JMIR Publications

ABSTRACT

Background:

Healthcare organizations and institutions continue to face challenges with the implementation of digital oral healthcare programs at multiple levels. To address these issues, an understanding of the state of e-readiness of countries, including the challenges, opportunities, capacities and obstacles, is necessary.

Objective:

This study aimed to explore the facilitators and barriers to the implementation of digital oral health programs from the perspective of Chief Dental Officers from countries across the WHO regions.

Methods:

An explanatory sequential mixed methods study was conducted. Participants included the Chief Dental Officers (CDOs) or responsible oral health officers in the Ministry of Health of countries from the six WHO regions. The quantitative data were collected using an adapted WHO e-health survey questionnaire. The qualitative data was collected through individual, virtual face-to-face interviews. An interview guide was developed, based on the preliminary results from the quantitative phase, and guided by the adapted versions of the Technology Acceptance Model (TAM) and the e-Health Readiness assessment tool as conceptual frameworks. Thematic analysis was applied to the qualitative data.

Results:

Data from 71 participants was analyzed in the quantitative phase, while the qualitative phase involved in-depth interviews with 15 participants. The main facilitators included the readiness of the government, having a national oral health policy or strategy, availability of funding for infrastructure and technology, support from global organizations, perceived usefulness and positive attitude toward using health technology, and e-training. The major barriers identified were the absence of e-oral health policies, low priority for oral health, insufficient funding, inadequate equipment and/or connectivity, lack of norms and standards to guarantee application interoperability, limited evidence on effectiveness and cost-effectiveness of the programs, and the lack of confidence in digital and data management.

Conclusions:

Successful implementation of digital oral healthcare programs requires an assessment of e-readiness at various levels. Supportive governmental policies, adequate funding and investment in digital infrastructure and technologies are essential to mitigate challenges encountered by oral healthcare organizations.