背景:在英国,利用数字技术来改变提供健康和社会护理的方式,并涵盖用于医疗保健各个方面的各种硬件设备和软件。然而,对卫生保健提供者在数字卫生技术能力方面的差异以及这与卫生保健能力和资源的地理和区域差异之间的关系知之甚少。
目的:本文旨在确定英国国家卫生服务临床调试小组(NHSCCG)已部署的一组数字技术。在这样做的时候,我们响应呼吁,阐明英国在卫生服务区域差异和卫生多样性方面的数字能力的内部动态和变化,股本,和包容。
方法:我们收集了135份年度报告,这些报告属于英格兰106份NHSCCG,总共超过18,000页,从2020年到2021年发布。使用此数据集,我们确定了2163个与数字技术相关的页面,并使用内容分析对其进行了标记。我们遵循数字期权理论使用的结构分类法,来自管理信息系统领域的理论,分析组织资源投资选择,根据数字主题对观察到的技术进行分类-我们识别和解释的固有设计模式。然后,我们使用分层聚类方法来提取实施类似技术主题的NHSCCG组。
结果:我们从报告中发现了31种技术,并将它们分为9个数字主题。这9个主题被进一步分配给数字期权理论的3个结构中的1个,患者需求的识别(我们识别了信息门户[76/106],数字健康参与[67/106],和数字包容支持[45/106]),新工作模式的发展(我们确定了远程医疗[87/106],远程医疗[35/106],和养老院技术[40/106]),实现效率和公众可访问性的提高(我们确定了在线预订[26/106],在线分诊[104/106],和数字精神卫生服务[74/106])。根据8个主题(霍普金斯=0.9914,轮廓=0.186)确定了3个CCG簇,即(1)数字断开,(2)数字参与,和(3)数字火炬手。
结论:我们的发现显示了每个构建组中突出的数字主题,即信息门户,远程医疗,和在线分诊,覆盖人们的基本健康信息需求。几乎一半的CCG属于数字分离组,和所有伦敦CCG(5/106)属于这个组。我们建议从业者应该向数字参与度有限的地区提供专门的帮助。强调数字健康素养,包容支持,和正在进行的评估,而不是只专注于技术进步。
BACKGROUND: In England, digital technologies are exploited to transform the way health and social care is provided and encompass a wide range of hardware devices and software that are used in all aspects of health care. However, little is known about the extent to which health care providers differ in digital health technology capabilities and how this relates to geographical and regional differences in health care capacities and resources.
OBJECTIVE: This paper aims to identify the set of digital technologies that have been deployed by the National Health Services clinical commissioning groups (NHS CCGs) in England. In doing this, we respond to calls to shed light on the internal dynamics and variation in the form of digital capability in England in terms of health service regional differences and health diversity, equity, and inclusion.
METHODS: We collected 135 annual reports that belong to 106 NHS CCGs in England, comprising more than 18,000 pages in total, released from 2020 to 2021. Using this data set, we identified 2163 pages related to digital technologies and labeled them using content analysis. We follow the construct taxonomy used by digital options theory, a theory from the management information systems field analyzing organizational resource investment choices, in classifying observed technologies according to digital themes-inherent design patterns that we identified and explained. We then used a hierarchical clustering method to extract groups of NHS CCGs that implement similar technology themes.
RESULTS: We found 31 technologies from the reports and grouped them into 9 digital themes. The 9 themes were further assigned to 1 of the 3 constructs of digital options theory, the identification of patients\' requirements (we identified information portals [76/106], digital health engagement [67/106], and digital inclusion support [45/106]), the development of new work patterns (we identified telehealth [87/106], telemedicine [35/106], and care home technologies [40/106]), the realization of improvements in efficiency and public accessibility (we identified online booking [26/106], online triage [104/106], and digital mental health services [74/106]). The 3 clusters of CCGs are identified based on the 8 themes (Hopkins=0.9914, silhouette=0.186), namely (1) digitally disengaged, (2) digitally engaged, and (3) digital torchbearer.
CONCLUSIONS: Our findings show prominent digital themes within each construct group, namely information portals, telehealth, and online triage, covering people\'s fundamental health information needs. Almost half of CCGs fell into the digitally disengaged group, and all London CCGs (5/106) belonged to this group. We propose that practitioners should offer specialized assistance to regions with limited digital engagement, emphasizing digital health literacy, inclusion support, and ongoing evaluation, rather than concentrating solely on technical advancements.