Garvin LA, Simon SR. (2017). Prioritizing measures of digital patient engagement: A Delphi expert panel study. Journal of Medical Internet Research. 19(5): e182. doi: 10.2196/jmir.4778
Researchers conducted a three-part study to develop assessment items for measuring patient engagement with the Veterans Affairs’ digital health portal (MyHealtheVet). Specifically, researchers focused on measuring patients’ engagement with the areas of the portal that allow patients to download portions of their health record (i.e. the Blue Button) and email their health care team (i.e. Secure Messaging). First, researchers conducted a literature review of frameworks and measures of patients’ health and health care, use of technology and digital health, and relationships with health care providers and the health system. Researchers then developed a framework that listed antecedents or structures that contribute to processes that result in patient engagement and use as outcomes. Researchers interviewed primary investigators for studies of MyHealtheVet to identify how they measured adoption and use. Finally, researchers developed lists of statements that a user would rate based on how accurate they are to their experience (e.g. I have all the information I need to manage my health and health care) as candidate items. A Delphi expert panel of twelve digital health experts rated the importance candidate items on a scale from -5 to +5 over three rounds. Accepted items had to have a median rating of at least three, an interquartile range of no more than two, and no more than one outlier. Ultimately, researchers accepted 58 items for Secure Messaging and 71 items for the Blue Button. Items mapped to researchers’ framework of antecedents (20 items), processes (77 items), and outcomes (6 items).