JMIR Publications

ABSTRACT

Background:

The present study reveals a wide variation in user experiences, with most participants encountering both opportunities and challenges. For a digital platform to improve efficiency in primary care, the study suggests considering the following key areas: ease of access, time-saving aspects, and a more individualised contact process. Failure to recognise the needs of returning patients may hinder higher uptake of digital primary care.

Objective:

To explore patients’ experiences of using a digital platform for chat-based consultation in primary healthcare in Sweden to understand concerns when contacting primary healthcare services digitally.

Methods:

23 semi-structured interviews were conducted with patients from three healthcare regions in southeastern Sweden regarding their use of the digital platform 1177-direkt for contacting their primary care centre at least once in 2024, and who were available for an interview in Swedish. The patients were invited to the study via a message in the chat conversation when they completed their 1177-direkt session. Interviews were conducted from March to December 2024. Thematic analysis was applied using an inductive approach. A sentiment analysis of the interviews was also conducted, where sentences or phrases emerged as either positive, negative or neutral.

Results:

Three main themes, with nine sub-themes, were generated: Digital technology impacts on access to services, Perceived digital platform functionality affects usability, and Digital communication changes the balance between patient and healthcare professionals. The sentiment analysis showed that frequent user’s (≥4 contact with primary healthcare during the past 12 months) were more positive when they talked about their experiences of using the platform compared to infrequent users. The patients expected the platform to provide quicker access to their PHCC but the perceived quick access was challenged when waiting time was transferred downstream in the contact process. Patient expected more personalised contact, particularly returning users. Most participants found it easy to navigate on the platform, but there was uncertainty regarding the types of situations and enquiries for which the platform should be used. Concerns were also raised regarding the automated symptom checker, where some participants perceived the range of symptoms to be either too broad or too specific, and blunt in its approach, as it failed to interpret and contextualise patient responses, leaving patients to make their own interpretations. Access via a computer or tablet was found to be easier compared to access via a smartphone.

Conclusions:

The present study reveals a wide variation in user experiences, with most participants encountering both opportunities and challenges. For a digital platform to improve efficiency in primary care, the study suggests considering the following key areas: ease of access, time-saving aspects, and a more individualised contact process. Failure to recognise the needs of returning patients may hinder higher uptake of digital primary care.