Enabling digital compassion in digital health environments: A modified eDelphi study to identify interprofessional competencies and technology attributes (Preprint)
Authors: Wiljer David , Charow Rebecca , Zhang Melody , Lo Brian , Sequeira Lydia , Shen Nelson , Sockalingam Sanjeev , Rossos Peter , Crawford Allison , Strudwick Gillian 
Published: September 2024

BACKGROUND

Healthcare continues to advance digital innovation, and technology-enabled processes and interventions are increasingly introduced to deliver and expand access to care. In this evolving digital health ecosystem, healthcare professionals, learners and organizations may not be prepared or equipped with the knowledge, skills, and behaviours required to navigate these new digital tools while simultaneously sustaining and integrating compassionate care. Moreover, the tools, themselves, may not be designed and implemented in a manner that facilitates digital compassion.

OBJECTIVE

The purpose of this study is to identify: 1) core digital compassion competencies for health professionals; and 2) digital compassion health information technology attributes.

METHODS

This study was based on the Delphi method, a consensus building technique using structured group communication that allow a group of experts to identify competencies and agree on items like standards and attributes by achieving consensus on a given topic. To encourage enriched discussions, a modified Delphi method was used, where the first round consisted of a group activity and focus group as opposed to a questionnaire. Due to COVID-19 restrictions, the first round was held online. Subsequent rounds consisted of online questionnaires administered by email and web-based survey. Using purposive sampling, participants were recruited from project partners and networks of the research team. A panel of experts across Canada, in the fields of compassion, health professional/medical education and technology, were engaged to identify and prioritize professional domains and competency statements, as well as essential attributes for the development and deployment of digital technologies for compassionate care.

RESULTS

Fifty-four experts across Canada were recruited, representing diverse professions including patients/service-users, health care professionals, administrators, policy makers, health educators, data scientists, health technology designers, and software engineers. Nine focus groups were conducted and were analyzed thematically. Seven domains of digital compassion were identified: 1) Digital Literacy, (2) Patient Preference, (3) Collaboration & Co-Design, (4) Therapeutic Relationship, (5) Ethical Implications, (6) Patient Safety, and (7) Technology Safety. Technology attributes to facilitate digital compassion were also generated. Through 4 subsequent rounds, consensus was reached producing 58 digital compassion competency statements, and 15 technology attributes.

CONCLUSIONS

This study identified a digital compassion framework consisting of competencies for healthcare professionals and attributes for digital technologies that would enhance compassion in virtual care encounters. To promote a cultural shift where technologies are perceived to not only be efficient, but also compassionate, practices of co-design, training, and ongoing evaluation and iteration must be prioritized within healthcare organizations. Future research should explore the adaptability of the professional competencies and technology attributes to specific medical specialties or within patient populations.