Digital Facilitation to Support Patient Access to Web-Based Primary Care Services: Scoping Literature Review

• Published in: Journal of medical Internet research 2022-07, Vol.24 (7), p.e33911
• Main Authors: Leach, Brandi, Parkinson, Sarah, Gkousis, Evangelos, Abel, Gary, Atherton, Helen, Campbell, John, Clark, Christopher, Cockcroft, Emma, Marriott, Christine, Pitchforth, Emma, Sussex, Jon
• Format: Article
• Language: English
• Subjects: Coaching; Communication skills; Conceptual development; Consortia; Coronaviruses; Cost analysis; COVID-19; Delivery of Health Care; Grey literature; Health care access; Health disparities; Health promotion; Health services; Humans; Internet; Literature reviews; Medical screening; Motivation; Multimedia; Pandemics; Patients; Primary care; Primary Health Care; Regulation; Retail banking; Review; State Medicine; Systematic review; Systematic Reviews as Topic; Technical skills; Text messaging; Underserved populations; Uptake; Usefulness; Websites
• ISSN: 1438-8871; 1439-4456; 1438-8871
• DOI: 10.2196/33911

The use of web-based services within primary care (PC) in the National Health Service in England is increasing, with medically underserved populations being less likely to engage with web-based services than other patient groups. Digital facilitation-referring to a range of processes, procedures, and personnel that seek to support patients in the uptake and use of web-based services-may be a way of addressing these challenges. However, the models and impact of digital facilitation currently in use are unclear. This study aimed to identify, characterize, and differentiate between different approaches to digital facilitation in PC; establish what is known about the effectiveness of different approaches; and understand the enablers of digital facilitation. Adopting scoping review methodology, we searched academic databases (PubMed, EMBASE, CINAHL, Web of Science, and Cochrane Library) and gray literature published between 2015 and 2020. We conducted snowball searches of reference lists of included articles and articles identified during screening as relevant to digital facilitation, but which did not meet the inclusion criteria because of article type restrictions. Titles and abstracts were independently screened by 2 reviewers. Data from eligible studies were analyzed using a narrative synthesis approach. A total of 85 publications were included. Most (71/85, 84%) were concerned with digital facilitation approaches targeted at patients (promotion of services, training patients to improve their technical skills, or other guidance and support). Further identified approaches targeted PC staff to help patients (eg, improving staff knowledge of web-based services and enhancing their technical or communication skills). Qualitative evidence suggests that some digital facilitation may be effective in promoting the uptake and use of web-based services by patients (eg, recommendation of web-based services by practice staff and coaching). We found little evidence that providing patients with initial assistance in registering for or accessing web-based services leads to increased long-term use. Few studies have addressed the effects of digital facilitation on health care inequalities. Those that addressed this suggested that providing technical training for patients could be effective, at least in part, in reducing inequalities, although not entirely. Factors affecting the success of digital facilitation include perceptions of the usefulness of the web-based service, tr