JMIR Publications

ABSTRACT

Background:

The digitalization of healthcare has many potential benefits, but it may also negatively impact healthcare professionals' well-being. Burnout can result in part from inefficient work processes related to suboptimal implementation and use of health information technologies. While strategies to reduce stress and mitigate clinician burnout typically involve individual-based interventions, emerging evidence suggests that improving the experience of using health information technologies can have a significant impact.

Objective:

The aim of this systematic review is to collect evidence of the benefits and challenges associated with the use of digital tools in clinical settings with a particular focus on the experiences of healthcare professionals using these tools.

Methods:

We conducted a systematic literature review, following the PRISMA guidelines, to explore healthcare professionals' experiences with digital tools in clinical settings. We included qualitative studies with distinct data that described the experiences of physicians and nurses, using a rigorous selection process and qualitative assessment of methodological quality. A panel of three independent researchers performed iterative data analysis and identified thematic constructs.

Results:

From 1,175 unique studies returned by the search, we identified 17 publications that focused on healthcare professionals' experiences with various digital tools in their day-to-day practice. Clinical decision support tools were the most studied (59%), followed by electronic health records (35%) and a remote patient monitoring tool (6%). We propose a theoretical framework to understand the complex interplay between the use of digital tools, experience, and outcomes. We identified six overall constructs that encompass positive and negative experiences of healthcare professionals when using digital tools, as well as moderators and outcomes. Positive experiences included feeling confident, responsible, and satisfied while using digital tools, while negative experiences included frustration, feeling overwhelmed, and feeling frightened. Positive moderators that reinforced the use of digital tools included sufficient training and adequate workflow integration, while negative moderators included unfavorable social structures and lack of training. Positive outcomes included improved patient care and increased workflow efficiency, while negative outcomes such as increased workload and increased patient safety risks and issues with information quality were reported.

Conclusions:

While positive and negative outcomes and moderators that affect the use of digital tools were commonly reported, the experiences of HCPs, such as their thoughts, emotions, and feelings, were less frequently discussed. Based on this, this study highlights the need for further research specifically targeting experiences as an important mediator of clinician well-being. It also emphasizes the importance of considering differences in the nature of specific tools, as well as the profession and role of individual users.