CARE-HOUSE: Developing a framework for conceptualizing social implications of digital health technologies in palliative care

Background The use of digital health technologies holds potential benefits for palliative care. Their implementation is fundamentally shifting routines and care practices. These shifts entail social implications that are complex, may emerge gradually and are challenging to identify. However, the social implications of digital health technologies are not conceptualized yet. This study addresses this gap by developing a framework on the social implications of digital technologies in palliative care, where the importance of social inclusion and interpersonal connection is particularly evident. Methods We assessed the potential social implications of digital health technologies’ use in palliative care through a sequential research design using qualitative empirical methods of social research. Alongside conducting an iterative narrative literature review, we held multidisciplinary expert consultations using a conceptual mapping method and focus groups involving researchers, clinicians, and a patient and public involvement group, analyzed with qualitative structured content analysis. Results Participants as well as the literature review identified key areas to the understanding and analysis of the social implications of digital health technologies in palliative care: principles and objectives of palliative care (patient-centered care, Total care, multiprofessional collaboration, relieving suffering, improving quality of life); the various actors involved in a specific care practice; the different roles they might have; the interactions among different actors; the tasks individual actors might carry out; the processes they are involved in; and the contexts they are embedded in. These factors were summarized and set out in the CARE-HOUSE Framework to conceptualize the social implications of digital health technologies’ use in palliative care and to support researchers in assessing the impacts of these technologies. Conclusions The CARE-HOUSE Framework provides guidance for analyzing the social implications of digital health technologies in palliative care. It will be for future studies to evaluate the framework's adaptability and scalability to diverse technologies and settings.