Deaf people’s experience of the digital transformation of UK healthcare services: a qualitative study using semi-structured interviews

BACKGROUND: Healthcare services are being transformed with the rapid adoption of digital technology, particularly since the COVID-19 pandemic. However, concerns have been expressed around digital exclusion of potentially vulnerable groups such as those experiencing mental health conditions and/or sensory impairment. This study sought to explore deaf people’s experiences of the digital transformation of UK healthcare services and identify opportunities for future service improvement. METHOD: A qualitative study using a social constructionist approach was conducted with data collected using semi-structured interviews. Deaf participants were recruited using purposeful sampling and drawing on existing professional and community networks. Recruitment information was available in British Sign Language (BSL) and plain English formats. Interviews were video recorded, then data transcribed from sign/spoken language to text, with non-verbal and contextual data from signing and social interactions also captured using notations. Video and textual data were analysed in parallel using reflexive thematic analysis informed by the social model of disability and a published framework for evaluating the success of health technologies. Overarching themes across participants’ accounts were identified. RESULTS: Eleven deaf people participated in the interviews. Ten participants were BSL users; one participant was non-signing and communicated in speech during the interview. Four themes were identified: (1) lack of consideration for deaf individuals’ communication preferences in digital healthcare; (2) social connections facilitate meaningful digital health inclusion; (3) problems with digital systems - flexibility, interoperability and psychological safety; and (4) models of care should optimise deaf people’s independence and accessibility. A study limitation is that data collection and analysis were completed by one researcher. CONCLUSIONS: The findings suggest digital health technology can risk exacerbating health inequalities faced by deaf people. Opportunities for early engagement and involvement of deaf people in designing developing, implementing and evaluating digital health technologies is crucial to ensuring acceptability and services tailored to the cultural, communication, language and literacy needs of deaf communities.