Patients’ digital health needs and the potential impact of a digital health navigator on the oncology care team: Provider and patient perspectives.

Abstract

e13712 Background: Patient use of digital health tools (e.g., patient portals) is associated with improved patient retention, engagement, satisfaction, medication and treatment adherence, and quality of patient-provider communication. However, even with access to digital tools, some patients may lack the digital literacy to effectively use digital tools for their care needs. To address the barrier of low patient digital literacy, we are evaluating the introduction of a Digital Health Navigator (DHN) into our oncology care teams. The DHN will integrate digital needs assessment and digital support and skills training into the role of patient navigators. As a primary step, we sought to build an evidence base on which to design and implement a DHN by conducting digital needs assessments with oncology providers and patients with cancer. Methods: We conducted semi-structured interviews with patients and oncology providers (e.g., physicians, patient navigators) caring for patients at an NCI-designated Comprehensive Cancer Center. Participants completed a brief demographic survey and allowed their interviews to be audio recorded. We asked providers about the following: patient use of (1) digital tools, (2) patient portals, (3) telehealth, and (4) smartphone healthcare applications; and (5) patients’ need for a DHN. We asked patients about what they needed to use (1) patient portals, (2) telehealth, and (3) smartphone healthcare applications, and (4) how a DHN could improve their personal digital health access. Recordings were transcribed verbatim. Deductive-dominant thematic analysis was used, guided by interview questions, to analyze data and derive emergent themes. Results: Twelve providers and 10 patients participated. Key themes identified in provider interviews included: 1) technology they encourage patients to use (e.g., portals, telehealth, email), 2) benefits of digital tools (e.g., improved access, communication, adherence), 3) barriers to using digital tools (e.g., limited internet and device access, limited skills), and 4) potential benefits of a DHN (e.g., assistance with access to internet and devices; improved technology skills). Key themes identified in patient interviews included: 1) devices used by patients (e.g., smart phone, computer, tablet), 2) benefits of digital tools (e.g., improved access and communication, reminders), 3) barriers to using digital tools (e.g., login issues/forgetting passwords, providers not discussing tools, technology mistrust), and 4) potential benefits of a DHN (e.g., troubleshooting login/password issues, improved use of the patient’s own device(s)). Conclusions: Future steps in this work include translating these data using a patient-centered care model and community perspectives to design the DHN role, integrating the DHN into our oncology care teams, and evaluating process and patient outcomes.