Are doctors the structural weakness in the e‐health building?

Hannan, Terry J.; Celia, Claire

doi:10.1111/imj.12270

Cited by 12 publications

(13 citation statements)

References 47 publications

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“…A national telemonitoring strategy should tackle the already existing social inequalities in the consumption of medical services and the potential aggravation towards a two-tier medicine [19]. Panel and private practitioners should be included in the planning of such services to increase the low readiness level shown in our study [43]. With most of respondents rating themselves as innovative, Austrian healthcare professionals seem to be in a promising mood for future innovations.…”

Section: Discussionmentioning

confidence: 97%

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Readiness to use telemonitoring in diabetes care: a cross-sectional study among Austrian practitioners

Muigg

Kästner

Duftschmid

et al. 2019

BMC Med Inform Decis Mak

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BackgroundTelemonitoring services could dramatically improve the care of diabetes patients by enhancing their quality of life while decreasing healthcare expenditures. However, the potential for implementing innovative treatment options in the Austrian public and private health system is not known yet. Thus, we analyzed the readiness to use telemonitoring in diabetes care among Austrian practitioners.MethodsWe conducted an online survey among a purposive sample of Austrian practitioners (n = 41) using an adapted German version of the practitioner telehealth readiness assessment tool. We assessed three readiness domains for telemonitoring in the context of diabetes care, i.e. core readiness, engagement readiness, and structural readiness, and validated the German tool using principal components analysis.ResultsStudy subjects perceived themselves as open to innovations and also expressed optimistic attitudes towards telemonitoring in general and offering telemonitoring-based services for their patients. Participants achieved a medium average readiness level for telemonitoring (58.2, 95% CI 53.9–62.5) and were thus in a good position to use telemonitoring, although some arguments may adversely affected its use. The top three perceived benefits of telemonitoring were enhanced quality of treatment, better therapy adjustment, and reduced travel and waiting times for patients. The top three barriers were reduced personal communication, practitioner time expenditure and equally placed poor financial compensation as well as data security and privacy issues.ConclusionOur data revealed that Austrian practitioners showed a quite moderate readiness to use telemonitoring in diabetes care. To further advance telemonitoring readiness among all pillars of diabetes care in Austria, joint efforts among healthcare stakeholders are required to overcome existing financial, organizational, and technical obstacles.

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Section: Discussionmentioning

confidence: 97%

“…Overall, the added value for health technologies might be greater for patients than for physicians. Thus, structural reforms should emphasize both on the curative thought in medical decision making and the financial aspect of a business model [43].…”

Section: Discussionmentioning

confidence: 99%

Readiness to use telemonitoring in diabetes care: a cross-sectional study among Austrian practitioners

Muigg

Kästner

Duftschmid

et al. 2019

BMC Med Inform Decis Mak

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“…Too often the focus is limited to defining an appropriate technical package – reporting formats, equipment, software, training, etc. – which long experience in OECD countries suggests is a necessary but by no means sufficient requirement [ 10 ]. Failure may just as easily result from institutional or social constraints, and stakeholder analysis may be as important as traditional information systems analysis [ 11 , 12 ].…”

Section: Literature Overviewmentioning

confidence: 99%

Beyond pilotitis: taking digital health interventions to the national level in China and Uganda

Blaschke²,

2017

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BackgroundInnovation theory has focused on the adoption of new products or services by individuals and their market-driven diffusion to the population at large. However, major health sector innovations typically emerge from negotiations between diverse stakeholders who compete to impose or at least prioritise their preferred version of that innovation. Thus, while many digital health interventions have succeeded in terms of adoption by a substantial number of providers and patients, they have generally failed to gain the level of acceptance required for their integration into national health systems that would promote sustainability and population-wide application. The area of innovation considered here relates to a growing number of success stories that have created considerable enthusiasm among donors, international agencies, and governments for the potential role of ICTs in transforming weak national health information systems in middle and low income countries. This article uses a case study approach to consider the assumptions, institutional as well as technical, underlying this enthusiasm and explores possible ways in which outcomes might be improved.MethodsLiterature review and case study analysis.ResultsThe two systems considered have had considerable success in terms of gaining and maintaining government support and addressing the concerns of providers without compromising their core elements. In Uganda, the system has flourished in spite of severe resource constraints, using a participatory approach that has encouraged a high level of community engagement. In China, concern with past failures generated the political will to build a high quality surveillance system, using the latest technology and drawing on a highly skilled human resource base.ConclusionsBoth example stress the importance of recognising the political, social and historical context within which information systems have to function. Implementers need to focus as much on the perceptions, attitudes and needs of stakeholders as on the technology. Implementers should distinguish between factors which may influence engagement at an institutional level and those aimed at supporting and supervising individuals within those institutions. Finally, we would suggest that designing interoperability into systems at the outset, rather than assuming that this can be achieved at some point in the future, may prove far easier in the longer term.

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“…Studies showed that doctors overemphasize potential barriers over benefits, with lacking financial incentives and resources, inter-operability, and regulatory frameworks on confidentiality and privacy being perceived as the main obstacles [14,15]. Ideally, stakeholders from academia, government, and industry likewise are involved at all stages of developing and implementing innovative concepts and sharing best practice examples for advancing healthcare services to overcome these barriers [16,17,18].…”

Section: Introductionmentioning

confidence: 99%

eHealth and telemedicine: Practices and beliefs among healthcare professionals and medical students at a medical university

2019

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Digitalization affects almost every aspect of modern daily life including healthcare delivery. Successful adoption and sustainable integration of information technology-based eHealth and telemedicine concepts in clinical practice depend on constant evaluation of end user needs, proficiencies, and preferences. We therefore assessed how current and future healthcare professionals perceived health technology solutions and whether their perceptions differed. We conducted an online survey among a purposive sample of employees and students at the Medical University of Vienna, Austria. The structured questionnaire collected self-reported practices and beliefs in the context of eHealth and telemedicine among 905 participants (59.0% females), of which 48.4% were employees and 51.6% were students. Participants expressed moderate knowledge of eHealth and telemedicine concepts with higher levels among employees compared to students (both: p<0.05). Compared to employees, students were less convinced that online health information improves patient knowledge (p<0.001), but were more optimistic that telemedicine reduces healthcare costs (p<0.05). Participants doubted that telemedicine services would enhance the doctor-patient relationship and raised concerns regarding data security and privacy issues. Accordingly, quantitative context analysis of free text comments revealed that the four most frequently mentioned themes were related to issues concerning data privacy and security, questions of responsibility, doctor-patient interaction, and reliability of information. This study provides valuable insights into how current and future healthcare professionals differ in their perceptions regarding eHealth and telemedicine. These findings raise awareness of the need to bridge the gap between digital age groups and professional groups, especially in clinical healthcare delivery in a clocked-through, strenuous academic setting as found at a medical university.

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Are doctors the structural weakness in the e‐health building?

Cited by 12 publications

References 47 publications

Readiness to use telemonitoring in diabetes care: a cross-sectional study among Austrian practitioners

Readiness to use telemonitoring in diabetes care: a cross-sectional study among Austrian practitioners

Beyond pilotitis: taking digital health interventions to the national level in China and Uganda

eHealth and telemedicine: Practices and beliefs among healthcare professionals and medical students at a medical university

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