is essential to consider the users’ perspective.

• The implementation of digital health tools should not override the humanization of processes and person-to-person contact, which are integral to care.