eHealth adoption and use among healthcare professionals in a tertiary hospital in Sub-Saharan Africa: a Qmethodology study

Abstract

Background The aim of the study was to explore the viewpoints of healthcare professionals (HCPs) on the adoption and use of eHealth in clinical practice in sub-Saharan Africa (SSA). Information and communication technologies (ICTs) including eHealth provide HCPs the opportunity to provide quality healthcare to their patients while also improving their own clinical practices. Despite this, previous research has identified these technologies have their associated challenges when adopting them for clinical practice. But more research is needed to identify how these eHealth resources influence clinical practice. In addition, there is still little information about adoption and use of these technologies by HCPs inclinical practice in Sub-Saharan Africa. Method An exploratory descriptive design was adopted for this study. Thirty-six (36) HCPs (18 nurses and 18 physicians) working in the clinical area in a tertiary health institution in SSA participated in this study. Using Qmethodology, study participants rank-ordered forty-six statementsin relation to their adoption and use of eHealth within their clinical practice.This was analysed using by-person factor analysis and complemented with audio-taped interviews. Results The analysis yielded four factors i.e., distinct viewpoints the HCPs hold about adoption and use of eHealth within their clinical practice. These factors include: “Patient-focused eHealth advocates” who use the eHealth because they are motivated by patients and their families preferences; “Task-focused eHealth advocates” use eHealth because it helps them complete clinical tasks; “Traditionalistic-pragmatists” recognise contributions eHealth makes in clinical practice but separate from their routine clinical activities; and the “Tech-focused eHealth advocates” who use the eHealth because they are motivated by the technology itself. Conclusion The study shows the equivocal viewpoints that HCPs have about eHealth within their clinical practice. This, in addition to adding to existing literature, will help policymakers/decision makers to consider HCPs views about these technologies prior to implementing an eHealth resource.

Integration of mHealth Information and Communication Technologies Into the Clinical Settings of Hospitals in Sub-Saharan Africa: Qualitative Study

“…As the amount of paper becomes cumbersome depending on the extent of a patient’s journey, a mobile device is ideal to support report writing and other information management tasks when nurses move from one point of care to the other. The task benefits or unintended consequences experienced by health care professionals while using mHealth ICTs to enable interaction moments influence the degree of its suitability, job, and patient satisfaction [ 48 ]. Otherwise, the mHealth ICTs would be partially used or even discarded when health care professionals are not satisfied with the values attributed to use, and ultimately, health care service delivery continues to be impaired by a lack of adequate technology integration [ 20 , 47 , 48 ].…”

Q Methodology in the COVID-19 Era

“…The methodology differs from qualitative approaches that rely mostly on the participants' narrative ability in expressing their viewpoints about a topic. With Q methodology, the participant is engaged in sorting/arranging pre-constructed statements according to his or her preference in a forced distribution [4] which is subsequently subjected to factor analysis so as to uncover varying viewpoint/subjectivities regarding a topic of discourse [3,15,16].…”

Unintended consequences of technology-enabled work activities experienced by healthcare professionals in tertiary hospitals of sub-Saharan Africa

“…The challenges to the use of health ICTs to support healthcare service delivery are categorized into: infrastructure, technical, contextual conditions and human-induced challenges (Botha, Botha, and Herselman 2014;Ladan, Wharrad, and Windle 2019). These challenges are, but not restricted to the initial high cost of implementation; lack of system integration; Data security concerns (Adler-Milstein and Bates 2010;Adebesin et al 2013;Owolabi, Agboola, and Alawiye 2018;Alam et al 2019).…”

“…While health ICTs may enable healthcare professionals to provide safe and quality healthcare services, there are concerns about the challenges that impede their effective use at points-of-care (Adler-Milstein and Bates 2010;Qureshi et al 2015). Some of the challenges include, but are not limited to infrastructure inadequacies, resistance to new technology innovation and change, security concerns, and a lack of systems interoperability (Ladan, Wharrad, and Windle 2019). In other postimplementation instances, health ICTs may shape how healthcare professionals perform their work activities especially in other unintended ways within certain contexts.…”