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Quality of Informed Consent and Interface Usability in Primary Care e-Consultation: Cross-Sectional Study.

Curtis Parfitt-Ford1, Lisa Ballard2,3, Adriane Chapman1,3

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Summary

Online consent processes for remote healthcare may not ensure true informed consent, risking patient autonomy. Improving interface usability can enhance consent quality, but current systems require significant redesign for ethical remote consultations.

Keywords:
digital triageelectronic consultationethicsinformed consentmedical informaticsprivacyremote consultationtelemedicine

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Area of Science:

  • Digital Health Ethics
  • Human-Computer Interaction
  • Informed Consent Research

Background:

  • Patient autonomy is a core ethical principle in healthcare, emphasizing informed consent.
  • Online consent processes risk superficial agreement due to manipulative or confusing interfaces, termed 'consent in name only'.
  • This is particularly concerning for remote primary care consultations that handle sensitive patient data.

Purpose of the Study:

  • To evaluate the quality of informed consent obtained via current and novel interfaces for remote e-consultations.
  • To assess the usability of these digital consent mechanisms.

Main Methods:

  • 55 UK adults interacted with mock e-consultation consent interfaces.
  • Participants completed usability questionnaires and were assessed on their understanding of consent details.
  • System Usability Scale (SUS) and a new Quality of Informed Consent Collected Digitally (QuICCDig) score were calculated.

Main Results:

  • Higher usability (SUS scores) correlated significantly with better consent quality (QuICCDig scores).
  • Both existing and novel interfaces performed poorly, with SUS scores equivalent to a grade 'F'.
  • A significant majority of participants did not recall making privacy decisions (45%) or being offered alternatives (87%).

Conclusions:

  • Current telemedical consent methods may be inadequate for obtaining valid informed consent.
  • Enhanced interface usability positively impacts the quality of digital consent collected.
  • Prioritizing high-quality interface design is crucial for developing ethical and effective e-consultation systems.