Health care professionals’ experiences of how an eHealth application can function as a value-creating resource - a qualitative interview study

Abstract

Background The number of patients with one or more chronic conditions is increasing globally. One strategy to achieve more sustainable care for these patients is by implementing use of home-based eHealth applications. Such services support patients to take on a more active role as value-creating co-producers of their own care, in collaboration with health care professionals. Health care professionals have a key role in the value creation process, but little is known about value formation within eHealth interactions, especially from their perspective. Therefore, this study aimed to provide a deeper understanding of how an eHealth application can function as a value-creating resource from the perspective of health care professionals. Methods Semi-structured interviews were conducted with thirteen health care professionals (nurses, physicians and first-line managers). Qualitative content analysis was used to analyze the interviews. Results The findings indicate that value formation processes are strongly influenced by the organizational preconditions and by the usability and functionality of technology. The experiences of the health care professionals indicated that value was conceptualized in dimensions of meaningfulness, building of relationships, building safety and feelings of trust. Although these dimensions were mainly expressed in a positive way, such as perceived improvement of medical care, accessibility and continuity, they also had a negative side that caused value destruction. This was primarily due to patient difficulties in using the application or making measurements. Subsequent efforts at value recovery resulted in value creation, but were often time-consuming for the professionals. Conclusions This study contributes by extending conceptualizations of value to the role of health care professionals and by highlighting technology as sometimes facilitating and sometimes hampering value formation processes. The findings indicate that the eHealth application was a value-creating resource, facilitating proactive communication and supporting patients’ engagement and control over their self-care. However, for the application to become a more valuable resource in practice and counteract inequity in care, it needs to be further developed to be adapted to the needs and preconditions of patients.

Finnish telehomecare workers' satisfaction with the inclusion of telehomecare in older adults' home care and factors associated with it

“…(2022) reported that taking up the technology itself and using the equipment turned out to be quite easy for the telehomecare workers. However, in accordance with previous research (Carlqvist et al., 2021; Jarva et al., 2022), clients' digital skills were related to telehomecare workers' satisfaction with the inclusion of telehomecare in home care in the current study. Patients' difficulties in using technologies have been reported as the most negative aspect that causes value loss and time‐consuming burden to professionals (Carlqvist et al., 2021).…”

“…Digital health solutions change professional–patient interaction and require new skills (Jarva et al., 2022). Although reduction of face‐to‐face encounters between health care professionals and clients has also been reported with the use of home care technologies (Lampi & Sihto, 2022) and remote services (Lie et al., 2019), the current study supports previous studies (Carlqvist et al., 2021; Heinonen et al., 2022; Laukka et al., 2020; Saari et al., 2022) that have reported improved client interaction in telecare services. Telehomecare workers have described that they get to meet their client more directly, focus and be present to the client better than in traditional home care, where doing other care duties at the same time requires their attention (Saari et al., 2022).…”

“…Client relationship, trust, verbal interaction and guidance are emphasised in telehomecare more than in traditional home care (Heinonen et al, 2022). These results are supported by the current study since interaction and trustful relationships with visible symptoms (Carlqvist et al, 2021). Face-to-face interaction, whether physical or by video, seems to be central in creating of trust.…”

“…These dimensions were mainly expressed in a positive light as health care professionals connected these to improvements in medical care, accessibility and continuity. Professionals favour video communication over the chat discussions since it enables the detection of patients' visible symptoms (Carlqvist et al., 2021). Face‐to‐face interaction, whether physical or by video, seems to be central in creating of trust.…”

“…In concrete terms, this means, for example, whether workers can trust that their clients have acted the way they say(Heinonen et al, 2022). Also,Carlqvist et al (2021) reported that the value expressed by health care professionals in the use of telemonitoring in the care of chronically ill patients was conceptualised in dimensions of meaningfulness, building of relationships and safety and feelings of trust. These dimensions were mainly expressed in a positive light as health care professionals connected these to improvements in medical care, accessibility and continuity.…”