JMIR Publications

ABSTRACT

Background:

In healthcare, the benefits of digitalization need to outweigh the risks, but there is limited knowledge about the factors affecting this balance in physicians’ work environment. To achieve the benefits of digitalization, a more comprehensive understanding of this complex phenomenon related to the digitalization of physicians’ work is needed.

Objective:

The aim of this study was to examine physicians' perceptions of the effects of healthcare digitalization on their work and to analyze how these perceptions are associated with multiple factors related to work and digital health usage.

Methods:

A representative sample of 4,630 (response rate 24.5%) Finnish physicians (64.5% women) was used. Statements measuring perceived effects of digitalization on work included the patients’ active role, preventive work, interprofessional cooperation, decision support, access to patient information and faster consultations. Network analysis among the perceived effects of digitalization and factors related to work and digital health usage was conducted using mixed graphical modeling. Centrality statistics were examined to evaluate the relative influence of each variable in terms of node strength.

Results:

Nearly half of physicians considered that digitalization has promoted an active role for patients in their own care (46.4%) and easier access to patient information (43.6%), but only one-tenth (9.8%) felt that the impact has been positive on consultation times with patients. Almost half of the respondents estimated that digitalization has neither increased nor decreased the possibilities for preventive work (45.2%) and supportiveness of clinical decision support systems (43.5%). When all of the variables were integrated into the network, the purpose of using health information systems, the employment sector, and specialization status were the most influential variables. However, the grade given to the electronic health record (EHR) system that was primarily used had the strongest direct links to faster consultations (b=0.32) and facilitated access to patient information (b=0.28). At least six months of usage of the main EHR was associated with facilitated access to patient information (b=0.18).

Conclusions:

The results highlight the complex interdependence of multiple factors associated with the perceived effects of digitalization on physicians' work. It seems that a good EHR system is critical to promoting smooth clinical practice. In addition, work-related factors may influence other factors that affect digital health success. These factors should be considered when developing and implementing new digital health technologies or services for physician work. The adoption of digital health is not just a technological project, but a project that changes existing work practices.