JMIR Publications

ABSTRACT

Background:

Digital technologies have influenced healthcare delivery worldwide and are increasingly being used in clinical practice. Although studies have been conducted on patient expectations of healthcare, of their attitudes towards technology adoption in healthcare, and their experiences with various technologies for specific medical conditions, there is a paucity of research on their expectations of and concerns with doctors’ clinical competencies when digital healthcare technologies (DHTs) are being used.

Objective:

This paper aims to address this gap by exploring the perspectives of patients towards the utilisation of telemedicine, mobile applications (apps), wearable devices, electronic health records (EHRs) and Artificial Intelligence (AI) in healthcare, using Singapore as a case study.

Methods:

Findings were drawn from individual semi-structured interviews with 25 patients from outpatient clinics. Participants were recruited using purposive sampling. Data were interpreted using qualitative thematic analysis.

Results:

Participants were from different ethnic, socio-economic and educational backgrounds and age bands, and had various chronic medical conditions. Regarding the use of apps and wearable devices, participants expected their doctors to be competent and more proactive in engaging them with the health data found in these tools. Interestingly, participants across all age bands did not find it necessary for doctors to maintain regular eye contact with them when using EHRs, as they valued the doctor’s efficiency more than eye contact and did not want the doctor to commit any errors while documenting clinical records. Nonetheless, they highlighted that doctors should still display empathy in other phases of the clinical encounter and this should not be compromised when DHTs are used. With regard to telemedicine, they expected doctors to exhibit similar clinical competencies and quality of care in a virtual consultation to a physical one. Additional expectations included having the doctor make a judgement call in determining the circumstances to use virtual consultation, give their undivided attention, identify cases that require further assessment and make a holistic assessment of patients’ conditions. Furthermore, participants from the younger age bands saw a more immediate need towards doctors using DHTs such as AI than their senior counterparts who were having similar conditions. They expected doctors to be trained in the algorithms behind these technologies, as well as their underlying principles and purposes to better assist them in diagnosis and treatment. Overall, this study reveals a nuanced perspective on patients’ expectations, beyond the oft-clear-cut assumption that specific social identities will necessarily influence their healthcare experience.

Conclusions:

By identifying patients’ expectations of doctors amid increasing digitalisation of healthcare, this study shows how doctors can practice patient-centred care in the digital age. Overall, it bears important implications for other developed countries that intend to address existing gaps in healthcare delivery when DHTs are being used. Clinical Trial: N.A.