The role of digital innovation in improving healthcare quality in extreme adversity: an interpretative phenomenological analysis study

Background: High quality is a necessary feature of healthcare delivery. These healthcare quality challenges are particularly present in areas of extreme adversity, such as in conflict settings or sustained humanitarian crises. Digital health technologies have recently emerged as an innovation to deliver care around the world in a variety of settings. However, there is little insight into how digital health technologies can be used to improve the quality of care where extreme adversity introduces unique challenges. Objective: This study aimed to identify where digital health technologies may be most impactful in improving the quality of care and evaluate opportunities for accelerated and meaningful digital innovation in adverse settings. Methods: A phenomenological approach (Interpretative Phenomenological Approach [IPA]), using semi-structured interviews, was adopted. Six individuals were interviewed in-person based on their expertise in global health, international care delivery, and application of digital health technologies to improve the quality of care in extreme adversity settings. The interviews were informed by a semi-structured topic guide with open-ended questions. The transcripts were compiled verbatim and were systematically examined by 2 reviewers, using the framework analysis method to extract themes and subthemes. Results: The participants identified several areas in which digital health technologies could be most impactful, which include engagement in care, continuity of care, workforce operations, and data collection. Opportunities for accelerated digital innovation include improving terminology, identity, ownership, and interoperability, identifying priority areas for digital innovation, developing tailored solutions, co-ordination and standardisation, and sustainability and resilience. Conclusions: These results suggest that there are conditions that favour or challenge the application of digital health technologies, even in specific areas in which they could be useful. A better understanding ...