A Web-Based Survey Assessing the Attitudes of Health Care Professionals in Germany Toward the Use of Telemedicine in Pregnancy Monitoring: Cross-Sectional Study

Abstract

BackgroundThe demand for fetal monitoring and constant reassurance is high in pregnant women. Consequently, pregnant women use various health apps and are more likely to visit emergency departments due to subjective but nonurgent complaints. However, electronic health (eHealth) and mobile health (mHealth) solutions are rarely used to prevent nonurgent emergency consultations. To implement modern care solutions, a better understanding of the attitudes, fears, and hopes of health care professionals toward eHealth and mHealth is needed.ObjectiveThe aim of this study was to investigate the attitudes of health care professionals in obstetrics toward telemedicine.MethodsA quantitative Web-based survey on health care professionals in obstetrics in Germany was conducted. The participants included nurses, midwives, and physicians of all age groups and job positions working in hospitals that provide various levels of health care. The questionnaire comprised 24 questions about the characteristics of the study population, views about emergency consultations in obstetrics, attitude toward telemedicine, job satisfaction, and sleeping behavior.ResultsIn total, 244 health care professionals participated in the Web-based survey. In general, health care professionals were skeptical (170/233, 72.9%) about the use of telemedicine in obstetrics; however, 55.8% (130/233) recognized its potential. Moreover, 72% (62/86) of physicians were optimistic in using apps for pregnancy monitoring, whereas 36.1% (47/130) of nonphysicians (P<.001) were not. Significantly, more nonphysicians rejected such developments (75/130, 57.7% rejected) compared with physicians (24/86, 28%; P<.001). We also found that obstetricians with more than 10 years of work-experience are more skeptical; however, approximately 49% (18/37) of them believed that telemedicine could reduce nonurgent emergency consultations, whereas 73.2% (106/145) of obstetricians with less than 5 years of experience (P=.01) thought otherwise. Our survey revealed a high job satisfaction and a prevalence of regular sleeping problems of 45.9% (91/198) among health care professionals in obstetrics. Surprisingly, both job satisfaction and sleeping problems were independent from the number of night shifts per month (P=.77 and P=.99, respectively). Yet, 56.6% (112/198) of the survey participants thought they would be happier with their job if they had to work fewer night shifts per month.ConclusionsOur study reveals an ambivalent attitude toward the use of telemedicine among health care professionals in obstetrics in Germany at the moment. Efforts to promote the use of telemedicine should focus on nurses and midwives because these groups are the most skeptical. By contrast, particularly young physicians recognize the potential of apps in patient care and would like to use such technology in pregnancy monitoring.

Being ‘A Google Mom’ or securely monitored at home: Perceptions of remote monitoring in maternity care

“…Furthermore, pregnant women had their own viewpoints focusing on their individual situations, but they were more positive and considered more opportunities from remote monitoring compared with the staff members (Runkle, Sugg, Boase, Galvin, & Coulson, ). The findings of this study confirm other current research, such as Grassl et al (), who also found healthcare providers had ambivalent and sceptical attitudes towards remote monitoring in obstetrics; in other studies, pregnant women gave mainly positive feedback on remote self‐monitoring (Krishnamurti et al, ; Schramm et al, ).…”

“…In the future, it is important to use new technological solutions in cooperation with end users; they need to be able to trust the new devices and applications (Grym et al, ). Young healthcare professionals, in particular, have favourable attitudes and recognize the potentials of modern technology (Grassl et al, ); thus, the future implementation of technological innovations could become easier and more natural.…”

“…Ensuring the safety of both mother and foetus must be the priority; therefore, monitoring needs to be effective in detecting possible pregnancy complications. In addition, remote monitoring should not burden the work of healthcare professionals (Given, Bunting, O'Kane, Dunne, & Coates, ; Grassl et al, ; Koivunen & Saranto, ; Penny, Bradford, & Langbecker, ). The perspectives of each stakeholder need to be understood before further developing this technology.…”

Implications for the future of Obstetrics and Gynaecology following the COVID‐19 pandemic: a commentary

“…9 However, despite the undoubted potential of telemedicine in O&G, many healthcare professionals remain sceptical, due to fear of late presentation of emergencies, lack of personalised care and concern regarding the replacement of the human workforce by machines. 10 Telemedicine can also facilitate training and education, and contribute towards continued professional development. For example, remote feedback from experienced surgeons during real-time surgery has been shown to provide a cost-effective method of learning with a similar efficacy and safety profile as in-person mentoring.…”

Diagnostic equivalency of mobile CTG devices and remote analysis to conventional on-site nonstress test

“…4 At the same time, the demand for fetal monitoring and constant reassurance is high amongst pregnant women. 5 Telemedicine applications in obstetrics can be categorized depending on the form of service provided (educational, teleconsultations, remote monitoring) or depending on the problem addressed (lifestyle issues, gestational diabetes, mental health, etc.). Many of the applications have been tested in the past few years and positive effects have been shown (reviewed by van den Heuvel et al 6 ); however, most of the studies lack an endpoint related to its clinical impact, which still remains to be determined.…”